Want health insurance, but not sure how much it will cost you?
Whether you get your health plan through your employer or purchase it through the Marketplace, it may be more affordable than you think. If you’re considering shopping the Marketplace for an Affordable Care Act (ACA) plan, quality healthcare coverage is within reach and affordable.
In this article, we’ll discuss the average cost of healthcare, what determines the cost, marketplace subsidies and how to get health insurance.
How much does Marketplace ACA health insurance cost on average per month?
ACA health insurance plans cost an average of $477 a month, but subsidies make the cost much more affordable—most Inshura consumers have a net premium of $10 or less per month after subsidies.
In 2020, the average national cost for health insurance was $456 for an individual and $1,152 for a family per month without any subsidies. However, subsidies make the premiums much more affordable.
What determines the cost of health insurance?
To calculate the cost of an individual’s health insurance, it is necessary to consider different factors. These may include:
- The health insurance company
- The insurance buyer’s age
- The insurance buyer’s zip code and state of residence
- Usage of tobacco and other lifestyle factors
- Income bracket
- The community where the individual resides
- The insurance plan type
You can get a reliable estimate of your costs when you know a health plan’s premiums, deductibles, cost-sharing expenses and maximum out-of-pocket limits. With this information, you can also compare health insurance plans. Inshura offers expert knowledge in available health plans. They can help customers compare options to find the affordable health plan that meets their needs.
If you have health insurance benefits through your employer, your employer will cover a certain amount of your monthly premiums. You’ll contribute the remainder—typically 18% of the premium for single coverage and 29% of the premium for family coverage. According to the Kaiser Family Foundation, covered workers on average contribute $1,186 per year for single coverage and $5,547 per year for family coverage.
Marketplace subsidies and how they work
Most people are eligible for subsidies for Marketplace insurance. This means you will get additional savings that reduce your monthly premium amounts for your ACA plan.
There are two types of health insurance subsidies:
Premium tax credits help make Marketplace insurance more affordable. You can have this credit applied monthly to reduce your monthly premium costs. Or, you can opt to have this amount credited back to you at the end of the year in full when you complete your annual tax return. The amount a person receives in premium tax credits depends on their annual income and household size. You can use a premium tax credit for any metal-tier Marketplace plan.
Cost-sharing reductions are “extra savings” that apply only to those who enroll in a Silver-tier plan. These extra savings lower the amount a person has to pay for deductibles, copayments, and coinsurance. If you qualify for cost-sharing reductions, you’ll also have a lower out-of-pocket maximum.
Average annual deductible for a Marketplace plan
Metal levels on the Marketplace
In 2019, there was an average annual deductible of $6,258 for Bronze Marketplace plans. That same year saw average annual deductibles of $4,375 for Silver plans and $1,335 for Gold plans. Platinum plans had average annual deductibles of $48. Each of these are for plans that had combined medical and prescription drug deductibles.
The average annual medical deductibles for plans with separate medical and prescription drug deductibles in 2019 were $5,977 for a Bronze plan, $4,043 for a Silver plan, $1,581 for a Gold plan and $365 for a Platinum plan.
Combined medical and prescription drug deductible-plans also had these annual out-of-pocket maximums in 2019: $7,374 for Bronze plans, $5,885 for Silver plans, $2,200 for Gold plans, and $1073 for Platinum plans.
All Marketplace plans are grouped into one of four of these metal tiers: Bronze, Silver, Gold and Platinum. Plans are assigned to these groups based on what’s known as their “actuarial value.” A plan’s “actuarial value” describes the average amount that it covers for healthcare for its enrollees.
For Silver plans, the actuarial value is 70%. The actuarial value for Gold plans is 80% and for Platinum plans is 90%. In simplest terms, the higher the actuarial value, the higher your monthly premiums will be. But keep in mind that the value of a plan isn’t only based on its premium amounts. Should you find yourself needing lots of medical care in a given medical year, higher premium plans will yield more cost-savings. This is because your plan will pay out and cover more of your healthcare costs.
Is there a penalty for not having health insurance?
As of Jan. 1, 2019, there is no longer any penalty for not having health insurance. This means you won’t need to qualify for an exemption to not have to pay a penalty fee when you pay your federal taxes at the end of the year if you don’t have health insurance.
However, Massachusetts, New Jersey, and Washington, D.C. maintain their own individual mandates. This means that if you decide not to enroll in coverage and live in one of these places, you may still owe a penalty fee when you file your taxes at the close of the year.
Getting an ACA health insurance plan
When you shop the Marketplace through Inshura.com, you’ll have the ability to instantly see if you qualify for savings. These subsidies and cost-savings measures help make Obamacare affordable and accessible for Americans looking for quality healthcare, regardless of the status of any employer-provided benefits.
Inshura is a FREE online ACA insurance tool, perfect for agents and agencies! Agents can boost their ACA and other enrollments using this easy-to-use solution for quoting, enrolling, automating renewals, and managing clients!
And inshura is CMS EDE PHASE III certified, so it automatically exchanges data directly from the Marketplace.