Healthcare has been one of the biggest talking points in politics over the past several decades. Health costs and the ability of the average person to afford them have been at the forefront of many presidential and Congressional debates -- from arguments for and against the Affordable Care Act (ACA) to the rise in insurance premiums to a growing support for a Medicare for All plan.
Many factors determine health insurance rates and premiums and what's offered. An individual seeking healthcare may have options provided by an employer or may get health insurance through the ACA. Depending on a person's income and health, he may have several options to choose from or may only be able to qualify for certain plans.
With this in mind, what is the average health insurance cost?
Average Health Insurance Costs
With so many different variables impacting how much health insurance will cost a person on a monthly or yearly basis, we're better off breaking things down instead of giving one general number.
So what are some of the biggest factors in determining how health insurance costs can vary? Certainly the type of plan someone has and the tier of plan she has go a long way. Medical history -- not to mention whether the person is a smoker -- can play a role in whether insurers give a higher rate. Someone in need of insurance for a family is going to have a higher premium than someone seeking an individual plan.
Two factors that can also play a large role in healthcare rates and premiums is how old someone is and where he lives.
Average Health Insurance Cost by Age
Age plays a big role in the cost of a premium for health insurance; generally, younger people have lower premiums, as they are seen as less risky and less likely to require more medical care.
Often, the starting point for an insurance rate is based on that of an individual who is 21 years old. According to ValuePenguin, as of 2019 the average health insurance premium for a 21 year old was $200 per month. This is also an average for a Silver insurance plan -- below Gold and Platinum plans, but above Bronze plans.
How does the breakdown of premiums by age look? Slowly in small increments, the average premium will increase. Ages 21-24 were all consistent at $200, but at 25 the premium goes up to $201 -- about 1.004 x $200.
Slowly the amount it goes up increases. At 26 the average premium is 1.024 times the base premium, up to $205. By the age of 30, though, it has gone up for an average premium to $227, or 1.135 x $200.
Going through the list of ages, this pattern is pretty consistent. The average premium for a policyholder at 35 years is $244, 1.222 times the base rate; at 40, it's 1.278 times that rate to bring the average premium up to $256.
From here, though, the premiums start going up at higher rates. The average health insurance premium for a policyholder at 45 is $289, up to 1.444 times the base rate, and by 50, it's all the way up to $357, which comes out to 1.786 x $200.
After age 50, premiums rise tremendously. At age 53 the average premium is more than double the base rate, and by 55 the average premium is $446. At age 60, the average premium is $543. If a person is 64 years old, the average health insurance premium is $600 - 3 full times what it is at 21.
It is also important to note that while this is a general guideline, prices vary dramatically from state to state. Some states, like New York, don't factor age into premiums at all.
Average Health Insurance Cost by State
Residents of different states can see some pretty stark differences in the average cost of health insurance. Which states have the highest premiums, and which ones have the lowest?
Using ValuePenguin data on certain states, the state with the highest monthly rates is Alaska at $426 for a 21 year old. Multiplying for someone who is 30, that becomes $483.51. It becomes $544.43. for a 40 year old, and a whopping $1,156.16 for a 60 year old. The second-highest rate is in Wyoming at $366. Doing that math again, for those who are 30, 40 and 60 that figure turns into $415.41, $467.75 and $993.32, respectively.
These are particularly extreme examples, but even states that aren't quite as high compared to the average rates can have monthly premiums not everyone can afford. The average health insurance premium for a 21-year-old in Florida is $285; not as large as Alaska or Wyoming, but still a lot, especially as a person gets older (for someone who is 60, the rate is $773.49).
Still, there are states where premiums aren't as expensive as these. Utah, for example, has an average cost of $180. While $180 can still be quite a lot of money per month for someone working in Utah at 21 (or $488.52 at 60), it is still a lesser figure than other states. In Montana, the average health care premium for someone at 21 is $210 per month. Check your state for more details, because the range of premiums can vary even more wildly than you may expect. ValuePenguin's list did not include every state, such as Massachusetts.
Average Health Insurance Cost by Plan
Less surprising, though, is how the cost will differ based on the plan you use. After all, different plans offer different services, and those with more services and flexibility come at the price of a higher premium.
The four types of plans you may be able to get for your health insurance are a health maintenance organization (HMO), point-of-service (POS), preferred provider organization (PPO) and exclusive provider organization (EPO). Per ValuePenguin, the average monthly rate for a 21-year-old on each plan is:
- HMO: $230
- POS: $244
- PPO: $251
- EPO: $254
Average Health Insurance Cost by Plan Tier
In addition to the different sorts of health plans, the offerings tend to get divided even further into "metal" tiers, as well as a lower "catastrophic" tier. These metal tiers -- Bronze, Silver, Gold and Platinum -- all offer progressively more coverage for medical care, and that results in progressively higher premiums for each tier.
For a policyholder 21 years of age, the average monthly premiums by tier are:
- Catastrophic: $167
- Bronze: $201
- Silver: $247
- Gold: $291
- Platinum: $363