How Much Should I Pay for Health Insurance Per Month Blue Cross Blue Shield

This national average is for private health insurance you buy on the government's Health Insurance Marketplace created by the Affordable Care Act, often called Obamacare.

MoneyGeek researched national data and analyzed how health insurance rates change based on the type of insurance plan, the number of people covered and the location of that coverage, among other factors.

Many Americans qualify for subsidies that make buying health insurance on the Marketplace more affordable. You may also have lower-cost options if your employer offers health benefits or you're eligible for government insurance programs such as Medicaid or Medicare, which offer comprehensive plans like Medicare Advantage for affordable prices.

Key Takeaways

The average health insurance premium for a 40-year-old is $477 per month.

Maryland has the lowest monthly average premium of $338, and West Virginia has the highest at $712.

Age, location, family size and plan type are all influential factors in the cost of health insurance.

How Much Is Health Insurance by State?

Wondering how much private health insurance costs? The answer is that monthly premiums can vary significantly depending on where you live.

Maryland has the lowest health insurance premiums, with a typical 40-year-old paying an average of $338 per month. On the other end, West Virginia has the highest average premiums at $712 per month.

Variation in rates stems from factors like how much competition there is in a given state, forcing insurers to offer attractive rates. Expenses may also vary because of the expected health costs of a population. For example, in states where people tend to be less healthy or where doctors and hospitals charge more, insurance companies set higher rates to cover those costs.

Average Health Insurance Premiums by State for 40-Year-Olds

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• State

  Monthly Cost

  Annual Cost

• $491

  $5,897

• $561

  $6,729

• $437

  $5,243

• $426

  $5,112

• $522

  $6,270

• $364

  $4,368

• $505

  $6,062

• $513

  $6,154

• $499

  $5,983

• $491

  $5,897

• $446

  $5,353

• $471

  $5,653

• $451

  $5,407

• $474

  $5,683

• $439

  $5,265

• $491

  $5,898

• $468

  $5,617

• $554

  $6,650

• $440

  $5,277

• $338

  $4,052

• $579

  $6,948

• $361

  $4,335

• $342

  $4,109

• $488

  $5,855

• $504

  $6,044

• $444

  $5,333

• $527

  $6,321

• $480

  $5,760

• $417

  $5,007

• $583

  $7,000

• $339

  $4,063

• $708

  $8,501

• $486

  $5,835

• $377

  $4,529

• $466

  $5,597

• $478

  $5,735

• $443

  $5,320

• $448

  $5,376

• $417

  $4,998

• $457

  $5,478

• $494

  $5,933

• $486

  $5,833

• $457

  $5,483

• $453

  $5,430

• $657

  $7,886

• $471

  $5,654

• $411

  $4,927

• Washington D.C.

  $455

  $5,461

• $712

  $8,546

• $462

  $5,548

• $637

  $7,646

Average health insurance rates are only part of the story. Your actual plan may cost you much more or less than the typical person pays.

Thanks to federal subsidies, many people find their premiums are much more affordable. More than 50% of people can find a Silver plan for less than $10 per month with federal cost-sharing adjustments.

Another way to save money on premiums is to opt for higher-deductible plans. You may pay less each month, but you are on the hook for more of the bill if you use health care services until you reach your deductible. If you don't use many services, this kind of trade-off may save you money in the long run.

How Much Is Health Insurance by Family Size?

Not surprisingly, the more people in your family are covered by your health insurance plan, the more you're likely to pay in premiums.

The average cost for a 40-year-old couple is $954 per month or double the cost for an individual in that age range. But adding kids isn't quite as linear. A 40-year-old couple with one child under age 14 would pay an average of $1,230 per month, and a family of five would pay around $1,782.

To estimate the average family's health insurance cost, MoneyGeek used national averages by age and added the premiums together. Actual family premiums may vary.

Average Health Insurance Premiums by Family Size

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• Family Type

  Average Monthly Cost

• Individual (40-Year-Old)

  $477

• Couple (Two 40-Year-Olds)

  $954

• Couple w/ a Kid (Age 0–14)

  $1,230

• Couple w/ Two Kids (Ages 0–14)

  $1,506

• Couple w/ Three Kids (Ages 0–14)

  $1,782

It seems logical that families would stick together on health insurance — it's convenient and easy to do so. And together, you're more likely to meet the out-of-pocket maximum, after which you shouldn't have to pay out-of-pocket costs for covered services.

But some families might be better off on separate plans.

For example, if one spouse can get low-cost coverage through their job, but that plan may not be open to family members (or costs too much to add them), it may make sense for that spouse to use their employer-provided insurance while the rest of the family uses a Marketplace plan.

Or, if one partner has more medical needs and higher costs, they may benefit from paying more for more coverage. But if the other partner has few health needs, they may be better off in a high-deductible plan just for themselves.

The Average Cost of Health Insurance by Age

Most people need more health care as they age, and health insurance rates go up for older people to cover those expected costs.

In MoneyGeek's analysis — which does not account for tax credits or other subsidies — the average premium for an 18-year-old was $324 per month compared to $642 for a 50-year-old and $970 for a 60-year-old. However, older people may be eligible for higher subsidies if they have low incomes, such as if they've retired or scaled back their working hours.

Average Health Insurance Premiums by Age

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• Age

  Average Monthly Cost

• 18

  $324

• 26

  $372

• 40

  $477

• 50

  $642

• 60

  $970

The Average Cost of Health Insurance by Plan Types and Metal Tier

The type of health plan and the level of coverage you choose impact how much you'll pay for health insurance.

For example, you might be willing to pay more for easier access to a broader range of providers, such as through a Preferred Provider Organization (PPO) or Point of Service (POS) plan. Or, you may opt for less flexibility with a Health Maintenance Organization (HMO) or Exclusive Provider Organization (EPO) plan but score lower-than-average premiums.

Another thing to consider is how much of the cost of care your insurance covers. Different metallic tiers (Bronze, Silver, Gold and Platinum) dictate how much of your health care expenses your plan will cover compared to what you'll pay in premiums. As you'd expect, the more a plan covers, the higher your premiums will typically be.

The Average Cost of Health Insurance by Plan Types

There are four types of health plans you can choose on the Marketplace, with varying degrees of flexibility and cost:

• Health Maintenance Organization (HMO): HMOs tend to have lower premiums but require you to use a specific set of providers and get referrals to specialists for covered services, except in emergencies. Silver HMOs average $473 per month.
• Exclusive Provider Organization (EPO): Somewhere between an HMO and a PPO, EPOs typically require that you use the health plan's in-network providers, but you don't always need referrals to see specialists. EPO Silver plans average $508 per month.
• Preferred Provider Organization (PPO): PPOs tend to be more expensive than HMOs but typically offer a broader range of providers. You usually don't need to get a referral to see specialists for covered services. On the Marketplace, Silver PPO plans have an average premium of $517.
• Point of Service (POS): POS plans tend to be the most flexible — at an increased financial cost. You can usually get care outside of the health plan's provider network, though you'll likely pay more for those services. POS Silver plans have an average monthly premium of $534.

Average Health Insurance Premiums by Plan Type - Silver Plans

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• Metal Tier

  Plan Type

  Average Monthly Cost

• Silver

  HMO

  $473

• Silver

  EPO

  $508

• Silver

  PPO

  $517

• Silver

  POS

  $534

The Average Cost of Health Insurance by Metal Tier

Plans offered on the Health Insurance Marketplace are categorized into metallic tiers: Bronze, Silver, Gold and Platinum.

The tier corresponds to the value of the coverage, or how health plans and members split the costs. For example, in Bronze plans, the health insurer pays approximately 60% of the costs of care, and the individual typically pays 40%. The provider typically pays 90% in Platinum plans, and the individual pays 10%. These ratios are set by tier and based on expected spending for a typical health plan member.

In MoneyGeek's analysis, the lowest average premiums (other than for Catastrophic plans, which have strict eligibility rules and offer minimal coverage) were $383 per month for Bronze plans. The average Platinum plan, by contrast, costs $782 per month.

Average Health Insurance Premiums by Metal Tier

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• Metal Tier

  Average Monthly Cost (40-Year-Old)

  Average Deductible

  Average MOOP

• Catastrophic

  $288

  $8,549

  $8,549

• Bronze

  $383

  $6,791

  $8,137

• Expanded Bronze

  $390

  $6,434

  $7,981

• Silver

  $503

  $4,236

  $7,954

• Gold

  $562

  $1,500

  $6,650

• Platinum

  $782

  $170

  $3,501

• Bronze: Bronze plans tend to have the lowest monthly premiums but the highest costs when you need to use health care services. Deductibles on these plans can be very high, sometimes many thousands of dollars, which means if you do need care, it could be costly until you satisfy the deductible. These plans are a way to protect yourself from astronomical costs if you wind up with an injury or serious illness.
• Silver: Silver plans tend to have moderate monthly premiums and out-of-pocket costs when you use services. If you qualify for cost-sharing reductions, one form of federal subsidy, you must choose a Silver plan to get those savings. As a result, Silver plans turn out to be the lowest-cost option for many people.
• Gold: Gold plans tend to have higher monthly premiums and lower costs when you need care. Deductibles tend to be lower than in Bronze and Silver plans. If you're likely to use a lot of services and want to make sure more of those costs are covered, Gold plans may make sense — if you can afford the premium.
• Platinum: Platinum plans have the highest monthly premiums and the lowest costs when you use services. Deductibles tend to be low, so if you're willing and able to pay more each month, you can be pretty confident that most of your costs will be covered.

The Average Cost of Health Insurance by Company

What you can expect to pay for health insurance differs by the insurance company. Some insurers want to grow, so they offer more attractive rates. Others are more cautious and will charge more to be sure they can cover their members' health care costs.

Among national carriers, rates can vary widely. For example, the average Silver plan premium for Kaiser Permanente plans is $427 per month. Anthem (BCBS) charges an average of $481, while UnitedHealthcare's average rate is $641. Newer plans, such as Bright Health and Oscar, fall somewhere in the middle, with average monthly premiums of $488 and $492, respectively.

Premiums are not the only factor when choosing a health plan. Some of the most affordable plans can have coverage that falls short of your needs. The best health insurance companies can cost a bit more, but are surprisingly affordable and give you the best value for your money.

Consider the plan's total cost by looking at things like deductibles, coinsurance and out-of-pocket maximums. Check that your preferred doctors and facilities are in-network to save money and hassle. Be sure to also review quality and customer satisfaction ratings available on the Marketplace to make sure you're not going to encounter more annoyances than a plan's potential premium savings are worth.

Average Health Insurance Premiums by Company

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• Company

  Average Monthly Cost

• Kaiser Permanente

  $427

• Molina

  $433

• Ambetter

  $480

• Anthem (BCBS)

  $481

• Cigna

  $482

• Bright Health

  $488

• Oscar

  $492

• Blue Cross Blue Shield

  $541

• UnitedHealthcare

  $641

The Average Cost of Health Insurance for Job-Based and Public Plans

The health insurance marketplace is just one way to get health insurance coverage. According to the Kaiser Family Foundation, most Americans get health insurance through a job (50%) or from the government (35%) via Medicare, Medicaid or military benefits.

1

Job-Based Insurance

In 2021, the Kaiser Family Foundation reported that the total cost of family coverage through employers averaged $22,221, with employees paying $5,969 of that. Individual deductibles averaged $1,669, though employee costs vary by type of plan, family or individual coverage and size of the company.

2

Medicare

Medicare is the government-run insurance program that covers nearly all Americans 65 and older. "Original Medicare" — also known as Medicare Parts A and B — covers hospital stays and medical care, respectively, and has set costs. Most people pay no premium for Part A but do pay a deductible ($1,556 in 2022) and coinsurance, or a share of costs for longer-term facility stays. Part B premiums are $170.10 per month (though your income can affect this amount), and the 2022 Part B deductible is $233. Once you meet that deductible, you typically pay 20% of the bill for Medicare-approved charges.

Some Medicare enrollees choose to get prescription drug coverage (Part D) or join a comprehensive managed care plan that combines all their Medicare benefits (known as Medicare Advantage or Part C). Parts C and D are optional. Offered by private companies, costs for these coverages vary by carrier, plan and geography.

Medicare Supplement plans (sometimes called Medigap) are another option for people who want more coverage than Original Medicare but do not need or want the full scope of coverage in Medicare Advantage. There are several types of Medicare Supplement plans, each with defined benefits but with different costs and extra features, depending on the insurer.

3

Medicaid

Medicaid is a government-run program primarily for people with very low incomes. It is jointly funded by the federal government and the states, with each state setting eligibility and other rules. Coverage is free or very low-cost for most Medicaid members, but specific requirements vary by state.

Expert Advice: Health Insurance Costs

1. What are the most important factors affecting the cost of my health insurance?
2. How can I lower my costs if I am purchasing health insurance individually through a private company?
3. Broadly speaking, what are the pros and cons of buying health insurance plans with higher monthly costs?

Patrick Bernet

Associate Professor at Florida Atlantic University

Dr. Susan G Rucker

Doctor of Health Administration, Fellow in the American College of Healthcare Executives, Associate Professor

Dr. Mauricio Codesso

Assistant Teaching Professor at Northeastern University

Anastasia Miller, Ph.D.

Assistant Professor of Healthcare Administration at Texas Woman's University

Daniel Roccato

Clinical Professor of Finance at the University of San Diego School of Business

Steven G. Ullmann

Professor and Director of the Center for Health Management and Policy at the University of Miami Herbert Business School

About the Author

sources

• Centers for Medicare & Medicaid Services (CMS) . "American Rescue Plan and the Marketplace." Accessed December 13, 2021 .
• Healthcare.gov . "The 'metal' categories: Bronze, Silver, Gold & Platinum." Accessed December 13, 2021 .
• Kaiser Family Foundation . "2021 Employer Health Benefits Survey." Accessed December 13, 2021 .
• Kaiser Family Foundation . "Explaining Health Care Reform: Questions About Health Insurance Subsidies." Accessed December 13, 2021 .
• Kaiser Family Foundation . "Health Insurance Coverage of the Total Population." Accessed December 13, 2021 .
• Medicaid.gov . "Medicaid." Accessed December 14, 2021 .
• Medicaid.gov . "How do Medicare Advantage Plans work?." Accessed December 13, 2021 .
• Medicaid.gov . "Medicare costs at a glance." Accessed December 13, 2021 .
• Medicaid.gov . "What Medicare Part D drug plans cover." Accessed December 13, 2021 .
• Medicaid.gov . "What's Medicare Supplement Insurance (Medigap)?." Accessed December 13, 2021 .

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Source: https://www.moneygeek.com/insurance/health/average-cost-of-health-insurance/

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