September 23, 2022
  • September 23, 2022

How much does health insurance cost in 2022? – Forbes Advisor

By on August 24, 2022 0

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The cost of health insurance in the Affordable Care Act (ACA) market varies depending on the insurance company, where you live, the plan you choose, the number of people covered, your age, whether you smoke and your family size and income.

What are the average costs of health insurance?

Average monthly premiums for an ACA Bronze health insurance plan are $928. Average monthly costs increase to $1,217 for a Silver plan and $1,336 for a Gold plan. These averages do not take into account premium tax credits and subsidies that can reduce the costs of an ACA plan based on household income.

Here’s a look at average ACA market health insurance premiums for four of the largest health insurance companies.

Average cost of health insurance per company

Average cost of health insurance by age

Average cost of health insurance by plan type

Average cost of health insurance by metal level

How to calculate and compare health insurance costs

Choosing the best health insurance plan for you involves evaluating your budget, your current health status, what you expect next year, and what you want from a health plan.

Premiums vs Deductibles

Health insurance plans usually have higher premiums/lower deductibles or lower premiums/higher 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 might be a good choice if you don’t expect to need a lot of care in the next year. Health insurance companies don’t start contributing to pay for health care services until you reach your deductible. Once you’ve reached your deductible, you typically pay coinsurance, which is when you and the health insurance company share the costs of health care services.

For example, this could mean that you pay 20% and Medicare pays 80% until you reach your plan’s spending limit.

When choosing a health plan, calculate how much you would pay in health insurance premiums over a year and factor in the deductible. Would lower premiums save you enough to make it worth paying a higher deductible? Or can you afford higher premiums and know you’ll save money if you need care during the year?

If you anticipate needing health care services, especially if you’re expecting a child or planning surgery, a health plan with a higher premium and lower deductible might be a good idea. But if you don’t expect to need many health care services, a high-deductible health insurance plan might be a good choice.

If you’re looking for an ACA plan, Bronze and Silver plans have higher deductibles, but you pay less premium than you would for a Gold or Platinum plan. Gold and Platinum plans have higher premiums, but you pay less when you need care.

Design of plan benefits

A plan’s benefit design influences your flexibility and the cost you pay for health insurance. HMO and EPO plans are the most common types of health insurance plans in the ACA market. PPO and point-of-service (POS) plans are also offered on ACA exchanges, but are not as common in the market.

Here is an overview of the differences between the four benefit designs:

Differences in benefit design of health care plans

HMOs and EPOs generally have the lowest premiums, but they also don’t allow out-of-network care. These plans typically only pay for out-of-network care if it’s an emergency. Otherwise, HMOs and EPOs require you to stay within your provider network. HMOs also often require you to be referred by a primary care provider to see a specialist.

PPOs and EPOs generally allow you to get care outside of your network of providers, but at a higher cost than if you received in-network care. This flexibility often comes with higher premiums.

Decide how much flexibility you want and if you’re willing to pay more for coverage. If you want the cheapest health insurance and don’t mind staying in the provider network, an HMO or EPO might be a better bet.

Factors that influence health insurance costs

The ACA allows health insurance to use multiple factors when setting health insurance premiums. Here is what influences costs in the ACA market.

Your age

Insurance companies in the ACA market use a person’s age when setting rates, which is different from the employer-sponsored health insurance market. Here’s a look at how a person’s age influences the cost of a health plan.

Average ACA Market Plan Costs by Age

Where you live

Your location influences how much insurance companies charge. Insurers in states that have fewer health insurance plans in the market may charge more for coverage because there are fewer companies to share the cost of providing health insurance in that region.

Rural areas may have fewer health plan options, so people in these areas may pay more for care than those in urban and suburban areas.

that you smoke

The ACA allows insurance companies to set higher rates for smokers in the market. A health insurance company can charge a smoker up to 50% more than a non-smoker.

Metal shelf

Metal levels in the ACA market help consumers choose packages based on cost. 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 Bronze or Silver plans, but lower out-of-pocket expenses. Platinum plans, which have higher premiums and low deductibles, are only a tiny fraction of ACA plans.

The level of metal you choose depends on whether you want to pay higher premiums or higher deductibles.

How many people are covered

Having single coverage costs less than having multiple people on your health plan. Here’s how adding people to your health plan affects health insurance costs.

Average ACA market plan costs by number of people on the plan

Type of health plan

The benefit design of a health plan 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 receive out of the network in an EPO and HMO. Instead, you must bear all 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 if flexibility or lower premiums are more important to you if you’re comparing a PPO with an HMO or EPO.

Your household income

The ACA Marketplace offers premium tax credits and cost-sharing subsidies based on your household income. This can save you money on your premiums and disbursements.

Individuals whose household income is at or below 400% of the federal poverty level are eligible for premium tax credits. Those with Silver plans can also get cost-sharing grants that reduce out-of-pocket costs.

The ACA market will consider these factors when entering your household income and family size on the exchange.

Here’s what constitutes a federal poverty line of 400% in 2022.

What is considered a federal poverty line of 400%

Find the best health insurance companies of 2022

Frequently asked questions about the cost of health insurance

How to find cheap health insurance?

You can enter your household income information on the ACA Marketplace website, which can help you find an affordable health insurance plan if your income qualifies.

ACA market plans are eligible for premium tax credits and cost reduction subsidies, which can lower the cost of health insurance.

You may also qualify for Medicaid, which is a federal/state health insurance program that provides comprehensive, low-cost, or free coverage. The ACA marketplace site will tell you if you qualify for Medicaid in your state when you include your household income and family size in the marketplaces website.

How much does health insurance cost per month for a single person?

The average monthly health insurance cost for a Bronze plan is $356 for a single 30-year-old. This same person pays an average of $468 for a Silver plan and $514 for a Gold plan.

A 40-year-old single person pays an average of $401 per month for a Bronze plan, $526 for a Silver plan, and $578 for a Gold plan.

Age is just one of the factors that health insurance plans use when setting prices in the ACA market.

What can you expect to pay for health insurance deductibles?

The average health insurance deductible for an ACA market plan is just over $5,000.

Most ACA plans are Bronze or Silver plans, which often have deductibles above $2,000. You can find a lower deductible plan, such as $1,000 or less, at the Gold level, but these health plans come with higher premiums.