How to get affordable health insurance
The best way to get the cheapest health insurance is through your workplace. Many employers offer group health insurance to their employees and families. Group health insurance is cheaper than getting individual health insurance, and most employers pay a portion of the health insurance premium, making your cost more affordable.
You might be eligible for even cheaper health insurance through Marketplace subsidies if your household income is at or lower than 400% of the federal poverty level for your household size.
Medicaid may be another option if you have a low income. This health insurance program can offer you comprehensive health insurance coverage at little or no cost.
Another option is to go directly to a health insurance company. Plans may not be ACA-compliant, however. It’s worth reviewing and comparing each plan’s summary of benefits and coverage (SBC) to determine which will best fit your needs.
How much does health insurance cost?
A bronze health insurance plan — the category with the cheapest premiums on the ACA Health Insurance Marketplace — costs an average of:
- $428 per month for a 21-year-old.
- $488 per month for a 30-year-old.
- $549 per month for a 40-year-old.
- $767 per month for a 50-year-old.
- $1,164 per month for a 60-year-old.
Factors that impact the cost of health insurance
The cost of health insurance available on the Health Insurance Marketplace will vary based on several factors, including:
- The health insurance company.
- The health insurance plan category (e.g. bronze, silver, gold).
- The type of health plan (e.g., EPO, HMO, PPO).
- Your age and the ages of your dependents.
- Your out-of-pocket costs, including deductibles and coinsurance.
Expert tip: The more the health insurance company covers, the more you’ll pay in health insurance premiums. You could save on your premium if you choose a higher health insurance deductible and out-of-pocket maximum. Just be prepared to pay more out of pocket for your health care in exchange for that lower premium.
Average cost by health insurance plan category
While bronze plans have the lowest monthly premiums, they also have the highest costs when you need care. So if you’re looking to save on expenses overall, you may want to consider a silver plan. Silver plans have a moderate premium and moderate out-of-pocket costs.
| HEALTH INSURANCE PLAN CATEGORY | HEALTH INSURANCE COMPANY PAYS | YOU PAY | AVERAGE COST OF MONTHLY PREMIUM |
|---|---|---|---|
| Bronze | 60% | 40% | $373 |
| Silver | 70% | 30% | $488 |
| Gold | 80% | 20% | $634 |
| Platinum | 90% | 10% | $664 |
How to find the best affordable health insurance for your needs
Comparing health insurance quotes can be overwhelming, but these tips can help you find the best cheap health insurance plan for you.
- Consider your health care needs. If you don’t anticipate going to the doctor much, you could save by choosing an HDHP. But a gold or platinum plan may be worth it if you have chronic health conditions or expect to see the doctor regularly.
- Which plan type is best? An exclusive provider organization (EPO) plan only covers in-network care, unless it’s an emergency. A health management organization (HMO) plan will cover out-of-network care, but only for urgent or emergency care. A preferred provider organization (PPO) plan will cover out-of-network care without a referral for an additional cost.
- Check for pharmacy benefits. A formulary, or drug list, is a list of prescription drugs your insurance will cover and what category and cost a particular drug falls under. Todd Ackerman, president of World Insurance Associates, advises considering, “With prescription drug costs rising like they are, what are your prescription costs, and where do your prescriptions fall in the formulary on the plan you’re moving to?”
- Ask your healthcare providers what insurance plans they accept. Before you buy a health plan, call your doctor to make sure they take the specific plan. The health insurance company’s online directory could be out-of-date or not accurate.
- Verify the health plan cost. The cost isn’t just the premium. You should also consider the coinsurance, copay, deductible and out-of-pocket maximum.
- Are there other options? You might be able to get health insurance through your employer or get added to your spouse’s or parent’s plan. These options may be cheaper than getting an individual health insurance plan.
What to consider when shopping for affordable health insurance
If you’re shopping for cheap health insurance, there are multiple things to consider, including the plan type, tax credits and coverage choices. We break down the most important factors to consider when comparing quotes to find cheap medical insurance.
Bronze plans
Of all the metal tiers, bronze plans have the lowest premiums, though you’ll pay the most for your health care costs. With a typical bronze plan, the insurance company pays 60% of covered expenses, while you pay 40%. Expect deductibles for bronze plans to be thousands of dollars per year.
A bronze plan is best for someone who wants health insurance coverage for severe injuries or illnesses but can afford to pay for some preventive and routine care out of pocket. All ACA-compliant health plans provide preventive care services free of cost-sharing, even before meeting the deductible, including screenings and counseling, routine immunizations, preventive services specifically for women and preventive services for children and youth.
Silver plans
Health insurance companies usually pay around 70% of health care costs on a silver plan, while you pay 30%. This metal plan offers lower deductibles than bronze plans but has higher monthly premium costs. Still, silver plan deductibles can still be in the thousands.
“If you qualify for a subsidy and reduced cost-sharing, silver plans may be the most affordable option for you,” said Evan Tunis, president of Florida Healthcare Insurance.
If you don’t qualify for a subsidy but are willing to pay a slightly higher premium to cover more routine care, consider a silver plan.
Gold plans
A gold plan might be worth the cost if you go to the doctor regularly or have high health care costs. Although it has higher premiums than bronze and silver plans, your deductible is lower and the insurance company pays about 80% of your cost of care.
Platinum plans
The metal tier plan with the highest cost is the platinum plan, but it comes with the lowest deductible. The health insurance company generally pays around 90% of your covered expenses, so nearly all your health care costs will be covered.
Tax credits for affordable health insurance
Some people qualify for a premium tax credit, which can unlock cheap medical insurance. When you apply for health insurance on the health exchange, you’ll enter your estimated income on the application. You could receive a tax credit depending on your income and household size. You can find out if your estimated income qualifies for a subsidy on the Marketplace website.
“If your income or household makeup changes during the year, you’ll want to update your application to see if it affects your credit,” said Tunis.
Gaining a household member or losing an income could increase your credit. Losing a household member or increasing your income could lower it. Taking more of a tax credit than you’re eligible for could mean you have to pay some of it back when filing your federal tax return.
HSA vs. FSA
HSAs and FSAs are two tax-advantaged savings vehicles you can use to pay for health care expenses.
A Health Savings Account (HSA) is available if you buy a high-deductible health plan (HDHP) with a minimum deductible of $1,600 for an individual or $3,200 for a family plan.
If you’re considering an HSA, check to see if the Marketplace plan has an “HSA eligible” label.
You can make pre-tax contributions and use the funds to pay for qualified medical expenses and costs to meet your deductible.
The HSA also accrues interest, and the entire balance rolls over yearly. You can keep the HSA no matter your employment status, and it acts like a retirement account once you turn 65.
Before age 65, non-medical HSA expenses will be subject to income tax and a 20% penalty. Once you turn 65, however, taxable non-medical expenses will no longer be subject to a penalty, and you can continue to use your account tax-free for qualified medical expenses.
A Flexible Savings Account (FSA) is sometimes offered as an employee benefit with an employer-sponsored group health insurance plan. An FSA allows employees to set aside a predetermined amount of money pre-tax for health care expenses and eligible dependent care.
Unlike the HSA, the FSA is generally a use-it-or-lose-it plan, meaning amounts in the account at the end of the plan year won’t carry over to the next year. However, some FSA plans allow a grace period of up to two and a half months, or a rollover of up to $610 to be used for qualifying medical expenses for the following year.
Out-of-network coverage
Going “out of network” means seeing a health provider not contracted with your health insurance company or plan. If you go out of network to see a doctor, you’ll usually pay a higher coinsurance amount — the percentage you pay for covered services after you’ve met your deductible — than you would to see an in-network doctor.
“Knowing your out-of-network coverage can help you save money in the long run, especially for those who travel frequently or live near a state border,” said Tunis.
Out-of-network coverage can vary depending on the type of health insurance plan you buy. For example, if you have a Health Maintenance Organization (HMO) plan, your insurance might not cover out-of-network care unless it’s an emergency.
If you like your doctor or specialist and want to keep going to them, make sure they’re in network for the health insurance plan you’re considering.
Out-of-pocket maximum
Your out-of-pocket maximum is the most you’ll pay toward covered health care for your plan year. Once you’ve paid your deductibles, coinsurance and copayments and have met your annual out-of-pocket limit, your plan will pay 100% for covered expenses.
The following expenses do not go towards your out-of-pocket maximum:
- Health insurance premiums.
- Out-of-network expenses.
- Costs your provider charges above the allowed amount.
- Cost of services not covered.
The 2024 out-of-pocket limit varies for Marketplace plans but cannot exceed $9,450 for individuals and $18,900 for family coverage.