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).

 

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 have cheaper premiums but you pay more out of pocket when you need care.
Gold and platinum plans offer a reverse situation—higher premiums but lower out of pocket costs.

 

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?

 

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.

 

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