If you're currently uninsured and looking to avoid being uninsured, you may be wondering about the cost of health insurance. Whether you get your health plan through your employer or purchase it through the Marketplace, it's likely more affordable than you think. If you're considering shopping the Marketplace for an Obamacare plan, you can find quality and affordable healthcare coverage. Thanks to the Affordable Care Act (ACA), there are a number of cost-saving measures in place.
On average, ACA health insurance plans cost $477 per month. However, subsidies make the cost much more affordable. Most Quality Health consumers end up with a net premium of $10 or less per month after subsidies. Without subsidies, the average monthly premium for a single person was $440 in 2018. For a family, the average monthly premium was $1,168. However, with subsidies, the premiums become much more manageable. On Quality Health, the median net premium was under $8 per month, and 97% of users received a subsidy.
The cost of health insurance depends on various factors. If you have health insurance benefits through your employer, they will cover a certain percentage of your monthly premiums, and you'll contribute the remaining amount. Typically, for single coverage, you contribute around 18% of the premium, and for family coverage, it's around 29%. The average contributions for covered workers in 2019 were $1,186 per year for single coverage and $5,547 per year for family coverage. For those purchasing insurance through the Marketplace, the average monthly premium was $477 in 2019. However, 87% of people enrolling through the federal Marketplace received a subsidy, making the actual cost much lower. The average subsidy in 2018 was $550.
Marketplace subsidies help make insurance more affordable. There are two types of subsidies: premium tax credits and cost-sharing reductions. Premium tax credits can be applied monthly to reduce your premium costs or credited back to you at the end of the year. The amount you receive depends on your annual income and household size. Cost-sharing reductions are additional savings that apply only to those who choose a Silver-tier plan. These savings lower the amount you have to pay for deductibles, copayments, and coinsurance. In 2019, Quality Health users paid an average gross premium of $818 per month but received an average subsidy of $724, resulting in an average monthly payment of $30. Nearly 1 in 5 consumers paid nothing for their health coverage after subsidies, and 1 in 4 had a net premium of $10 or less per month. Half of all Quality Health consumers had a net premium of $50 or less per month after subsidies.
The average annual deductibles for Marketplace plans vary by metal tier. For Bronze plans, the average annual deductible was $6,258 in 2019. Silver plans had an average deductible of $4,375, Gold plans had $1,335, and Platinum plans had $48. These figures are for plans with combined medical and prescription drug deductibles. If you're looking to get health insurance, there are specific enrollment periods.
The Open Enrollment period is a six-week window from November 1 to January 15 each year when almost all Americans can buy ACA-compliant health insurance through the Marketplace for the following year. If you missed the Open Enrollment period, you may still have options. You may qualify for a Special Enrollment Period (SEP) if you've experienced a Qualifying Life Event (QLE). Some examples of QLEs include getting married, getting divorced, having a baby, losing a job, or moving to a new county or state. The SEP lasts for 60 days from the date of your QLE. Depending on your income level, you or your dependents may qualify for Medicaid or CHIP. Medicaid is a federal insurance program that provides health insurance to low-income Americans. You can apply for Medicaid or CHIP at any time during the year, and if you qualify, your coverage will start immediately.
As of Jan. 1, 2019, there is no longer a penalty for not having health insurance, except in Massachusetts, New Jersey, and Washington, D.C., which have their own individual mandates.
To get an ACA health insurance plan, you can shop through Quality Health. When shopping the Marketplace, you'll be able to instantly see if you qualify for savings and subsidies, making health insurance more affordable and accessible, regardless of your employer-provided benefits.