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How much is health insurance per month?

Published in Health Insurance Costs 4 mins read

The cost of health insurance per month is not a single, fixed amount but varies significantly based on numerous factors unique to each individual and their chosen plan. While there isn't one exact answer that applies to everyone, understanding the key determinants can help you estimate potential expenses.

Understanding Health Insurance Costs

Health insurance premiums, the amount you pay monthly to maintain your coverage, depend on a variety of factors. These costs can range widely, from a few hundred dollars to over a thousand per month, particularly without financial assistance.

Average Monthly Premiums for Benchmark Plans

To provide a concrete understanding of potential costs, it's useful to look at average premiums for "benchmark plans." These are typically second-lowest-cost Silver plans available on health insurance marketplaces, which are used to calculate premium tax credits. The following table illustrates average monthly premiums for benchmark plans in select states in 2023, without the application of premium tax credits:

State 2023 Average Monthly Premium (Benchmark Plan) Percent Change from Previous Year
California $432 8%
Colorado $380 19%
Connecticut $627 5%
Delaware $549 -3%

These figures represent averages for benchmark plans before any subsidies or tax credits are applied.

Key Factors Influencing Your Monthly Premium

Several critical elements dictate how much you'll pay for health insurance each month:

  • Location: As shown in the table above, average costs vary significantly by state and even by specific regions within a state.
  • Age: Generally, older individuals tend to have higher premiums due to an increased likelihood of needing medical care.
  • Plan Type:
    • HMO (Health Maintenance Organization): Often have lower premiums but require you to choose a primary care physician (PCP) and get referrals for specialists within a network.
    • PPO (Preferred Provider Organization): Typically offer more flexibility, allowing you to see out-of-network doctors (though at a higher cost), but usually come with higher premiums.
    • EPO (Exclusive Provider Organization): Similar to PPOs but generally do not cover out-of-network care, except in emergencies.
    • POS (Point of Service): A hybrid of HMOs and PPOs, offering some out-of-network coverage with a referral.
  • Coverage Level (Metal Tiers): Plans are categorized into "metal tiers" based on how costs are split between you and your insurer:
    • Bronze: Lowest premiums, but you pay a higher percentage of medical costs (high deductible).
    • Silver: Moderate premiums and cost-sharing; eligible for cost-sharing reductions if you qualify based on income.
    • Gold: Higher premiums, but the plan covers a larger share of medical costs (lower deductible).
    • Platinum: Highest premiums, lowest out-of-pocket costs when you receive care.
  • Deductible, Copay, and Coinsurance:
    • Plans with higher deductibles (the amount you pay before your insurance starts to pay) typically have lower monthly premiums.
    • Lower copays (fixed amounts you pay for doctor visits or prescriptions) and lower coinsurance (your percentage share of the cost after your deductible) usually correlate with higher monthly premiums.
  • Family Size: Premiums increase if you're covering more people, such as a spouse or children, compared to an individual plan.

Finding Your Specific Cost

To determine your exact monthly health insurance premium, you typically need to:

  • Visit a Health Insurance Marketplace: Depending on your state, this could be HealthCare.gov or a state-run exchange. These platforms allow you to compare plans and see if you qualify for premium tax credits (subsidies) that can significantly lower your monthly payment.
  • Consult a Licensed Insurance Broker: Brokers can help you navigate options from various providers and clarify what each plan covers, tailored to your specific needs.
  • Check Employer-Sponsored Plans: If available through your job, these plans often have different cost structures, with employers typically covering a portion of the premium.

Understanding these variables is key to anticipating your monthly health insurance expenditure. For more detailed information on health insurance costs, you can explore resources like HealthMarkets.