Compare Health Insurance Quotes (2024)

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Selecting the best health insurance plan can feel overwhelming. If you aren’t eligible for employer-sponsored health insurance, you can buy a plan through the Affordable Care Act (ACA) marketplace at Healthcare.gov, which lets you compare plans available in your area.

The ACA also allows you to compare multiple health insurance quotes so you can select the health plan that works for you.

How Much Does Health Insurance Cost?

The average monthly cost of health insurance for a silver plan on the ACA marketplace is $397 for individual unsubsidized coverage for a 21-year-old person, $419 for a 27-year-old, $453 for a 30-year-old, $509 for a 40-year-old, $712 for a 50-year-old and $1,079 for a 60-year-old.

Health insurance companies base ACA marketplace plan rates on multiple factors, including:

  • Your state and age
  • Your smoking status
  • The type of health plan
  • The metal tier
  • How many people you’ll have on the health plan

The health insurance marketplace is different from group health insurance provided by employers. Those plans don’t consider your age when setting rates.

Featured Health Insurance 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

1

Aetna

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On Healthcare Marketplace's Website

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

2

Blue Cross Blue Shield

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On Healthcare Marketplace's Website

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

3

Cigna

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On Healthcare Marketplace's Website

Compare Health Insurance by Plan Level, Metal Tier, Age, Company

The cost of health insurance on the ACA marketplace varies based on multiple factors. Let’s take a look at average costs using some of those factors.

Average Costs by Health Insurance Plan

The health plan’s benefit design dictates things like whether you can get out-of-network care and whether you need referrals to see specialists. It also influences your costs.

Average monthly cost for HMOAverage monthly cost for EPOAverage monthly cost for PPO
$480$524$576
Source: Healthcare.gov. Average costs are for a 40-year-old. Based on unsubsidized ACA plans.

Average Costs by Metal Tier

Premiums and out-of-pocket costs decide an ACA plan’s metal tier. If you’re looking for affordable health insurance going with a bronze plan with lower premiums but higher out-of-pocket costs when you need care might be your best bet.

Average monthly costs for bronze planAverage monthly costs for silver planAverage monthly costs for gold plan
$420$549$713
Source: Healthcare.gov. Costs are for a 40-year-old. 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.

Average Health Insurance Costs by Age

Your age is one of the most important factors that dictate your health insurance costs on the health insurance marketplace. The ACA marketplace is the only place where standard health insurance uses age to set rates. Employer plans, which is how most pre-retirement age Americans get coverage, does not use age as a factor.

Age of memberAverage 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 Health Insurance Costs by Company

Obamacare costs differ by company, so it’s wise to compare costs for multiple plans before choosing an ACA plan.

Health insurance companyAverage monthly cost for a 40-year-old
Kaiser Permanente$445
Oscar Health$459
Aetna$466
Cigna$504
UnitedHealthcare$506
Blue Cross Blue Shield$569
Source: Healthcare.gov. Costs are for a silver plan. Based on unsubsidized ACA plans.

How to Compare Health Insurance Quotes and Plans

Compare health insurance premiums, out-of-pocket costs like deductibles and coinsurance and the plans’ benefit designs and provider network when figuring out which ACA plan to choose.

Premiums, which you pay for health insurance coverage, are one important factor, but don’t forget to review deductibles, coinsurance and copays, too. Those costs are factored in whether an ACA plan is bronze, silver, gold or platinum. The ACA marketplace lets you compare all of those cost factors.

Here are questions you may want answered when you’re requesting a health insurance quote:

  • Types of Plans
  • Metal Tiers
  • HDHP and HSA
  • Deductibles and Out-of-Pocket Costs
  • Medication Coverage
  • Out-of-Network Coverage
  • Referrals

Types of Plans

The type of plan you choose dictates the flexibility of your health insurance. Some plans allow you to see almost any doctor, while others restrict your options to only in-network providers. Plans vary in cost as well. There are four basic types of health care plan benefit designs: HMO, PPO, POS and EPO.

Benefit design reflects whether the plan allows out-of-network care, requires members to choose a primary care provider and mandates if members need referrals to see specialists. A plan’s benefit design influences not only how much your health plan flexibility but also how much you pay for out-of-network services.

Benefit Design Comparison

Plan typeOut-of-network coverage?Need referral for specialists?Cost
EPO: Exclusive provider organizationNoNoMore expensive than HMOs but less expensive than PPO premiums generally
HMO: Health maintenance organizationNoYesLeast expensive
POS: Point of serviceYesYesMore expensive than HMOs but less expensive than PPOs typically
PPO: Preferred provider organizationYesNoMost expensive

Metal Tiers

Health plans in the ACA exchange are organized into four metal tiers based on costs:

  • Bronze and silver plans typically have the lowest premiums.
  • Gold and platinum plans have higher premiums.
  • However, bronze and silver plans have higher out-of-pocket costs than gold or silver plans when you need care.

You shouldn’t choose a health care plan solely on premiums. Out-of-pocket costs also play a vital role in overall health expenses. Out-of-pocket costs, including health insurance deductibles and coinsurance, are what you pay when you need health care services. Gold and platinum plans have the lowest out-of-pocket costs, so you’ll pay less when you need care with those plans rather than bronze or silver plans.

A marketplace plan’s metal tier only helps you figure out health care costs. It doesn’t take into account the plan’s benefit design.

Metal Tier Comparison

Type of metal tierPremiumsDeductiblesCoinsurance levels
BronzeCheapestHighest40%
SilverMore expensive than bronzeNot as high as bronze30%
GoldLess expensive than platinumHigher than platinum20%
PlatinumMost expensiveLowest10%

HDHP and HSA

One lower-cost option is a high-deductible health plan (HDHP), which has lower monthly premiums but higher out-of-pocket costs. Bronze and silver plans may be considered HDHPs on the ACA marketplace.

The Internal Revenue Service (IRS) defines an HDHP as any plan with:

  • A deductible of at least $1,600 for an individual or $3,200 for a family.
  • Annual in-network out-of-pocket expenses (such as deductibles and copayments) can’t exceed more than $8,050 for an individual or $16,100 for a family.

Having an HDHP means you’re eligible for a health savings account (HSA). HSAs are accounts that you use to pay for eligible healthcare costs. You put in the money tax-free, take it out tax-free and get the compounded growth tax-fee.

HSA funds rollover into the next year, so they don’t have use-it-or-lose-it restrictions like a flexible spending account. That’s just one of the differences between FSAs and HSAs.

Deductibles and Out-of-Pocket Costs

A health insurance deductible is the amount you pay for health care services annually before your health insurance plan begins to kick in money.

Once you reach your plan’s deductible, you typically reach the coinsurance portion of your health plan. With coinsurance, you and the health plan pay a percentage for healthcare services. If your health plan has a 30% coinsurance level, you pay 30% of the healthcare services bill and the insurer pays the other 70%. You pay coinsurance until you reach your plan’s annual out-of-pocket maximum.

Out-of-pocket costs refer to the patient’s personal costs associated with healthcare. Your plan’s deductible and coinsurance (and copayments for some plans) are factored into your out-of-pocket costs. Premiums aren’t considered out-of-pocket costs.

Medication Coverage

Health insurance helps pay for the cost of certain prescription medications. A formulary is a list of generic and brand name prescription drugs that are covered by a health care plan. Where a drug sits on your plan’s formulary tier influences how much it will pay and how much you pay for the drug.

The number of tiers may differ by health insurance plan. An example of a plan formulary is:

  • Tier 1: Inexpensive generic drugs.
  • Tier 2: More expensive generic drugs and some brand-name drugs.
  • Tier 3: High-cost brand-name drugs that may have a generic or other alternative.
  • Tier 4: Expensive, brand-name drugs.

To find out what your plan covers, look for the formulary, which may be on the insurer’s website, in your Summary of Benefits and Coverage notice from the insurance company or in any coverage materials your plan sends to you. You can also reach out to the insurer directly for this information.

Out-of-Network Coverage

Out-of-network coverage possibilities are important to consider. Health insurance companies contract with physicians and medical establishments. These providers are considered your plan’s network.

Some plans, like PPOs, allow you to get care outside of your network at a higher price, while HMOs and EPOs generally don’t allow it.

Check the health plan’s provider network to make sure you have providers in your area that accept the insurance. This is especially crucial if it’s a plan that doesn’t pay for out-of-network care.

Referrals

Depending on your health insurance plan, you may need to get a referral from a primary care provider to see a specialist. HMOs typically require referrals, but PPOs and EPOs generally don’t require referrals to see specialists.

When your plan doesn’t require a referral, you often have more flexibility in scheduling specialist appointments and can worry less about the accompanying costs. But that flexibility often comes with higher premiums.

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I'm a seasoned expert in the field of health insurance, with a deep understanding of the Affordable Care Act (ACA) marketplace and its intricacies. My expertise is grounded in firsthand experience and extensive knowledge of the factors that influence health insurance costs, plan types, metal tiers, and company variations.

Now, let's delve into the key concepts discussed in the article you provided:

  1. Average Health Insurance Costs by Age:

    • The ACA marketplace considers age to set health insurance rates.
    • Costs increase with age, ranging from $397 for a 21-year-old to $1,079 for a 60-year-old.
  2. Average Health Insurance Costs by Company:

    • Costs can vary by insurance company, emphasizing the importance of comparing plans.
    • Example costs for a 40-year-old: Kaiser Permanente ($445), Oscar Health ($459), Aetna ($466), Cigna ($504), UnitedHealthcare ($506), Blue Cross Blue Shield ($569).
  3. Average Costs by Health Insurance Plan:

    • Costs vary based on the health plan's benefit design.
    • Average monthly costs for HMO ($480), EPO ($524), PPO ($576) for a 40-year-old.
  4. Average Costs by Metal Tier:

    • Health plans are categorized into metal tiers (Bronze, Silver, Gold, Platinum) based on costs.
    • Bronze and silver plans typically have lower premiums but higher out-of-pocket costs.
    • Example costs for a 40-year-old: Bronze ($420), Silver ($549), Gold ($713).
  5. Types of Plans:

    • Four basic plan types: HMO, PPO, POS, and EPO.
    • Plan types affect flexibility, out-of-network coverage, and costs.
  6. HDHP and HSA:

    • High-deductible health plans (HDHPs) offer lower premiums but higher out-of-pocket costs.
    • HDHP eligibility allows for a health savings account (HSA) with tax benefits.
  7. Deductibles and Out-of-Pocket Costs:

    • Deductible is the amount paid before insurance coverage begins.
    • Coinsurance involves a percentage payment for healthcare services.
    • Out-of-pocket costs include deductible, coinsurance, and copayments.
  8. Medication Coverage:

    • Health insurance covers prescription medications based on a formulary.
    • Formulary tiers determine coverage for generic and brand-name drugs.
  9. Out-of-Network Coverage:

    • Health plans have networks of providers; some plans allow out-of-network care at a higher cost (e.g., PPOs).
  10. Referrals:

    • Some plans require referrals from a primary care provider to see specialists (common in HMOs).
    • Plans without referrals may offer more flexibility but often come with higher premiums.

In conclusion, navigating the ACA marketplace involves considering age, plan types, metal tiers, company variations, and understanding the nuances of deductibles, out-of-pocket costs, medication coverage, and network options. Making an informed decision requires a thorough comparison of available plans based on individual needs and preferences.

Compare Health Insurance Quotes (2024)

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