About this tool
This tool provides an easy way to compare health insurance quotes for individual health plans. Individual health insurance plans are policies you buy on your own, rather than through work. This tool shows plans that are offered through state and federal health insurance marketplaces. If you qualify for tax subsidies to lower your monthly payments, you must buy one of these plans to receive a subsidy.
When to buy health insurance
You can only sign up for health insurance during open enrollment. Open enrollment for 2018 health insurance marketplace plans is Nov. 1 to Dec. 15, 2017. Outside of that time window, the only way to buy individual health insurance is to qualify for a special enrollment period.
Why buy health insurance
The federal Affordable Care Act requires that all Americans (with few exceptions) buy health insurance, or be subject to a tax penalty. For 2018, that penalty could be 2.5% of your household income or more. If Congress changes or repeals the law, that could all change, but for now the ACA is in effect.
But also, having health insurance is the best way to protect your family from high medical bills. If someone in your family gets sick or is injured, hospital costs could quickly reach thousands — or hundreds of thousands — of dollars.
How to compare plans
Finding the right plan for you and your family is just as important as getting covered in the first place. You may have several plans to choose from, depending on where you live. To make comparing medical insurance plans easier, policies are grouped into metal tiers: bronze, silver, gold or platinum.
You can think of the metal tiers similarly to how you think of the actual metals. The tiers relate to value, so the more valuable the metal, the more richly it reimburses your medical expenses. Metal tiers are based on average medical expenses for a population, so your actual portion of costs may be different than the percentages below.
Within those tiers, the monthly premiums — how much you pay to have health insurance — should be relatively similar. The most popular health insurance marketplace plans are silver plans, with 71% of consumers choosing a silver plan.
What to look for in a health insurance plan
There’s more to comparing health insurance quotes than looking at premiums. Deductibles, copays and coinsurance might all be different, so you’ll want to take a close look at those out-of-pocket costs while you compare.
Look at the plan’s deductible — how much you must pay out of pocket before the plan starts to pay a portion of the costs. This will appear next to the premium of any plan you look at. If someone on the plan goes to the emergency room or needs a lot of health care services, you’ll likely have to pay that amount toward care in 2018. For an emergency room visit or expensive treatment, you could be charged the deductible all at once, so there is a risk if you choose a plan with a high deductible.
Pay special attention to prescription coverage if someone in your family relies on a prescription medication. If that drug is an expensive one, you may have to pay full cost for it until the deductible is met, and a coinsurance percentage after that. Ask yourself: Would it be a better deal to pay a higher monthly premium in exchange for a flat copay each time you need to refill at the pharmacy?
Check the plan’s provider network to make sure there are doctors and hospitals near you who take that plan. If you go out of the network to receive care, you might have to pay full price, whether you knew you went to a non-network provider or not. If you have a doctor you like, also make sure he or she accepts your medical insurance plan.
How much you pay when you go out of network and how many doctors are in your network will depend on which type of plan you get. Your plan type will also determine whether you need a referral from your primary doctor before you see a specialist. Here’s more about how to choose among HMO, PPO, POS or EPO health plans.
Health Insurance premiums have risen dramatically over the past decade. In the past, insurers would price your health insurance based on any number of factors, but after the Affordable Care Act, the number of variables that impact your health insurance costs have been reduced dramatically. We conducted a study to look at how health insurance premiums vary based on these characteristics. In our data we illustrate these differences by using an example 21 year old. Older consumers will see higher rates with 30 year olds paying 1.135 times more, 40 year olds paying 1.3 times more, 50 year olds paying 1.786x and 64 year olds paying 3 times the cost listed.
Average Cost Of Health Insurance
One of the primary factors in your health insurance costs depends on where you live. In this first table we look at health insurance premiums and how they differ based upon the state you reside in.
Average Health Insurance Premiums By Metal Tier
Health Insurance plans are separated into different metal tiers based on the proportion of health care costs the insurance plan is expected to cover. Bronze plans cover the smallest proportion, having the highest deductibles, copays and coinsurance. On the other end of the spectrum, Platinum plans offer the greatest amount coverage expected to cover 90% of all costs. The average rates paid for insurance plans are inversely related to the amount of coverage they provide, with platinum plans being the most expensive and bronze / catastrophic plans being the cheapest. The following table shows the average rates a 21 year old would pay for insurance based on plans in the different tiers. Older consumers would see their plans increase according to the age scale set by the federal guidelines.
Average Rates By Plan Type
Another distinction between plans that can change the rates you pay, is the type of network the plan uses. Depending on whether the plan is a PPO, HMO, EPO or POS plan, consumers will have access to the health care providers managed in different ways. HMOs tend to be the most restrictive about which doctors you can see and what you must do to see them. This usually means that the insurers save on your cost of care and thereby provide lower premiums.