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Health insurance covers a portion of a policyholder’s medical care costs. The plan you enroll in determines how much your health insurance covers. The premiums you pay may cover the medical expenses related to experiencing illness or injury.
Employers often provide healthcare to employees, though Americans can also access healthcare benefits through the ACA marketplace or through state marketplaces.
Finding affordable health insurance helps you purchase the care you need without exceeding your budget. Several factors affect health insurance costs, so comparing health insurance quotes online can help you make informed decisions about your health plan.
Here’s what you need to know about comparing quotes, looking for a healthcare plan, and using simple strategies to reduce health insurance premiums.
Quick Facts
Americans pay $8,951 per year, on average, for health insurance coverage.[?]
The average monthly rate for ACA marketplace plans is $364 for bronze, $468 for silver, and $488 for a gold plan.
HMO plans typically don’t cover out-of-network care. PPO plans may, but you’ll have to pay an extra fee.
What are the different types of health insurance plans?
You have a few options when it comes to the type of health insurance plan you enroll in. Each type of plan operates with different rules for accessing out-of-network care. The average monthly costs listed below were calculated using yearly data from the Kaiser Family Foundation 2024 Employer Health Benefits Survey.
A health maintenance organization (HMO) plan covers care from doctors who work for or contract with an HMO — a type of insurance group with a network of doctors, healthcare providers, and hospitals. An HMO plan typically won’t cover out-of-network care, except in emergency situations. This type of plan costs $729 per month, on average.
A preferred provider organization (PPO) plan offers lower costs for care from doctors or hospitals in your network. If you want to access care outside your network, you’ll pay an additional cost but won’t need a referral. On average, this plan type costs $782 per month.
A point of service (POS) plan offers lower costs for care from doctors or hospitals in your network. You must get a referral to see an out-of-network specialist. Policyholders pay an average of $743 per month.
An exclusive provider organization (EPO) plan only covers services from doctors, specialists, and hospitals within the plan’s network, except in the event of an emergency. EPOs are much less common than PPOs and HMOs, so reliable information on the average cost of this plan type is unavailable.
How to compare health insurance plans
Different medical insurance plans offer different coverages, allow different out-of-network care, and come with different costs. Consider these factors when comparing health insurance plans:
Coverage: Plans differ in terms of provided coverages. For example, some cover prescription drugs, while others don’t. Look for mental health, vision, and dental coverage in your summary of benefits, as some plans don’t include them.
Provider networks: Policyholders can only access covered care from a specific network of providers and healthcare systems. Some plans might cover care from an out-of-network provider in emergency situations or if you receive a referral from your primary care doctor.
Premiums: Your monthly premium comprises the largest portion of your healthcare costs. These costs recur regularly and vary based on your plan’s deductible.
Deductibles: Your deductible determines how much you can expect to pay out of pocket before coverage kicks in. Some policyholders set a higher deductible to lower monthly premiums.
Copays and co-insurance: These other out-of-pocket costs vary from plan to plan.
Out-of-pocket maximums: This number refers to the maximum amount you can pay in a given coverage period, including deductibles, copays, and co-insurance. After you reach this maximum, insurance will cover all subsequent care in that coverage period.
How to compare health insurance quotes
Whether you receive a health plan from your employer or are looking for a plan on the Affordable Care Act (ACA) marketplace, online quote comparison helps you find the right plan at the right price. Here’s how to compare health insurance quotes in five steps:
How much does health insurance cost?
The ACA marketplace splits health plans into bronze, silver, gold, and platinum categories. These are the average monthly costs of plans from the three most common metal tier categories:[?]
Bronze: $364
Silver: $468
Gold: $488
Gold and platinum plans come with higher monthly premiums and lower deductibles, which results in fewer out-of-pocket expenses when you do need care. A bronze plan has a high deductible and a lower premium, making it a good option if you don’t need prescription medications or expect to visit the doctor often in a given coverage period.
“Factors that determine health insurance premiums depend on the type of plan,” says financial expert Laura Adams. “For instance, ACA-qualified coverage can only rate policyholders based on their location, age, family size, and tobacco use. They can’t use your health, medical history, or gender to price policies.”
Good to know
Employer-sponsored health insurance can vary widely depending on the type of plan and coverage levels an employer offers. Medical confidentiality rules prevent employers from sharing an employee’s health status or medical history with insurance companies.
How to reduce the cost of health insurance premiums
Health coverage costs can add up quickly, but here are some simple strategies that can help you reduce your health insurance premiums:
Look into ACA subsidies. Policyholders with annual income below a certain level can qualify for premium tax credits and other cost savings through the ACA marketplace.
Raise your deductible. If you raise your deductible, your monthly premiums will be lower. Choose a bronze plan on the ACA marketplace if you want lower monthly premiums but a higher deductible.
Pair your health savings account (HSA). An HSA is a special savings account where you can set aside money for medical expenses on a pre-tax basis. If you pair your HSA with a high-deductible healthcare plan, you’ll lower your premiums and pay your deductible with tax-free money out of your HSA.
Choose an HMO. An HMO tends to have lower monthly premiums compared to a PPO. Your health coverage will be limited to providers who work for or contract with your HMO.
Common pitfalls to avoid when shopping for health insurance
Choosing your next health insurance plan is a big decision. As you begin your search, be sure to avoid the following pitfalls:
Only comparing premiums: The premium you pay for your health insurance is an important consideration, but it isn’t the only one. Understanding the breadth of your coverage and the size of the provider network is important, too — as is your deductible amount. The best plan for your needs may not always be the one with the lowest premium.
Ignoring out-of-pocket costs: Out-of-pocket costs can have a considerable and unwelcome impact on your bottom line. That’s why it’s important to understand these costs ahead of time and budget for them before you need support from your healthcare plan.
Overlooking specific healthcare needs: The best plan for you matches your specific healthcare needs. Whether it’s covering the drug you need, having your primary doctor in network, or offering an affordable rate for rehabilitation services, find the plan that matches your needs.
Health insurance quotes FAQs
If you still have questions about comparing health insurance plans, check out the additional information below.
What is the cheapest health insurance plan?
HMO plans tend to be cheaper than PPO plans, though they offer less freedom to visit out-of-network providers.
What are the best health insurance companies?
The National Committee for Quality Assurance (NCQA), an independent nonprofit that evaluates health insurance companies, awarded the Kaiser Foundation Health Plan a 5-star rating in its 2024 Health Plan Ratings.[?] Blue Cross Blue Shield has also received high marks from the NCQA in previous rankings. The best insurer for you depends on your healthcare needs and life situation.
What is open enrollment?
Open enrollment refers to an enrollment period once a year, from the beginning of November to the middle of January, when anyone can enroll in an ACA healthcare plan. Certain qualifying life events — such as marriage or the birth of a baby — enable you to enroll in a new plan outside the annual open enrollment period.
Will ACA subsidies affect health insurance premiums?
ACA subsidies, including the premium tax credit, lower health insurance premiums for people whose household income level falls between 100% and 250% of the U.S. federal poverty level.
Should you choose a PPO instead of an HMO?
A PPO plan offers more flexibility with the providers you can visit, though they can be more expensive. If you prefer a cheaper alternative and don’t mind staying in your network, an HMO may be the best plan for you.
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