Based on health insurer annual statement data. Does not include health insurance data from the property/casualty and life/health annual statements. Excludes territories.
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Leading health insurance companies in the U.S. 2021, by direct premiums written
In 2021, UnitedHealth Group wrote direct health insurance premiums amounting to approximately billion U.S. dollars making it the largest health insurer in the United States. Anthem and Centene followed behind with **** billion U.S. dollars and **** billion U.S. dollars in direct premiums written in that year, respectively.
UnitedHealth Group
UnitedHealth Group Inc. is a health care company headquartered in Minnesota. It offers products and services such as health insurance coverage, health care savings accounts and pharmacy benefits. However, the majority of their revenues are generated through insurance premiums, and it looks set to remain so in the near future. Optum is the business segment, which focuses on health care services, and OptumRx is one of the largest pharmacies in the United States.
Revenue outlook
UnitedHealth Group’s revenues have been steadily climbing over the past decade, reaching roughly 372 billion U.S. dollars in 2023 the organization has more than doubled the level of revenue in the last 10 years, up from billion U.S. dollars in 2013.
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Insurance Information Institute. (September 1, 2022). Leading health insurance companies in the United States in 2021, by direct premiums written (in billion U.S. dollars) [Graph]. In ÌÇÐÄÆƽâ°æ. Retrieved August 01, 2026, from /statistics/428792/leading-health-insurance-groups-usa-by-premiums-written/
Insurance Information Institute. "Leading health insurance companies in the United States in 2021, by direct premiums written (in billion U.S. dollars)." Chart. September 1, 2022. ÌÇÐÄÆƽâ°æ. Accessed August 01, 2026. /statistics/428792/leading-health-insurance-groups-usa-by-premiums-written/
Insurance Information Institute. (2022). Leading health insurance companies in the United States in 2021, by direct premiums written (in billion U.S. dollars). ÌÇÐÄÆƽâ°æ. ÌÇÐÄÆƽâ°æ Inc.. Accessed: August 01, 2026. /statistics/428792/leading-health-insurance-groups-usa-by-premiums-written/
Insurance Information Institute. "Leading Health Insurance Companies in The United States in 2021, by Direct Premiums Written (in Billion U.S. Dollars)." ÌÇÐÄÆƽâ°æ, ÌÇÐÄÆƽâ°æ Inc., 1 Sep 2022, /statistics/428792/leading-health-insurance-groups-usa-by-premiums-written/
Insurance Information Institute, Leading health insurance companies in the United States in 2021, by direct premiums written (in billion U.S. dollars) ÌÇÐÄÆƽâ°æ, /statistics/428792/leading-health-insurance-groups-usa-by-premiums-written/ (last visited August 01, 2026)
Leading health insurance companies in the United States in 2021, by direct premiums written (in billion U.S. dollars) [Graph], Insurance Information Institute, September 1, 2022. [Online]. Available: /statistics/428792/leading-health-insurance-groups-usa-by-premiums-written/
