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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, 2021 for coverage starting Jan. 1, 2022. This year, the federal exchange is open for an additional month (to Jan. 15, 2022) for coverage starting Feb. 1, 2022. 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. Editor’s Pick.

Average 2020 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 $7,149 in 2020. This was up 2.5% from the prior year MEPS data. Table I.C.1 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 $7,234 per month. Report on private-sector establishments, from the Medical Expenditure Panel Survey (MEPS) Insurance Component summary tables.

Average 2021 Premium on the Health Insurance Exchange (Feb. 2021)

On average, 2021 individual premiums were under $600 per month for a plan on last year’s health insurance exchanges, as of February 2021. Across all states, the average premium in February was $575 for the plans selected by individuals, about the same as in the prior year. About 86% of people received the Advance Premium Tax Credit (APTC) (which is based on income) to bring the net cost to individuals, down to about $89 per month. The difference (about $486 per month) is covered by the government (“Obamacare”). Average cost varied by state. Eleven (11) states (CO, MA, MD, MI, MN, ND, NH, NM, RI, UT, WA) had average monthly premiums under $500, before factoring in the APTC. Utah was the only state to have an average monthly premium under $400 before the tax credit. Highest average premium states were West Virginia at $1,036 ($204 per month, with premium tax credit), Wyoming at $865 ($47 with premium tax credit) and Louisiana at $741 per month ($113 with APTC). The national average premium of $574.59 per month works out to $6,895 premium cost per year. Source report from CMS, June 5, 2021, Early 2021 Effectuated Enrollment Snapshot.

Average Deductible and Co-Pay in Health Insurance: MEPS, 2019

Find the average health insurance deductible and co-pay in the MEPS Insurance Component 2019 Chartbook. The report shows that about 87% of employees had health insurance plans with an annual deductible. Average individual deductible was $1,931, but in small (under 50 employees) and medium size firms (50-99 employees) deductibles averaged about $2,400 (single). Family average deductible in US was up 8% to $3,655 in 2019. However, for the smallest companies, the average family deductible was $5,067. Average copayment for an office visit was $26.68. Average deductible and copays are also shown by state. Hawaii, for example, is unusual in that only 38% of employees are in a plan with a deductible. Large report and many charts showing trends since 2006. See Section 5 for employee cost-sharing, and scroll to the charts for a quick view. Data from the 2019 Medical Expenditure Panel Survey, Chartbook #24, published October 2020.

Average Health Insurance Cost, MEPS 2020, by State (KFF)

Find the average health insurance cost for each state in 2020. The Kaiser Family Foundation (KFF) shows average Single,  Family and Employee Plus One health insurance premiums and deductibles using MEPS data for 2020. For US employer coverage, the average Single premium cost was $7,149 ($596 per month), and the average Family premium cost was $20,758. Alabama had the lowest Single premium rates ($6,393), followed by Arkansas ($6,414). Alaska had the highest average single premium cost at $8,635. Family rates were lowest in Arkansas ($17,093 per year); highest in New Hampshire ($23,654, almost $2,000 per month).

Deductibles: Single deductibles averaged $1,945. Hawaii had the lowest single person deductibles again in 2020, averaging $1,346. Washington DC had an average $1,432 single deductible. These were the only two that had average deductibles under $1,500. The highest average deductible for a single plan topped $2,500 (Montana). Family deductibles averaged $3,722, ranging from $2,979 in Alabama, to $4,992 in Arizona.

Amounts paid by Employers: On average, employers paid 79% of the single premium cost, and paid 71% of the family premium. Employees paid the difference: 21% 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 2021.

Average Total Premiums and Employee Contribution, Selected Cities, 2020 Editor's Pick

The 2020 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 continue to exceed $8,000: Alaska, and parts of Connecticut, New York, New Hampshire and Vermont. Lowest single rate $6,184 was in out-state Utah. Average employee-plus-one premiums were over $11,000 across the US; just one exception was the Virginia Beach-Norfolk VA area, where premiums for employee-plus-one cost $10,509. The Alaska and New Hampshire metro area near Boston had employee-plus-one rates that topped $17,000. Family premiums were best in Birmingham-Hoover, Alabama at $16,408 per year. Family premiums were highest in parts of New Hampshire, nearing $26,000. Average Single contribution was under $2,000 in almost all parts of the US. Coverage levels and plan design will vary. Data from MEPS, the Medical Expenditure Panel Survey, Insurance Component.

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.

Federal Exchange Marketplace Average Rate Changes for 2022 (CMS)

CMS reported average rate changes in health insurance premiums for 2022 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 be reduced by 3%, on average, for the 2022 enrollment starting Nov. 1. According to CMS, the average benchmark silver plan premium for a 27 year old is expected to be $368 in 2022. The average benchmark plan (after the American Rescue Plan implementation) was estimated to be $379 per month in 2021. After subsidies, a 27 year old with income at 150% of federal poverty level (i.e., $19,320 per year) would pay $0 for the lowest cost silver plan in 2022. For the Family of Four example, the benchmark silver plan cost $1,440 per month on average. The lowest cost plan (probably a Bronze plan) will cost $1,061 per month for incomes at 250% of the federal poverty level ($66,250 household income). However, after qualifying subsidies, the family cost was just $3 per month.

The healthcare.gov exchange will open on November 1, 2021. Open enrollment closes January 15, 2022. However, if you want coverage to start January 1, 2022, you must enroll by December 15, 2021.

No information about average price hikes or reductions was presented for older consumers. Older enrollees pay more, but costs for older consumers in 2022 were not disclosed in the press release. Also not disclosed in the CMS press release, Oct. 25, 2021, is the size of deductibles. The report accompanying the news release is one of the most confusing written.

For reference, the average 2020 total monthly premium for Marketplace enrollees was $573, before Advance Premium Tax Credits and before adjustment credits due to the pandemic. This was down 3% from 2019. The average enrollee is older than 27 years of age. AARP noted that a 2019 Kaiser Family Foundation report found that a 60-year-old not eligible for subsidies paid $708 a month for the lowest-cost bronze plan and $943 a month for the lowest-cost silver plan.

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, 2021 for coverage starting Jan. 1, 2022. 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, 2020 Survey (Mercer)

Mercer’s annual National Survey of Employer-Sponsored Health Plans, estimates that the total health insurance benefit cost increased 3.4% in 2020, to an average of $13,674 per employee. However, size mattered. Large employers (500 employees and over) had an average increase of 1.9%, compared to almost 7% (6.9) for employers with 50 to 499 employees. A snapshot only is available free. Highlights of the survey were released October 2020.

Health Insurance MEPS 2019-2020

Health Insurance MEPS Chartbook #24  analyzes health insurance in 2019. Average total premium in 2019 was $6,972 for single; $13,989 for single plus one; and $20,486 for family coverage. Employees contributed 21.4% on average toward the single premium. Employee contributions rose to 28% for family coverage, with employers covering the rest of the cost. Average single deductible was $1,931, more than double the 2009 deductible. Chartbook examines employer offer rates and employee participation rates by industry sector. Detailed report shows trends back to 2006 and costs by state, as well as employer size. Medical Expenditure Panel Survey Insurance Component 2019 Chartbook (MEPS data) published October 2020

Health Insurance Premiums – 2021 Employer Health Benefits Survey – KFF Editor's Pick

KFF’s annual Employer Health Benefits survey for 2021 reports that premiums for employer-sponsored health insurance coverage rose 4% for families and 4% for singles. Average single coverage cost $7,739 per year ($1,299 paid by workers), and family coverage averaged $22,221 per year ($5,969 paid by employees). Monthly costs averaged $645 per month for single coverage and $1,852 per month for family. High deductible health plans (with savings option) have about 28% share of covered workers (down 3 points), but overall, 85% of workers had a deductible. PPOs were the most common type of plan, enrolling 46% of covered workers. The average single deductible was $1,669, up $25 from 2020. More than one in four covered workers (29%) had a deductible of at least $2,000. For small firms, the average single deductible was $2,379, although firms may make a contribution toward that cost. Average copays were $25 for a primary care visit, and $42 for a specialist. Survey of 1,686 nonfederal public and private companies with 3 or more employees completed Jan. to July, 2021. Findings released November 2021 by the Kaiser Family Foundation (KFF). Very detailed report

How much has health insurance cost increased up to 2020?

How much has health insurance cost increased up to 2020? According to a new government report of health insurance trends, the total Single premium went up 2.5% (from $6,972 to $7,149) for private company employees in 2020. See figure 6 for breakouts by small, medium and large employers. Employee-plus-one rates went up 1.4% to $14,191 on average (figure 7). Family rates went up 1.3% on average to a total premium cost of $20,758.  Figure 9 shows the average cost increase every year, since 2008. Trends in average deductibles are shown in figures 14 and 15. The average annual deductible for single employee coverage in a private company was $1,945 in 2020 (close to what it was in 2019). However, for medium size companies with 50-99 workers, the average deductible cost was $2,464. Other charts show how much employees contribute to the annual premiums. Statistical Brief #536 uses MEPS data (Medical Expenditure Panel Survey); published September 2021.

Individual Employee Annual Health Insurance Premium Cost – 2020

Average health insurance premium cost was $7,149 per year (about $596 per month) in 2020 for an individual employee. This was up about 2.5% 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 Hawaii at about $71 per month, and in Washington state, at about $95 per month. Employer contributions picked up the rest of the cost. Employees paid on average $158 per month in South Carolina, the highest contribution. Average single employee contribution in US was about $128 per mo. ($1,532 per year) or 21% of the total premium; employers paid 79% of single coverage premiums on average. Employers paid the most in Alaska and New York, where total premiums were over $8,000 for single employee coverage. 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 2019 health insurance cost in the public sector (all state and local government) market. The Medical Expenditure Panel Survey (MEPS) data tool identifies the nationwide 2019 average premium cost for public sector job-related health insurance at $8,202 for singles and $21,645 for family coverage. However, the employee contributions to the premiums were fairly modest if they worked for government employers: an average of $930 for Single coverage, and $4,048 for Family coverage in 2019. The average deductible in 2019 was $1,326 for a Single plan (compared to $1,931 in a private sector plan), and $2,557 for a Family plan through the government (vs. $3,655 private sector). Regional breakouts of government data are available. If using the PDFs, see Table III.C.I beginning on page 20 to view relevant public sector data. Updated 2021.

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 (2021)

Analysis by the American Hospital Association shows that Medicare and Medicaid under-pay the true cost of hospital care by about $76 billion. This cost ends up being borne by other payers and commercial insurance. Using 2019 data, it is estimated Medicare pays 87 cents on the dollar, and Medicaid pays 90. January 2021 report.

HSAs and HDHPs now enroll 21.8 million people – Jan. 2017 (AHIP)

HSAs and HDHPs enroll 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 have 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 still represent a majority (at least 59%) of HSA high deductible plan enrollments. AHIP is an association representing health insurance companies. Report released April 2018. Separately, research as of April 2021 by Devenir Research, indicates that more there are now 30 million HSA accounts covering 63 million people. The minimum deductible for a HDHP that qualifies for an HSA remains at $1,400 for 2021 and 2022.

Medicare Advantage Plans Part C Premium Costs for 2022 (CMS)

CMS announced that the average Medicare Advantage plan (Part C) premium cost will decrease again in 2022. CMS estimates the average monthly rate will be $19 per month (plus what you will pay directly to Medicare for Part B). The average premium in 2021 was about $21. Medicare Advantage plans may or may not include Part D drug coverage. More than 4 in 10 Medicare beneficiaries are already in Medicare Advantage plans. The Advantage plan enrollment has been increasing in recent years as people switch from traditional Medicare. Plans vary widely by state and region. Read very carefully. For many consumers, there will be a $0 monthly premium. However, in all plans, there will be copays, deductibles, and potentially large out of pocket maximums to consider. At the end of the press release are links to actual premiums by name of health plans in each state. Press Release issued September 30, 2021.

Medicare Part B Premiums and Part A Deductibles for 2022

CMS announced the standard Medicare Part B monthly premium will be $170.10 (up $21.60) in 2021 for most recipients ($2,041 per year), with a $233 deductible (up $30). Part B premiums are up 14.5% and the deductible is up by almost 15%. High income seniors will pay between $238.10 and $578.30 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 $72 (4.9%) to $1,556. Released Nov. 12, 2021.  See more Medicare cost news here 

MLR Rebates on Health Insurance – 2020 – 2021

How much are the rebates on health insurance, due to the MLR (medical loss ratio) in 2021?  Over 10 million people are expected to receive rebates in 2021, for the 2020 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, based on the 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 is $198. However, this varies by type of insurance. Those in individual plans had an average rebate of $299 or 5.6% of premium, as medical loss ratios were between 70% and 76% in each of the past 3 years. Small group member rebates were $127 and large group rebates just $95 per member. Overview published April 2021.

WI Group Health Insurance Rates for Small Employers Jan. 1, 2021

Compare 2021 group health insurance rates for small employers in Wisconsin. The Wisconsin Office of the Commissioner of Insurance (OCI) published the 2021 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 $3,200 deductible), effective January 1, 2021. 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 $3,250 individual deductible with a premium cost that ranged from $737/month (Appleton) to $1,126 in Hudson, to $1,277 (Eau Claire). Dean Health Plan HMO silver plan with a $4,300 individual deductible was $463 in Madison (50-year old nonsmoker), but $700/month in Eau Claire.  Similar WPS PPO premiums were $733 (Green Bay) to $1,130 (Madison). United PPO ($3,500 deductible) was $742/month for a nonsmoking 50-year old in Milwaukee; Appleton rates were $712/month, up to $972/month in La Crosse. Group Health, CompCare, Aspirus, Security, Humana, HealthPartners, Medica, Quartz and others 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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