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What Are the Costs of ACA Health Insurance?

December 11, 2023

What Are the Costs of ACA Health Insurance?

If you're looking for an Affordable Care Act (ACA) health insurance plan, you may be wondering about the costs of health insurance and the types of plans available. In this guide, we'll go over some of the factors that affect the cost of an insurance plan and how you can find the right insurer and policy for your healthcare needs.

Keep in mind that there is no "one size fits all" ACA plan. The plan you choose will depend on your health needs, your budget, and your provider preferences. A plan's cost will vary due to a number of factors. Keep reading to learn more about how much a health plan costs and how its cost is determined by an insurance company or marketplace.

Factors That Affect the Cost of ACA Health Insurance

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There are a lot of different factors that can affect the cost of your marketplace plan. Some factors that affect your monthly premium include the amount of health coverage that you choose, your household income, your location, age, number of dependents, and also your plan category. Learn more about these factors that affect cost:

  • Type of coverage: Some plans will have more coverage than others, and those with more coverage could potentially cost more.
  • Age: The costs of ACA health insurance will differ depending on age. For example, older adults may have to pay for insurance at a higher cost because they have more healthcare needs overall. Younger people are more likely to obtain a health plan at a lower cost.
  • Location: Location, state laws, and local rules can affect the cost of premiums. The cost of living in your area also affects the cost of insurance.
  • Number of dependents: If you're adding family members to your plan, then it will result in a higher cost.
  • Household income: You can obtain a premium subsidy based on your household's income. For example, if your household income is under the federal poverty level (FPL) for your number of household members, you may be eligible for lower premiums.
  • Plan category: Different plan categories vary in cost. There are several plan categories (bronze, silver, gold, and platinum). As an example, bronze plans have lower premiums and higher out-of-pocket costs.

Some state laws limit how much these factors can result in a higher premium. You'll also want to keep in mind that all ACA plans cover the same essential health benefits. Also, insurance companies can't charge different pricing based on gender. They also can't take into account any pre-existing conditions in order to increase your monthly premium.

Types of ACA Insurance Plans

Now that you're aware of the factors that affect the costs of ACA health insurance, you'll want to learn more about different insurance plans. There are several types of ACA insurance plans to choose from, including bronze, silver, gold, and platinum. The plans differ in the amount you'll pay for your monthly premium and the out-of-pocket costs you'll need to pay when you receive medical care. Check out the five plan categories and find out what differentiates each one.

Bronze

Bronze plans have the lowest premium. You pay 40% while the insurance company pays 60% of the cost of the service. This plan is a great way to protect yourself from worst-case scenarios or unexpected life events and works well for those who are generally healthy. You'll have to pay for most routine care yourself, and the amount of medical costs you pay yourself before your plan starts to pay can be thousands of dollars per year. Bronze plans start at $313 a month.

Silver

Silver plans constitute you paying 30% while the insurance company pays 70%. The cost of the monthly premium is moderate, meaning the costs you pay yourself before the plan pays for anything is typically lower than those of Bronze plans. Silver plans start at $410 a month.

If you qualify for cost-sharing reductions (CSR), you'll have to pick the Silver plan to get extra savings. A CSR is a discount that essentially lowers the amount you have to pay for deductibles, copayments, and coinsurance.

Gold

Gold plans typically have a higher monthly premium but lower costs when you need care. Comparing the costs of ACA health insurance, the deductibles for this are typically low. So, if you're willing to pay a higher health insurance rate every month to get more costs covered when you get medical treatment, then this plan may be of good value for you. Gold plans start at $450 a month.

Platinum

Platinum plans have the best monthly premium out of all the plan categories. But in return, you get the lowest possible costs when getting medical care. Deductibles are very low, so the plan starts paying its share a lot earlier than other categories. It's a great choice if you make frequent health visits. Platinum plans start at $500 a month.
 

Average Costs for ACA Plans

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Bronze and silver plans are the most common ACA plans. The average cost for an ACA health plan can be anywhere from $277 to $994 for an individual depending on their chosen category and health insurance coverage. Couples will typically spend anywhere from $730 to $1,900. Keep in mind that these numbers don't account for any premium tax credits or CSRs (Cost Sharing Reduction) that could potentially reduce plan costs if your household qualifies.

Cost-Sharing Reductions for and Premium Tax Credits

Cost-sharing reductions lower the amount you have to pay for copayments, deductibles, and coinsurance. These are often referred to as "extra savings." You can use a premium tax credit for a plan within any plan category. But if you qualify for extra savings, you'll need to enroll in a Silver plan specifically.

When you qualify for CSRs, you have a lower out-of-pocket maximum, which is the amount you pay for covered medical services annually. When you reach the maximum, your plan covers 100% of all covered health services

Qualifying for Cost Sharing Reductions and Premium Tax Credits

To qualify for lower costs of ACA health insurance, you must have U.S. citizenship or legal residency. You'll also need to have a household income of anywhere between 100% and 250% of the Federal Poverty Level (FPL). The lower limit is at around 139% in states that have expanded Medicaid eligibility. Medicaid typically covers individuals within low-income households well below the poverty guidelines.

Native American populations are also eligible for additional cost-sharing reductions to eliminate out-of-pocket costs altogether.

How To Find an ACA Health Insurance Plan

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Ready to find your ideal health care plan? We're here to help! You can visit our website and explore all the ACA marketplace health plans that are available in your area quickly and easily. Choose a plan depending on your needs and benefits preferences. You can call 1-800-314-5594 to speak to a licensed insurance agent. We're available weekdays from 8 a.m. to 8 p.m. ET, or you can compare health plans online to find affordable coverage!

In summary, the costs of coverage depend on factors such as household income, the insurance plan you choose, and your location. Taking the time to research, compare, and evaluate different options online can help you make an informed decision that ultimately benefits your health and your wallet!


It's crucial to understand the costs of ACA health insurance since it can significantly affect your budget and overall financial situation. Feel free to check out our Learning Center to find out more about choosing the right plan for you.

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