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Find Health Insurance Plans and Prices on the Marketplace Exchange – healthcare.gov Editor's Pick

Find individual health insurance plan options and prices at healthcare.gov. This is the ONLY health insurance site to use if you want (and qualify for) the federal subsidies for affordable health insurance AND your state participates in the federal marketplace exchange. Compare plans on monthly premium prices, deductibles, plan features and star quality ratings. The federal marketplace exchange shows Bronze, Silver, Gold and Platinum metal levels. It first opened for 2014. People who don’t get subsidies can also choose a plan and enroll at healthcare.gov. Open enrollment for everybody (except Medicare) between November 1 and December 15, 2022 for coverage starting Jan. 1, 2023. This year, the federal exchange is again open for an additional month (to Jan. 15, 2023) for coverage starting Feb. 1, 2023. Select Preview Now if you just want to scan the plans before you create an account. At minimum, enter your age, or you may get false prices. If you lose coverage during the year, you may also qualify to enroll outside of the Nov.-Dec. open enrollment. Links are provided to your state marketplace if your state has its own health insurance website. This year, a new concept of “easy pricing” has been added. Unfortunately, it is not easy to understand what it means or how it works. Nonetheless, this site is Editor’s Pick.

Average 2021 Health Insurance Plan Premium for Single Coverage (MEPS)

The average single coverage premium for each private sector employee enrolled in a health insurance plan was $7,380 in 2021. This was up 3.2% from the prior year MEPS data. Table I.C.1 (page 91) shows average premium by size of company, industry, for-profit vs nonprofit, union establishments vs nonunion, and other breakouts. For companies of less than 10 employees, the average single premium was $7,707 per month, up 6.5% from 2020. Report on private-sector establishments, from the Medical Expenditure Panel Survey (MEPS) Insurance Component summary tables.

Average 2022 Premium on the Health Insurance Exchanges

On average, 2022 individual premiums were under $600 per month for a plan on last year’s health insurance exchanges. Data are shown in the “2022 Open Enrollment Report”. Across all states, the average premium was $585 for the plans selected by individuals, up 1% from the prior year. About 89% of people received the Advance Premium Tax Credit (APTC) (which is based on income) to bring the net cost to individuals, down to about $133 per month. For those who qualify for the APTC, the difference (about $505 per month) is covered by the government (“Obamacare” and the American Rescue Plan). Average monthly premium net cost for those who qualified for the APTC was $111 per month on the federal Healthcare.gov exchange, and $188 on the state-based marketplaces. The national average premium of $585 per month works out to $7,020 premium cost per year. Source report from CMS, undated.

In an older report, “Early 2021 Effectuated Enrollment Snapshot“, details by state are provided for the prior year’s 2021 enrollment.

Average Deductible and Co-Pay in Health Insurance: MEPS, 2020

Find the average health insurance deductible and co-pay in the MEPS Insurance Component 2020 Chartbook. The report shows that about 89% of employees had health insurance plans with an annual deductible. Average individual deductible was $1,945, but in small (under 50 employees) and medium size firms (50-99 employees) deductibles averaged about $2,400 to $2,500 (single). Family average deductible in US was up 2% to $3,722 in 2020. For the smallest companies, the average family deductible dropped from $5,067 (2019) to $4,666. Average copayment for an office visit was just under $27. Average deductible and copays are also shown by state. Hawaii, for example, is unusual in that only 41% of employees are in a plan with a deductible. Large report and many charts showing trends since 2008. See Section 5 for employee cost-sharing, and scroll to the charts for a quick view. Data from the 2020 Medical Expenditure Panel Survey, Chartbook #24, published December 2021.

Average Health Insurance Cost, MEPS 2021, by State (KFF)

Find the average health insurance cost for each state in 2021. The Kaiser Family Foundation (KFF) shows average Single,  Family and Employee Plus One health insurance premiums and deductibles using MEPS data for 2021. For US employer coverage, the average Single premium cost was $7,380 ($615 per month), and the average Family premium cost was $21,381. Arkansas had the lowest Single premium rates ($6,340), followed by Hawaii ($6,573). Alaska had the highest average single premium cost at $9,037. Family rates were lowest in Arkansas ($18,339 per year); highest in Washington D.C. ($24,455, $2,038 per month).

Deductibles: Single deductibles averaged $2,004. Hawaii had the lowest single person deductibles again in 2021, averaging $1,232. Washington DC had an average $1,338 single deductible. These were the only two that had average deductibles under $1,500. The highest average deductible for a single plan topped $2,600 (Maine). Family deductibles averaged $3,868, ranging from $2,570 in Hawaii, to $4,684 in Colorado.

Amounts paid by Employers: On average, employers paid 78% of the single premium cost, and paid 71% of the family premium. Employees paid the difference: 22% of single premium cost and 29% of the family monthly premium. See specifics in each state. MEPS is the Medical Expenditure Panel Survey. Updated September 2022.

Average Total Premiums and Employee Contribution, Selected Cities, 2021 Editor's Pick

The 2021 average health insurance premiums and amounts of employee contribution are shown for selected cities and metropolitan regions. MEPS table IX.A.2 shows annual premium costs for single, single-plus-one, and family coverage for private-sector businesses. All areas had average single premiums over $6,000 per year. Average single premiums in in a few parts of the country exceeded $9,000: Alaska, and Charleston, West Virginia. The New York, Newark-Jersey City, NY-NJ-PA region nearly hit $9,000 for a single premium. Lowest single rate $6,057 was in Columbus, Ohio. Average Single contribution was under $2,000 in most parts of the US.

Average employee-plus-one premiums were over $12,000 across the US; just two exceptions: Columbus, OH ($11,660) and Fargo ND ($11,736). Parts of Maryland had employee-plus-one rates that topped $19,000. Anchorage Alaska Employee-plus-one was $18,370.

Family premiums were best in parts of Hawaii, at $17,000 per year; Columbus OH came in second at $17,480. Family premiums were highest in Charleston WV, topping $28,000. Coverage levels and plan design will vary. Table starts on page 7. Data from MEPS, the Medical Expenditure Panel Survey, Insurance Component.

Federal Exchange Marketplace Average Rate Changes for 2023 (CMS)

CMS reported average rate changes in health insurance premiums for 2023 on the federal exchange marketplace for two types of sample consumers – a 27 year old, and a family of four. The premium cost for the second-lowest cost silver plan (benchmark) is reported to increase by 4%, on average, for the 2023 enrollment starting Nov. 1. According to CMS, the average benchmark silver plan premium for a 27 year old is expected to be $382 in 2023. The average benchmark plan (with the American Rescue Plan implementation) was estimated to be $368 per month in 2022. After subsidies, a 27 year old with income at 150% of federal poverty level (i.e., $20,385 per year) would pay $0 for the lowest cost silver plan in 2023. For the Family of Four example, the benchmark silver plan cost $1,503 per month on average. The lowest cost plan (probably a Bronze plan) will cost $1,093 per month for incomes at 250% of the federal poverty level ($69,375 household income). However, after qualifying subsidies, the family cost was just $1 per month.

The median deductible for 2023 is $7,471 for a Bronze plan and $5,388 for a standard Sliver plan. The bronze deductibles are up 8% ($538) on average. The silver deductibles are up 4% ($223) for 2023. Since the 2019 plan year, deductibles have increased by $1,103 for bronze plans and $917 for the silver standard plan.

The healthcare.gov exchange will open on November 1, 2022. If you want coverage to start January 1, 2023, you must enroll by December 15, 2023. Open enrollment on the Federal Exchange closes January 15, 2023 for coverage starting Feb. 1, 2023.

No information about average price hikes or reductions was presented for older consumers. Older enrollees pay up to 3 times more, but costs for older consumers in 2023 were not disclosed. Extra information for each state on 27 year olds and families of 4 can be found in the appendix file. CMS report October 26, 2022.

Find Health Insurance Plans and Prices on State-Based Marketplace Exchanges Editor's Pick

Find health insurance plans and prices in states that use the state-based marketplace exchanges, instead of the federal healthcare.gov marketplace. Here are the links for 17 states and DC. The federal subsidies still apply to these state exchanges: CA, CO, CT, Washington DC, ID, KY, ME, MD, MA, MN, NV, NJ, NM, NY, PA, RI, VT and Washington state.  The states will show Bronze, Silver, Gold and Platinum metal levels. Compare plans on monthly premium prices, deductibles, plan features and quality ratings. Open enrollment for everybody (except Medicare) between November 1 and December 15, 2022 for coverage starting Jan. 1, 2023. You may have to create an account before you can see the plan options. But each state will vary. If you lose coverage during the year, you may also qualify to enroll outside of the Nov.-Dec. open enrollment.

Health Insurance Cost Estimate, 2021 Survey (Mercer)

Mercer’s annual National Survey of Employer-Sponsored Health Plans, estimates that the total health insurance benefit cost increased 6.3% in 2021, to an average of $14,542 per employee. However, size mattered. Large employers (500 employees and over) had an average increase of 5.0%, compared to 9.6% for employers with 50 to 499 employees. Overall, employers expected an average of 4.4% increase for 2022. A snapshot is available free. Highlights of the survey were released December 2021.

Health Insurance MEPS 2020-2021

Health Insurance MEPS 2020 Chartbook #25 analyzes health insurance. Average total premium in 2020 was $7,149 for single (up 2.5%); $14,191 for single plus one; and $20,758 for family coverage. Employees contributed 21.4% on average toward the single premium. Employee contributions for family coverage were 28.8% of the total premium, with employers covering the rest of the cost. Average single deductible was $1,945, almost double the 2010 deductible. Chartbook examines employer offer rates and employee participation rates by industry sector. Detailed report shows trends back to 2008 and costs by state, as well as employer size. Medical Expenditure Panel Survey Insurance Component 2020 Chartbook (MEPS data) published December 2021.

Health Insurance Premiums – 2022 Employer Health Benefits Survey – KFF Editor's Pick

KFF’s annual Employer Health Benefits survey for 2022 reports that premiums for employer-sponsored health insurance coverage rose 1% for families and 3% for singles. Average single coverage cost $7,971 per year ($1,327 paid by workers), and family coverage averaged $22,463 per year ($6,106 paid by employees). Monthly costs averaged $664 per month for single coverage and $1,872 per month for family. High deductible health plans (with savings option) have about 29% share of covered workers, but overall, 88% of workers had a deductible. PPOs were the most common type of plan, enrolling 49% of covered workers. The average single deductible was $1,763, up $94 from 2021. Nearly one in three covered workers (32%) had a deductible of at least $2,000. For small firms, the average single deductible was $2,543, although firms may make a contribution toward that cost. Average copays were $27 for a primary care visit, and $44 for a specialist. Survey of 2,188 nonfederal public and private companies with 3 or more employees completed Feb. to July, 2022. Findings released October 2022 by the Kaiser Family Foundation (KFF). Very detailed report

How much has health insurance cost increased up to 2021?

How much has health insurance cost increased up to 2021? According to a new government report of health insurance trends, the total Single premium went up 3.2% (from $7,149 to $7,380) for private company employees in 2021. See figure 6 for breakouts by small, medium and large employers. Employee-plus-one rates went up 3.1% to $14,634 on average (figure 7). Family rates went up 3.0% on average to a total premium cost of $21,381.  Figure 9 shows the average cost increase every year, since 2009. Trends in average deductibles are shown in figures 14 and 15. The average annual deductible for single employee coverage in a private company was $2,004 in 2021 (up 3%). However, for small size companies with less than 50 workers, the average deductible cost was $2,485. Other charts show how much employees contribute to the annual premiums. Statistical Brief #543 uses MEPS data (Medical Expenditure Panel Survey); published July 2022.

Individual Employee Annual Health Insurance Premium Cost – 2021

Average health insurance premium cost was $7,380 per year (about $615 per month) in 2021 for an individual employee. This was up about 3.2% from last year. See table of costs for single person policy. Costs are for employee enrollees. No states managed to come in under $6,000 for a year for one person. Employee contributions were the lowest in Oregon and Hawaii at about $81 per month. Employer contributions picked up the rest of the cost. Employees paid on average $170 per month in Rhode Island, the highest contribution. Average single employee contribution in US was about $137 per mo. ($1,643 per year) or 22% of the total premium; employers paid 78% of single coverage premiums on average. Employers paid the most in Alaska and New York, where total premiums for single employee coverage were over $9,000 and $8,500, respectively. Compare how much a month health insurance costs in each state. Benefit coverage varies by state and policy. Kaiser Family Foundation (KFF) prepared the tables using MEPS data (Medical Expenditure Panel Study).

Medicare Personal Plan Finder (medicare.gov)

The Medicare Personal Plan Finder site at medicare.gov helps you locate supplemental health insurance plans, find out their prices (premiums), and link to a page to check Medicare Eligibility. Generally, one has to be age 65 or disabled to qualify for Medicare. Early retirement at age 62 does NOT by itself allow someone to receive Medicare benefits

Average Health Insurance Cost, Group Market: MEPS: public sector vs private sector

Find the average 2020 health insurance cost in the public sector (all state and local government) market. The Medical Expenditure Panel Survey (MEPS) data tool identifies the nationwide 2020 average premium cost for public sector job-related health insurance at $8,344 for singles and $22,399 for family coverage. However, the employee contributions to the premiums were fairly modest if they worked for government employers. Employees paid an average of $953 for Single coverage, and $4,294 for Family coverage in 2020. The average deductible in 2020 was $1,305 for a Single plan (compared to $1,945 in a private sector plan), and $2,434 for a Family plan through the government (vs. $3,722 private sector). Regional breakouts of government data are available. If using the PDFs, see Tables Series III, Table III.C.I beginning on page 23 to view relevant public sector data. Updated 2022.

Cost-Shifting adds $1,788 to health insurance cost for family of four (Milliman study)

Study by Milliman shows that cost-shifting from Medicare and Medicaid underpayments added $1,788 to a family health insurance cost in 2006-2007. This amounted to about 15% of the amount paid for hospital and physician costs for privately insured people. Premiums paid through employer-provided insurance were estimated to be 10.6% higher due to the cost-shifting. With medical inflation, the cost shift would be more than $2,700 in today’s dollars, or more than $225 on the monthly premium. Study was commissioned by the AHA (American Hospital Association), AHIP and Blue Cross Blue Shield Assn/Premera Blue Cross, released December 2008. Old study.

Other Helpful Listings

Average Health Insurance Cost, Individual Market: MEPS 2014 (pdf)

Average health insurance cost for someone who bought a policy privately (non-group individual market) in 2014 was $3,137 (approximately $261 per month for a single policy). According to MEPS, the family policy cost $6,904 a year (approximately $575 per month). The median annual premium cost was $2,317 for a single, and $5,287 for a family. Data source: Medical Expenditure Panel Survey (MEPS); 2014 was the first year of the health insurance exchange. MEPS has not updated the table, but more recent information is available at the links above.

Fact Sheet: Underpayment by Medicare & Medicaid (2022)

Analysis by the American Hospital Association shows that Medicare and Medicaid under-pay the true cost of hospital care by about $100 billion. This cost ends up being borne by other payers and commercial insurance. Using 2020 data, it is estimated Medicare paid 84 cents on the dollar, and Medicaid paid 88. February 2022 report.

HSAs and HDHPs cover 22 to 67 million people

HSAs and HDHPs enrolled 21.8 million people according to America’s Health Insurance Plans (AHIP), as of Jan. 2017. An 8% growth in the number of people enrolled in Health Savings Accounts (HSAs) / High Deductible Health Plans (HDHPs) brought the number to nearly 22 million Americans, Twenty two states had at least 200,000 people enrolled in these types of plans in their states (down from 24 states). California, Illinois, Minnesota, Ohio and Texas have over 1 million each. Average premiums shown, but not out of pocket costs. Minimum deductible was $1300 single for 2017, with $6550 maximum out of pocket costs. Double the numbers for family coverage. Enrollments by large employers have shrunk from their high of 15.3M in Jan. 2015, to 12.9M in Jan. 2017. Large groups represented a majority (at least 59%) of HSA high deductible plan enrollments. AHIP is an association representing health insurance companies. Report released April 2018. However, only an infographic is now available in 2022. Separately, newer research as of July 2022 by Devenir Research, indicates that more there are now 32.5 million HSA accounts covering 67 million people. The minimum deductible for a HDHP that qualifies for an HSA rises to $1,500 in 2023, up from $1,400 for 2022.

Medicare Advantage Plans Part C Premium Costs for 2023 (CMS)

CMS announced that the average Medicare Advantage plan (Part C) premium cost will decrease again in 2023. CMS estimates the average monthly rate will be $18 per month (plus what you will pay directly to Medicare for Part B). The average premium in 2022 was $19.52. Medicare Advantage plans may or may not include Part D drug coverage. Nearly 32 million Medicare beneficiaries are expected to enroll in Medicare Advantage plans in 2023. The Advantage plan enrollment has been increasing in recent years as people switch from traditional Medicare. Plans vary widely by state and region. For example, the average Medicare Advantage premium for 2023 in various states is projected as follows:

  • California – $16.42
  • Florida – $9.41
  • Illinois – $11.39
  • New York – $26.02
  • Pennsylvania – $30.05
  • Tennessee – $17.08
  • Texas – $8.94

Read very carefully. For many consumers, there will be a $0 monthly premium. However, in all plans, there may be copays, deductible costs, and potentially large out of pocket maximums to consider. At the end of the press release are links where you can find actual premiums by name of health plans in each state. Press Release issued September 29, 2022.

Medicare Part B Premium, Deductible and Part A Deductible for 2023

CMS announced the standard Medicare Part B monthly premium will cost $164.90 (down $5.20) in 2023 for most beneficiaries ($1,979 per year), with a $226 deductible (down $7). Part B premiums and the Part B deductible are both down about 3%. Lower cost on the drug Aduhelm is one of the reasons for lower premiums. High income seniors will pay between $230.80 and $560.50 per month. CMS says about 7% of Medicare beneficiaries pay the high-income premiums for Part B. Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and other items. The Medicare Part A hospital insurance deductible will rise by $44 (2.8%) to $1,600. High-income people will also pay more for Part D drug insurance – between $12.20 and $76.40 extra per month. Released September 27, 2022.  See more Medicare cost news here 

MLR Rebates on Health Insurance – 2021 – 2022

How much are the expected rebates on health insurance, due to the MLR (medical loss ratio) in 2022?  Over 8 million people are expected to receive rebates in 2022, for the 2021 health insurance year. That’s because insurers spent less than 80% of premium dollars (or 85% for large group plans) on medical care and quality improvement over the prior 3-year average. When their charges prove to be too high as happened in 2019 and 2020, based on the 3-year MLR calculation, insurance companies are required to issue a rebate back to the consumer or company who paid the bill. The average rebate per member due this year is estimated at $128. However, this varies by type of insurance. Those in individual plans had an average rebate of $141. Small group member rebates are estimated at $155 and large group rebates just $78 per member. Overview published June 2022.

WI Group Health Insurance Rates for Small Employers Jan. 1, 2022

Compare 2022 group health insurance rates for small employers in Wisconsin. The Wisconsin Office of the Commissioner of Insurance (OCI) published the 2022 health insurance company premium rates for small employers (2 to 50 employees) for group health insurance policies. Companies were asked to provide rates for a sample Silver Plan (such as 80/20 with a $3,000 deductible), effective January 1, 2022. Many plans have increased their deductibles to be higher than $3000. Premiums varied by company and city. Examples shown apply to 50 year olds, 35 and 37-year olds. Anthem Blue Cross’ PPO silver plan for a 50 year old non-smoker required a $3,700 individual deductible with a premium cost that ranged from $745/month (Appleton) to $944 in Hudson, to $1,070 (Eau Claire) to $1,173 in Prairie du Chien. Dean Health Plan HMO silver plan with a $4,300 individual deductible was $409 in Madison (50-year old nonsmoker), but $706/month in Eau Claire.  WPS PPO premiums for an 80/20 plan with a $3,200 deductible were $703 (Green Bay) to $1,084 (Madison). United PPO ($3,500 deductible) was $810/month for a nonsmoking 50-year old in Milwaukee; Appleton rates were $776/month, up to $1,060/month in La Crosse. Group Health, Aspirus, Security, Humana, HealthPartners, Medica, Quartz and other insurance companies are listed.

Wisconsin Health Insurance Cost Rankings 2018

Annual premiums and deductibles (2018) for employee health insurance in various metro markets averaged $10,043 per year for single coverage. Citizen Action of Wisconsin, a coalition of individuals and organizations (such as AFSCME locals, AFL-CIO, WEAC, WI Farmers Union), reports health insurance cost in 18 metro regions, including Twin Cities. Rates in Eau Claire ($10,908 per yr, single) were 20% higher than Madison rates ($9,096 per yr.) Most areas exceeded $10,000 single. Health plan costs shown for Twin Cities, Oshkosh, Green Bay, Appleton, Manitowoc, Sheboygan, Fond du Lac, Janesville/Beloit, Wausau, Stevens Point, La Crosse, Superior, Eau Claire, Kenosha, Racine, Milwaukee, Dubuque, more. Uniform benefits package was used for all areas, however the report does not specify what type of benefits and deductibles were included. The report also does not indicate whether the rates were adjusted for regional differences in age, or healthy behaviors. Shows annual inflation pre-ACA (2000 to 2013) compared to after ACA (2014-2018), with post-ACA so very much lower. However, this summary can be misleading. In 2018, large group rates went down 5%, while individual inflation was up 51% (up 60% in Madison, doubled in Green Bay), and small group inflation was 10% compared to 2017. Large Group information reflects government employee rate paid by State of Wisconsin’s Group Health Insurance Program (GHIP). Published December 2017.

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