Health insurance is necessary and yet can be a financial strain, with monthly premiums from an Affordable Care Act (ACA) plan for an individual averaging $477.
However, your costs could be higher or lower depending on factors you can’t change (such as your age) and some factors you might have control over (such as your selected coverage level or which health insurance company you choose). If you are eligible for an employer or government plan, your monthly costs should be far lower than if you have to bear all the costs yourself either with an ACA plan or on the open marketplace.
Learn more about health insurance costs below.
Key Takeaways
- Health insurance costs depend on how you get your coverage and factors such as age, insurance company, family size, where you live, Affordable Care Act (ACA) metal level, and plan type.
- Individual monthly insurance costs range widely, from $12 for TRICARE to $1,758.16 for a 60-year-old on a platinum ACA plan.
- For ACA plans, monthly premium costs increase with age, family size, and metal tier. Premiums are also higher if you smoke or choose a plan with more provider choices (such as a PPO).
What Is Health Insurance?
Health insurance helps partially cover the cost of medical care in exchange for a monthly premium or payment. According to a 2023 Census survey, 92% of Americans had health insurance at some point during the year.
Employer-provided health insurance covers 55% of the insured population. Ten percent have a plan purchased from a private company, or through the ACA Marketplace or a state health insurance exchange. Around 36% of the population has health insurance through the government, which includes:
- 19% on Medicaid
- 19% on Medicare
- 2% on TRICARE, which covers active military service members and their families
- 1% on VA and CHAMPVA, which covers veterans and their family members
How Much Does Health Insurance Cost Per Month?
| Average Single Coverage Premium/Month | |
|---|---|
| Employer plan | $116 |
| ACA plan | $477 |
| TRICARE | $12 |
| Medicare Part B | $175 |
| Medicare Advantage | $19 |
One of the most significant factors influencing the cost of your health insurance is where you get it. An ACA plan purchased on the healthcare exchange is generally far more expensive than a plan you get through your employer or a government program such as Medicare or Medicaid. However, it may be cheaper than an individual plan bought on the open marketplace, and if you qualify for a premium tax credit due to your income, you may pay a far lower premium for your Health Insurance Marketplace plan.
Note
Compared to the 18.2 million enrolled in an ACA plan, only around 2.5 million people purchased individual plans from off-Marketplace providers as of early 2023, according to the most recent estimates from KFF (formerly the Kaiser Family Foundation). These plans include short-term health insurance and plans that don’t comply with the ACA due to grandfathering.
Even within employer plans, differences exist. The average employee at a private, for-profit firm contributes more for their healthcare coverage (19%) than a public organization employee, who contributes 13%.
For the remainder of the cost survey, we’ll dive deeper into ACA and exchange plans to learn more about how costs are influenced by such factors as age and where you live.
How Much Does Health Insurance Cost by Age?
| Member Age | Monthly Cost |
|---|---|
| Age 18 | $383.04 |
| Age 21 | $428.51 |
| Age 27 | $450.20 |
| Age 30 | $487.19 |
| Age 40 | $548.29 |
| Age 50 | $766.43 |
| Age 60 | $1,163.90 |
Health insurance purchased from the ACA heavily relies on several variables. Age is a major factor, as insurance companies are allowed to raise rates based on age. Young insurance enrollees benefit from the lowest monthly health insurance costs, no matter their health status. As you can see from the chart above, the monthly cost for a 60-year-old is about twice that for a 40-year-old.
How Much Does Health Insurance Cost by Plan Type?
| Member Age | Average EPO Monthly Premium | Average HMO Monthly Premium | Average PPO Monthly Premium | Average POS Monthly Premium |
|---|---|---|---|---|
| Age 21 | $436.79 | $408.91 | $464.96 | $443.03 |
| Age 27 | $459.18 | $430.01 | $487.28 | $464.29 |
| Age 30 | $496.82 | $465.21 | $527.73 | $502.84 |
| Age 40 | $559.05 | $523.45 | $594.22 | $566.19 |
| Age 50 | $781.52 | $731.78 | $830.43 | $791.25 |
| Age 60 | $1,186.63 | $1,111.01 | $1,261.91 | $1,202.38 |
Health insurance costs also depend on the type of insurance you buy. Plans with the least choice use HMOs (health maintenance organizations) and EPOs (exclusive provider organizations). For these plans, you primarily must work within the insurer’s network and see a physician who acts as a gatekeeper for your care. Preferred provider organizations (PPOs) and point-of-service (POS) plans offer more choice—but cost more, too. If cost containment is your top priority, an HMO provides the lowest monthly pricing.
How Much Does Health Insurance Cost Per Company?
Health insurance costs can also vary by company. When we compared pricing from eight different companies across two ZIP codes in Florida and Texas, we found the following average premiums.
| Company | Monthly Cost |
| Ambetter | $487.23 |
| BCBS | $479.63 |
| Molina | $505.32 |
| Oscar | $474.96 |
| Aetna | $454.76 |
| UnitedHealthcare | $522.74 |
| Cigna | $488.71 |
| Kaiser Permanente | $441.05 |
As you can see, Kaiser Permanente and Aetna offered some of the lowest premiums. The highest premiums were found at UnitedHealthcare and Cigna. But keep in mind that your premium isn’t the only consideration when you’re looking for affordable health insurance. Your deductible and the amount you have to shell out for copays or coinsurance also are factors when you need to get care.
How Much Is Health Insurance by Metal Tier?
| Member Age | Average Monthly Bronze | Average Monthly Silver | Average Monthly Gold | Average Monthly Platinum | Average Monthly Catastrophic |
|---|---|---|---|---|---|
| Age 21 | $347.58 | $447.62 | $486.07 | $644.46 | $266.83 |
| Age 27 | $364.27 | $470.07 | $510.56 | $686.27 | $279.63 |
| Age 30 | $394.51 | $508.77 | $552.55 | $739.57 | $302.84 |
| Age 40 | $444.21 | $572.62 | $621.88 | $830.01 | $341.00 |
| Age 50 | $620.78 | $800.41 | $869.27 | $1,161.85 | $476.55 |
| Age 60 | $943.35 | $1,215.64 | $1,320.16 | $1,758.16 | $724.16 |
The metal level of your plan determines how you split healthcare costs with your insurance company. In general, bronze and silver plans offer lower monthly premiums, but you’ll pay a higher percentage of out-of-pocket healthcare costs on an ongoing basis. Gold and platinum plans charge the highest premiums, but you won’t pay as much every month in copays and coinsurance.
Catastrophic plans are the least expensive but are only available to applicants under 30 or people experiencing extreme financial hardship. You’ll also have very high deductibles and more limited coverage. These plans have the lowest monthly premiums of all plan types but also don’t qualify for cost-sharing or premium reductions.
Average Cost of Health Insurance by Location
The highest premiums were found in Vermont, Alaska, West Virginia, Wyoming, and New York. The lowest premiums were found in New Hampshire, Minnesota, Maryland, Virginia, and Michigan.
States with premiums closest to the national average of $477 were Texas, Wisconsin, Illinois, New Mexico, and California.
| State | Average Benchmark Premium for a 40-Year-Old |
|---|---|
| Alabama | $564 |
| Alaska | $889 |
| Arizona | $403 |
| Arkansas | $424 |
| California | $468 |
| Colorado | $451 |
| Connecticut | $661 |
| Delaware | $533 |
| District of Columbia | $532 |
| Florida | $489 |
| Georgia | $463 |
| Hawaii | $468 |
| Idaho | $417 |
| Illinois | $473 |
| Indiana | $399 |
| Iowa | $451 |
| Kansas | $486 |
| Kentucky | $431 |
| Louisiana | $563 |
| Maine | $515 |
| Maryland | $346 |
| Massachusetts | $419 |
| Michigan | $381 |
| Minnesota | $343 |
| Missouri | $501 |
| Montana | $504 |
| Nebraska | $570 |
| Nevada | $387 |
| New Hampshire | $335 |
| New Jersey | $461 |
| New Mexico | $471 |
| New York | $736 |
| North Carolina | $495 |
| North Dakota | $486 |
| Ohio | $435 |
| Oklahoma | $508 |
| Oregon | $488 |
| Pennsylvania | $445 |
| Rhode Island | $400 |
| South Carolina | $492 |
| South Dakota | $616 |
| Tennessee | $501 |
| Texas | $475 |
| Utah | $507 |
| Vermont | $950 |
| Virginia | $371 |
| Washington | $415 |
| West Virginia | $847 |
| Wisconsin | $476 |
| Wyoming | $821 |
Average Cost of Healthcare by Family Size
Your family size can also influence your monthly health insurance bill. If your family includes children, you’ll pay less per child than you would per adult due to the age-related cost scenarios described earlier. If you have more than three children, you pay the same rate as if you had three children.
| Family Type | Monthly Cost |
|---|---|
| Couple, age 30 | $974.39 |
| One adult, age 30, and one child | $811.45 |
| One adult, age 30, and two children | $1,135.71 |
| Couple, age 30, and one child | $1,298.64 |
| Couple, age 30, and two children | $1,622.90 |
| Couple, age 30, and three or more children | $1,947.16 |
Factors Influencing Health Insurance Costs
You can control some health insurance cost factors—such as whether or not you smoke or buy a bronze or platinum plan—but not others, such as your age.
Age
Age is a significant factor in health insurance costs. For ACA plans, ages are generally separated into three larger bands to calculate and set premiums:
- Children ages 0-20
- Adults ages 21-63
- Adults 64 and older
Premiums are least expensive for those 20 and under, and most expensive for those 64 and older.
Within the age 21 to 63 range, premiums are set in one-year bands, but generally, premiums don’t start increasing until age 25. You’ll find the cheapest premiums at age 21. By age 46, premiums will be roughly 1.5 times what they were at age 21. Premiums typically double by age 53 and triple by age 64 and older.
Metal Tier
The Marketplace offers five types of plans with varying cost-sharing options and premiums. However, not all plans are available from all insurers or in all locations.
The plans are as follows:
| Plan | Description | Insurer’s Responsibility for Cost of Care | Your Responsibility |
|---|---|---|---|
| Bronze | Lowest premium, highest deductible and out-of-pocket costs | 60% | 40% |
| Silver | Moderate costs and premiums | 70% | 30% |
| Gold | High monthly premium, lower out-of-pocket costs | 80% | 20% |
| Platinum | Highest premium, lowest out-of-pocket costs | 90% | 10% |
| Catastrophic | Only available to those under 30 or who qualify for hardship exemptions; very low premiums and very high deductibles | Insurer pays 100% of in-network provider costs after you meet the deductible | $9,450 deductible |
Tobacco Use
Your healthcare costs could be impacted if you used any tobacco product or products four or more times per week within the past six months. Your rates could be as much as 50% higher compared to someone who doesn’t smoke. So, if a nonsmoker pays $500 monthly, you could pay $750.
Location
Each state is divided into rating areas, typically by county or groups of counties. Issuers use those rating areas to set premiums—all premiums in a particular rating area are similar, with adjustments only based on age and smoking status. So, your insurance premium could increase or decrease depending on whether you move out of one county into another or from one state to another.
Family Size
In general, the tiers of family size are as follows:
- Single: Insurance for one person
- Couple: Two people who are married
- Single parent: Head of household (HoH) with one or more children aged 25 or younger
- Family: Couple with one or more children aged 25 or younger
For ACA plans, the single parent and family premiums are tiered based on whether you have one, two, or three or more children under age 21. If you have four or more children, you’ll pay the same rate as someone with three children.
Total Costs for Health Insurance
Your total health insurance costs could add up to almost $20,000 per year for a family. Beyond the monthly premium, you’ll also pay for the following:
- Deductibles: You must spend this amount before coverage begins for your in-network medical care and medications.
- Copayments and coinsurance: These refer to the percentage or flat-rate dollar amount you pay for services such as PCP and specialist visits; emergency room treatment; and generic, preferred, and specialty medications.
- Maximum out-of-pocket expenses: This is the total you spend in a year (including the two amounts above) before your insurance begins covering all expenses.
Add up the totals you think you’ll spend plus premiums to estimate the total cost of your health insurance. In general, ACA plans will usually cost more than a group plan.
In 2024, your out-of-pocket costs (deductible, copayments, and coinsurance) can’t be more than $9,450 for one person and $18,900 for a family for an ACA plan. The out-of-pocket costs don’t include your premiums or non-covered medical services.
How to Buy Health Insurance
Buying health insurance depends on your life situation and available options. The options include:
- Enrolling in an employer plan through your workplace or your spouse’s
- Buying private health insurance through an agent or on the federal Marketplace or your state’s marketplace
- Qualifying for Medicaid based on your income and family status
- Applying for COBRA coverage if you’ve recently left a job and you qualify
- Enrolling in Original Medicare or a Medicare Advantage plan, if eligible
Depending on your state and circumstances, you might enroll during open enrollment or qualify for a particular enrollment period.
Alternatives to Health Insurance
Alternatives to health insurance can include primary care memberships (paying a subscription fee to access services), healthcare sharing ministries, medical discount cards, and short-term health insurance. However, many of these alternatives are not regulated like other types of insurance and so lack essential consumer protections.
Of course, going without health insurance is another alternative—but it could lead to serious consequences, such as crushing medical debt or state-based tax penalties.
Frequently Asked Questions (FAQs)
How Much Is Health Insurance Without a Job?
You could qualify for free or low-cost Medicaid health insurance or $0 premiums for a Marketplace health insurance plan based on your household income, state of residence, family status, disability, or other factors. Nearly 20% of California health marketplace enrollees have $0 premiums. Health insurance pricing is not based on your employment status. The best health insurance for unemployed people will have low premiums, copays, and deductibles, and offer catastrophic plans that could tide you over if you’re in a temporary bind.
How Much Is Health Insurance for a Family of Four?
Much depends on how you get your health insurance. If you have an employer-based plan, the cost of a family plan, on average, is $6,575 annually, or around $548 a month. Compare this to $1,622.90 for an ACA plan for a family of two adults and two children. However, depending on their income, families may also qualify for financial help through the Marketplace. Or your children could qualify for Medicaid or the Children’s Health Insurance Program (CHIP).
What Is the Most Expensive Health Insurance?
On the Marketplace, a platinum plan will feature the highest monthly premiums. However, you’ll pay less for doctor’s visits and medications and have a lower deductible. The insurance company will pay 90% for each covered medical service, while you’ll pay 10%.