Affordable Health Insurance Near Me - How much does health insurance cost? In the United States, Americans pay very different monthly premiums for health insurance. Although these premiums are not determined by gender or health conditions covered by the Affordable Care Act, several other factors affect how much you pay. We explore the factors below to help you understand how much you can afford to pay in health insurance and why.
Many factors that affect how much you pay for health insurance are out of your control. However, it's good to know what they are. Here are the top 10 factors that affect health insurance premiums.
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Employer-provided coverage contributes to some of the biggest factors that determine how much your insurance will cost and how comprehensive it is. Let's take a closer look.
Group Health Insurance Cost Affordable Insurance
If you work for a large company, health insurance can cost as much as a new car, according to the 2020 Employer Health Benefits Survey from the Kaiser Family Foundation. Kaiser found the average annual premium for home coverage to be $21,342 in 2020, about the same as the base manufacturer's suggested retail price for the 2022 Honda Civic at $22,715.
Workers contributed an average of $5,588 in costs each year, meaning employers received 73% of premium payments. The average premium for a worker in 2020 is $7,470. Of this, workers paid $1,243, or 17%.
Kaiser included health maintenance organizations (HMOs), PPOs, point-of-service (PPO) plans, and high-deductible health plans with savings options (HDHP/SO). ) to obtain average premium rates. It found that PPOs were the most common type of plan, covering 47% of employees. HDHP/SO covers 31% of employees participating in health insurance.
Of course, what employers spend on health insurance for workers leaves less money in wages and salaries. So workers are actually getting more premiums than these numbers suggest. In fact, one reason wages may not have risen significantly over the past two decades is that health care costs have risen so much.
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Also, because employees pay health insurance premiums with pre-tax dollars, their burden may be lower than those who purchase insurance on their own through the federal health insurance marketplace or insurance exchange. (For the purposes of this article, "market" and "exchange" are synonymous.)
The type of plan an employee chooses will affect their premiums, deductibles, health care provider and hospital choices, and whether they can have a Health Savings Account (HSA). No, among many options.
For families where both spouses have employer-provided health insurance, it's important to compare carefully—one plan may be much better than the other. Partners with an unused plan can use the portion of their salary that is not withheld for health insurance. Or a childless couple may decide to each individually choose their own company's plan (couples insurance rarely includes any kind of discount—mostly, a copay, which just doubles the individual rate).
The federal insurance plan marketplace HealthCare.gov, aka Obamacare, is still going strong in 2021, despite years of political opponents trying to kill it. It offers plans from about 175 companies. About 12 states and the District of Columbia run their own health exchanges, which essentially mirror the federal website but focus on plans for their residents. People in these areas apply to them through the state, not the federal, exchange.
How Much Does Health Insurance Cost? Price Factors
Each available plan offers four levels of coverage, each with its own price. From highest to lowest in price, they are labeled platinum, gold, silver, and bronze. The standard plan is the second lowest cost silver plan available through the health insurance exchange in a certain area, and it may even vary by state where you live. It's called a benchmark plan because it's the plan the government uses—along with your income—to determine your premium subsidy, if any.
The good news is that prices are coming down a bit. According to the Centers for Medicare & Medicaid Services (CMS), the average premium for the second-lowest-cost silver plan on HealthCare.gov fell 4% from 2019 to 2020 for a 27-year-old. Six states experienced double-digit percentage drops in the second-lowest silver plan premiums for 27-year-olds, including Delaware (20%), Nebraska (15%), North Dakota (15%), Montana (14%). Oklahoma (14%) and Utah (10%).
And between 2020 and 2021, the second-lowest-priced silver package is down 3% on average at 27 years old. Four states (Iowa, Maine, New Hampshire and Wyoming) had average standard plan premiums increase by 10% or more.
The US Savings Plan Act of 2021 also establishes a Special Enrollment Period (SEP) for market-based programs from February 15 to July 31, 2021. For new customers who chose to choose plans through HealthCare.gov during that time, the plan's average monthly premium dropped by 27%. %, from $117 to $85, thanks to extended benefits. It also helps reduce out-of-pocket costs: the deductible drops by nearly 90%, from $450 to $50.
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However, it's not all good news. For more information, we consulted CMS's 2020 Health Exchange Premium Review Issue Summary. It turns out that 27-year-olds who bought silver plans saw their premiums increase by 10% or more in Indiana, Louisiana and New Jersey.
More importantly, he found that the percentage change doesn't tell us much about what people are actually paying: "Some states with the biggest reductions still have relatively high premiums, and vice versa," the summary said. For example, while Nebraska's standard plan premium decreased 15% from PY19 [plan year 2019] to PY20, the PY20 standard plan premium for a 27-year-old is $583. Indiana's premium PY20 benchmark, on the other hand. There is a 13% increase compared to PY19, the average PY20 premium for 27-year-olds is $314.
In 2021, this trend continues. The 2021 edition of the CMS Summary notes that, for example, while Wyoming's average standard plan premium declines 10% from PY20 to PY21, the average PY21 standard plan premium for 27-year-olds is $648—the highest in the United States. Can one-year-old children afford such a monthly premium? By contrast, New Hampshire's standard plan premium for 27-year-olds is the lowest in the nation at $273.
All of these numbers apply to just the 36 states whose residents buy plans through the federal exchange on HealthCare.gov. Residents of California, Colorado, Connecticut, Idaho, Maryland, Massachusetts, Minnesota, Nevada, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Washington, DC. Buy insurance through their state exchange.
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The good news is that many people who buy Marketplace plans will pay lower premiums with what the government calls the Enhanced Premium Tax Credit, also known as a subsidy. In 2019, 88% of HealthCare.gov enrollees were eligible for the Enhanced Premium Tax Credit.
What are these grants? These are credits that the government applies to your health insurance premiums each month to make them affordable. Essentially, the government pays part of your premium directly to your health insurance company, and you are responsible for the rest.
As part of the American Rescue Plan Act (ARPA) passed in March 2021, benefits were increased for low-income Americans and extended to high-income earners. ARPA expanded the market subsidy above 400% of the poverty level and increased subsidies for those earning between 100% and 400% of the poverty level.
You can claim your advance premium tax credit in three ways: in equal amounts every month; More in some months and less in others, which is useful if your income is irregular; Or as a credit against your income tax liability when you file your annual tax return, which may mean you owe less tax or get more back. The tax credit is designed to make the premium affordable depending on your family size and income.
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Your credit is based on your estimated income during the year, so if your income or family size changes during the year, you should immediately update your information on HealthCare.gov so your premium credits can be adjusted accordingly. That way, you won't have an unpleasant surprise at tax time, nor will you have to pay more premiums than you need to throughout the year.
In addition to the premium, everyone who has health insurance must pay a deductible. This means that you pay 100% of your medical expenses until you pay a pre-determined amount. At that point, repayment begins and you pay a percentage of your account, the insurance company collects the rest. Most workers are covered by the annual general deductible, which means that the deductible applies to most or all health care services. Here's how general deductions change in 2020:
Individuals who qualify for reduced cost-sharing (a type of federal benefit that reduces health care costs, such as deductibles and co-pays) are responsible for the deductible. Up to $115 for those with immediate federal family. income. poverty level.
If you miss an annual enrollment period and you don't have one of the reasons to qualify for a SEP, you may have to buy a short-term health plan that lasts from three months to 364 days. Because these plans cost an average of 54% less than exchange plans, according to the Kaiser Family Foundation, you might as well decide
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