Health Insurance

Health Insurance Marketplace Prices

Health insurance marketplace costs vary by plan type, location and other factors. You can use eHealth’s free online comparison tool to find the best health plans in your area.

The cost of a plan’s monthly premium and the deductible you pay when you use services are major parts of overall healthcare marketplace prices. Other factors include medical trend (increases in the prices paid by insurers for health services and medications) and broader economic inflation.

Age

While the cost of health coverage is typically based on age, older consumers pay rates that are often three times higher than those of their younger counterparts. This is due to the fact that many plans have a premium multiplier that scales up as people get older, with the highest rates paid by individuals aged 60 and over.

Growth in prices for health care services and medications (referred to as “medical trend”) was a significant driver of premium changes in 2024. This was driven by a mix of factors including increased utilization from the pandemic and general price inflation that accelerated during the year.

Across the 320 ACA Marketplace participating insurers for which we have detailed filings, median proposed premium changes fell between 2% and 10%.

Pregnancy

Pregnancy is considered a pre-existing condition under the Affordable Care Act (ACA). Because of this, you can’t be denied or charged more money for coverage. Pregnancy also counts as one of the ten essential health benefits and must be covered by all marketplace plans and employer-sponsored plans.

If you don’t have insurance through an employer or a marketplace plan, you can sign up during the open enrollment period or during a special enrollment period. You can also apply for Medicaid or the Children’s Health Insurance Program if you meet the income requirements in your state.

The best health insurance for pregnancy will depend on your financial situation and needs. You can get the cheapest rates by choosing a plan with a high deductible, which will keep your monthly premium low.

Smoking

Smokers must pay a higher premium for health insurance, although the amount varies by state. Some states also limit the number of metal tiers on the marketplace for smokers, which can increase costs even further.

People start smoking for a variety of reasons. For some it is about rebellion, and for others it has to do with social status or the need for a calming ritual. Whatever the motivation, most smokers begin during adolescence or early adulthood.

The ACA allows insurers to charge smokers up to 50% more for their premium than non-smokers. However, many “smoker-friendly” carriers do not impose a surcharge at all. Some smokers are tempted to lie about their smoking in order to avoid paying the hefty surcharge, but doing so is considered fraud and can result in penalties.

Health History

ACA marketplace plans are based on your age, whether you’re in a special enrollment period because of a life event, and how much income you make. To estimate your cost, simply enter your zip code and answer a few quick questions.

In 2024, most insurers are requesting modest premium increases. Growth in health prices – called medical trend – and utilization are driving these increases.

Early forms of healthcare included sickness funds, which were arranged by fraternal organizations and employers, and workers’ compensation. American physicians, guided by the AMA, opposed “compulsory nationalized healthcare.” They were concerned that any system would impact their ability to set reasonable fees for their services. That’s why they formed their own association: Blue Shield. This arrangement proved very successful.

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