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The Affordable Care Act (ACA) marketplace at Healthcare.gov lets you compare health plans that are sold in the marketplace. The cost of health insurance in the ACA marketplace varies by insurance company, where you live, which plan and metal tier you choose, how many people are covered, your age, whether you smoke and your household family size and income.
How Much Is Health Insurance?
The average monthly premium for a bronze ACA health insurance plan is $420 for a 40-year-old. The average monthly cost for that same person increases to $549 for a silver plan and $713 for a gold plan. Those averages don’t consider premium tax credits and subsidies that can reduce costs for an ACA plan based on household income.
How Much Does Health Insurance Cost Per Month?
The average monthly health insurance cost for a 30-year-old individual is:
- $466 for an exclusive provider organization (EPO) plan.
- $427 for a health maintenance organization (HMO).
- $512 for a preferred provider organization (PPO).
| Age of member | Average monthly cost for EPO | Average monthly cost for HMO | Average monthly cost for PPO |
|---|---|---|---|
Age 21 | $407 | $374 | $451 |
Age 27 | $432 | $395 | $473 |
Age 30 | $466 | $427 | $512 |
Age 40 | $524 | $480 | $576 |
Age 50 | $733 | $671 | $805 |
Age 60 | $1,109 | $1,017 | $1,224 |
Source: Healthcare.gov. Based on unsubsidized ACA plans.
Average Cost of Health Insurance by Company
It’s wise to compare quotes from multiple health insurance companies to find the best affordable health insurance for you.
ACA plans base rates on multiple factors, including your age, smoking status, type of plan and metal tier. Aetna and Cigna are two insurers to check out in the ACA marketplace if you want to pay less for coverage.
| Age of member | Aetna | Blue Cross Blue Shield | Cigna | UnitedHealthcare |
|---|---|---|---|---|
Age 21 | $365 | $444 | $390 | $396 |
Age 27 | $382 | $468 | $417 | $415 |
Age 30 | $414 | $506 | $449 | $450 |
Age 40 | $466 | $569 | $504 | $506 |
Age 50 | $651 | $795 | $705 | $708 |
Age 60 | $990 | $1,206 | $1,066 | $1,076 |
Source: Healthcare.gov. Based on unsubsidized ACA plans.
Average Health Insurance Rates by Age
Age is a major factor for ACA marketplace plan costs.
| Age of member | Average monthly costs |
|---|---|
Age 21 | $397 |
Age 27 | $419 |
Age 30 | $453 |
Age 40 | $509 |
Age 50 | $712 |
Age 60 | $1,079 |
Source: Healthcare.gov. Based on unsubsidized ACA plans.
Average Cost of Health Insurance by Plan Type
A health plan’s benefit design influences your costs. Health maintenance organization (HMO) and exclusive provider organization (EPO) plans are usually cheaper than a preferred provider organization (PPO) plan.
| Age of member | Average monthly cost for EPO | Average monthly cost for HMO | Average monthly cost for PPO |
|---|---|---|---|
Age 21 | $407 | $374 | $451 |
Age 27 | $432 | $395 | $473 |
Age 30 | $466 | $427 | $512 |
Age 40 | $524 | $480 | $576 |
Age 50 | $733 | $671 | $805 |
Age 60 | $1,109 | $1,017 | $1,224 |
Source: Healthcare.gov. Based on unsubsidized ACA plans.
Average Cost of Health Insurance by Metal Tier
A plan’s metal tier affects how much you pay in premiums and out-of-pocket costs. Bronze, silver, gold and platinum plans are distinguished from one another based on how much you pay on premiums and out-of-pocket costs.
- Bronze and silver plans cost less in premiums but you pay more out of pocket when you need care.
- Gold and platinum plans have a reverse situation—higher premiums but lower out of pocket costs for care.
| Age of member | Average monthly costs for bronze plan | Average monthly costs for silver plan | Average monthly costs for gold plan |
|---|---|---|---|
Age 21 | $327 | $428 | $558 |
Age 27 | $345 | $452 | $585 |
Age 30 | $373 | $488 | $634 |
Age 40 | $420 | $549 | $713 |
Age 50 | $587 | $767 | $997 |
Age 60 | $890 | $1,164 | $1,515 |
Source: Healthcare.gov. Based on unsubsidized ACA plans. Note: Platinum plans aren’t usually offered and we don’t have enough cost data on those types of plans to offer an accurate picture of costs.
Compare Health Insurance Costs From Our Partners
1
Aetna
Coverage area
Offers plans in all 50 states and Washington, D.C.
Number of providers in network
About 1.2 million
Physician copays start at
$20
2
Blue Cross Blue Shield
Coverage area:
Offers plans in all 50 states and Washington, D.C.
Number of providers in network
About 1.7 million
Physician copays start at
$10
3
Cigna
Coverage area
Offers plans in all 50 states and Washington, D.C.
Number of providers in network
About 1.5 million
Physician copays start at
$0
How to Calculate and Compare Health Insurance Costs
Choosing the best health insurance plan for you involves assessing your budget, your current health, what health care needs you expect in the next year and what you want from a health plan.
Premiums vs. Deductibles
Health insurance plans generally have higher premiums/lower deductibles or lower premiums/higher health insurance deductibles. What you choose influences how much you’ll pay in premiums each month and how much you’ll pay out-of-pocket when you need health care.
A health plan with a high deductible could be a good choice if you don’t expect to need much care over the next year. Health insurance companies don’t start chipping in to pay for health care services until you reach your deductible. Once you hit your deductible, you generally pay coinsurance, which is when you and the health insurance company share the costs of health care services.
For example, this could mean you paying 20% and the health plan paying 80% until you reach your plan’s out-of-pocket maximum.
When choosing a health plan, calculate how much you would pay in health insurance premiums over a year and consider the deductible. Would lower premiums save you enough that it would be worth paying a higher deductible? Or can you afford higher premiums with the understanding that you’ll save money if you need care during the year?
Bronze and silver health plans typically have lower premiums and higher deductibles, while gold and platinum plans generally have higher premiums and lower out-of-pocket costs.
If you expect to need health care services, especially if you’re expecting a child or planning a surgery, a health plan with a higher premium and lower deductible might make sense. But if you don’t expect to need many health care services, a high-deductible health plan could be a good choice.
If you’re looking for an ACA plan, bronze and silver plans have higher deductibles but you pay less in premiums than you would for a gold or platinum plan. Gold and platinum plans have higher premiums but you pay less out-of-pocket when you need care.
Plan Benefit Design
A plan’s benefit design influences your flexibility and cost you pay for health insurance. HMO and EPO plans are the most common types of health insurance plans found in the ACA marketplace, sometimes called Obamacare. PPO and point of service (POS) plans are also offered on the ACA exchanges, but aren’t nearly as common on the marketplace.
Health Plan Benefit Design Differences
| Feature | HMO | EPO | PPO | POS |
|---|---|---|---|---|
Cost | Low premiums | Low premiums | Higher premiums | Mid-range premiums |
Referrals required? | Yes | No | No | Yes |
Out-of-network care? | No | No | Yes | Yes |
HMOs and EPOs typically have the lowest premiums, but don’t allow out-of-network care. Those plans generally only pay for out-of-network care if it’s an emergency. HMOs and EPOs otherwise require that you stay within your provider network. HMOs also often demand that you get primary care provider referrals to see a specialist.
PPOs and EPOs typically let you get care outside of your provider network, but at a higher cost than if you got in-network care. That flexibility often comes with higher premiums, too.
Decide how much flexibility you want and whether you’re willing to pay more for cover for it. If you want the cheapest health insurance and don’t mind staying in the provider network, a HMO or EPO might be a better bet.
7 Factors That Influence Health Insurance Costs
The ACA lets health insurance use multiple factors when setting health insurance premiums. Here’s what influences costs on the health insurance marketplace.
1. Your Age
ACA marketplace insurance companies use a person’s age when setting Obamacare costs, which is different from the employer-sponsored health insurance market.
How much of a difference? A 21-year-old pays slightly under $400 monthly on average for an ACA plan, while a 60-year-old pays $1,079 on average.
2. Where You Live
Your location influences how much insurance companies charge. Insurers in states that have fewer health insurance plans on the marketplace may charge more for coverage since there are fewer companies to share the cost of providing health insurance in that area.
Rural areas may have fewer health plan options, so people in those regions may pay more for care than those in urban and suburban areas.
3. Whether You Smoke
The ACA lets insurance companies set higher rates for smokers in the marketplace. A health insurance company can charge a smoker as much as 50% more than a nonsmoker.
4. Metal Tier
Metal tiers on the ACA marketplace help consumers choose plans based on costs. The metal tiers are bronze, silver, gold and platinum.
Bronze and silver, which have lower premiums and higher deductibles, make up most ACA health plans. Gold health plans have higher premium costs than either bronze or silver plans but lower out-of-pocket costs. Platinum plans, which have higher premiums and low deductibles, comprise a tiny fraction of ACA plans.
The metal tier you choose depends on whether you want to pay higher premiums or higher deductibles.
5. How Many People Are Covered
Having single coverage costs less than if you have multiple people on your health plan. Adding a spouse to your plan may double costs, and having a child or two on coverage will likely increase it even more.
6. Type of Health Plan
A health plan’s benefit design affects costs and how you get care.
HMOs and EPOs generally have the lowest premiums, but you must stay within the plan’s provider network. Health insurers generally won’t cover non-emergency care you get out of network in an EPO and HMO. You instead have to pick up all the costs.
PPOs have the most flexibility to get care outside of your network and you don’t need to name a primary care provider or get referrals to see specialists.
You need to decide whether flexibility or lower premiums are more important to you if you’re comparing a PPO with an HMO or EPO.
7. Your Household Income
The Affordable Care Act (ACA) marketplace offers premium tax credits and cost-sharing subsidies based on your household income. That can save you money on your premiums and out-of-pocket costs.
People with household income at 400% of the federal poverty level or below are eligible for premium tax credits. Those with Silver plans may also get cost-sharing subsidies that reduce out-of-pocket costs.
The ACA marketplace at HealthCare.gov will take into account those factors when you enter your household income and family size into the site.
What’s the 400% federal poverty level?
| Family size | 400% of federal poverty level |
|---|---|
One person | $58,320 |
Two people | $78,880 |
Three people | $99,440 |
Four people | $120,000 |
Five people | $140,560 |
Source: U.S. Department of Health and Human Services
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FAQs About the Cost of Health Insurance
How can I save on health insurance?
One way to save on health insurance through the ACA marketplace is by entering your household income information into the marketplace website at HealthCare.gov, which can help you find an affordable health insurance plan if your income qualifies.
ACA marketplace plans are eligible for premium tax credits and cost-saving subsidies, which can lower the cost of health insurance.
You may also qualify for Medicaid, which is a federal/state health insurance program that offers comprehensive, low- or no-cost coverage. The ACA marketplace site will inform you if you qualify for Medicaid in your state when you add your household income and family size to the exchange’s website.
How much does health insurance cost per month for a single person?
The average monthly health insurance cost for a bronze plan is $373 for a single 30-year-old person. That same person pays an average of $488 for a Silver plan and $634 for a Gold plan.
A 40-year-old single person pays $420 on average each month for a bronze plan, $549 for a silver plan and $713 for a gold plan.
Age is just one factor that health insurance plans use when setting rates on the ACA marketplace.
What can you expect to pay for health insurance deductibles?
You can expect to pay a health insurance deductible anywhere from $6,000 to $9,000 for a bronze plan, $3,000 to $7,000 for a silver plan and $1,000 to $3,000 for a gold plan.
Those are rough estimates. You may find a metal level plan with cheaper deductibles or even more expensive deductibles. When comparing health plan options, take into account all costs, including premiums, deductibles and coinsurance.
