Most expensive and least expensive states for individual insurance

At $477 a month for a benchmark plan, 2024 ACA plan costs are up $21 on average from the 2023 average of $456.

Vermont remains the most expensive state for a benchmark plan in 2024. Alaska climbed from fourth place to second place for 2024 at $889 a year, while last year's second most expensive state, West Virginia, dropped down a place to third.

5 most expensive states for ACA plans

  • Vermont - $841
  • Alaska - $889
  • West Virginia - $847
  • Wyoming - $821
  • New York - $736

5 cheapest states for ACA plans

  • New Hampshire - $335
  • Minnesota - $343
  • Maryland - $346
  • Virginia - $371
  • Michigan - $381

Here are the average monthly premiums for the ACA benchmark plans in 2024 by state compared to 2023.

Average monthly premiums
State20232024
Alabama$567$564
Alaska$762$889
Arizona$410$403
Arkansas$416$424
California$432$469
Colorado$380$451
Connecticut$627$661
Delaware$549$533
District of Columbia$428$532
Florida$471$489
Georgia$413$463
Hawaii$469$468
Idaho$425$417
Illinois$453$473
Indiana$397$399
Iowa$484$451
Kansas$471$486
Kentucky$422$431
Louisiana$565$563
Maine$457$515
Maryland$336$346
Massachusetts$417$419
Michigan$362$381
Minnesota$335$343
Mississippi$461$485
Missouri$473$501
Montana$477$504
Nebraska$550$570
Nevada$386$387
New Hampshire$323$335
New Jersey$441$461
New Mexico$445$471
New York$627$736
North Carolina$512$495
North Dakota$475$486
Ohio$413$435
Oklahoma$510$508
Oregon$462$488
Pennsylvania$433$445
Rhode Island$379$400
South Carolina$496$492
South Dakota$626$616
Tennessee$473$501
Texas$461$475
Utah$471$507
Vermont$841$950
Virginia$371$371
Washington$395$415
West Virginia$824$847
Wisconsin$456$476
Wyoming$802$821

What contributes to premiums?

Many factors go into average premiums. Competition and the health of a state’s people are two factors.

More competition helps bring down rates as insurers battle for customers. Plus, spreading members across more insurance companies means they’re also balancing the sickest members. Not having to cover more high-cost members allows insurers to keep down rates.

Overall inflation and fallout from the pandemic continue to affect the cost of health insurance, and with the end of pandemic-era rules regarding Medicaid, more people will be seeking coverage in the marketplace.

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COBRA

Consolidated Omnibus Budget Reconciliation Act
People who lose their employer-sponsored health insurance may qualify for a COBRA plan. COBRA lets you keep your former employer's health plan, but you're responsible for paying all of the costs, including your former employer's portion.
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Medicare

People who are 65 and over qualify for Medicare. You can choose Original Medicare (also called Parts A and B), which is offered by the federal government, or Medicare Advantage (also called Part C), which private insurers provide. The average annual premium for Original Medicare is about $1,600. Medicare Advantage's average yearly premium is $336, but you may have higher out-of-pocket costs than Original Medicare.
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Medicaid

Low-income Americans qualify for Medicaid. Thirty-eight states expanded Medicaid eligibility, so lower-middle-class Americans may also be eligible in those states. Medicaid offers comprehensive benefits, but at little to no cost depending on your income. Each state has its own eligibility. Some states are flexible with Medicaid eligibility for people who are pregnant, a parent or disabled. If your household income is below 138% of the federal poverty level, you're likely eligible for Medicaid if you live in a Medicaid expansion state. That level is $17,609 for an individual, $23,791 for a family of two, $29,974 for a family of three and $36,156 for a family of four. Non-Medicare expansion states have stricter income guidelines. Check with your state's Medicaid program to see if you qualify.
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Parent's employer-based health insurance

The Affordable Care Act lets children stay on a parent's health plan until the age of 26. Having a child on a parent's health plan may or may not increase premiums. It depends on whether you already have family coverage when adding the child to the plan. If a parent already has family coverage, adding a child won't likely increase premiums. However, going from single or couple to family coverage could cause premiums to skyrocket. The average single coverage employer-sponsored plan premium is $1,186. The average family plan is $5,447.
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Spouse's employer-based health insurance

Most employers allow employees to add spouses to their health insurance. Going from single health coverage to a family plan may triple or quadruple your premiums. The average single coverage employer-sponsored plan premium is $1,186. The average family plan is $5,447. Not all jobs allow for spouse's coverage, so you'll want to check with your employer to make sure it's an option.
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Employer-based health insurance

Most people with private health insurance get their coverage through a job. employer-sponsored health insurance is usually cheaper than individual health insurance unless you qualify for Affordable Care Act subsidies. Job-based plans are generally less expensive because businesses often pick up more than half of employer-sponsored health insurance premiums. Kaiser Family Foundation estimates the average premiums for a single coverage employer-sponsored health plan is $1,186 and the average family plan is $5,447 annually.
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Employer plans are often one of these types of four plans. Click on each one to find out more.
  • PPO
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Preferred-provider Organization (PPOs)

  • Pay higher premiums with a lower deductible
  • You have access to more providers, but pay much more for health insurance
  • You don't want to choose a primary care physician
  • You don't want to get a referral
  • You want the ability to get out-of-network care
Preferred-provider organization (PPOs) plans are the most common type of employer-based health plan. PPOs have higher premiums than HMOs and HDHPs, but those added costs offer you flexibility. A PPO allows you to get care anywhere and without primary care provider referrals. You may have to pay more to get out-of-network care, but a PPO will pick up a portion of the costs.
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Health maintenance organization (HMO)

  • Pay higher premiums with a lower deductible
  • Restricted network of providers with lower premiums
  • You want to choose a primary care physician
  • You don't mind getting a referral
  • You don't care about the ability to get out-of-network care
Health maintenance organization (HMO) plans have lower premiums than PPOs. However, HMOs have more restrictions. HMOs don't allow you to get care outside of your provider network. If you get out-of-network care, you'll likely have to pay for all of it. HMOs also require you to get primary care provider referrals to see specialists.
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High-deductible health plans (HDHPs)

  • Pay lower premiums with a higher deductible
High-deductible health plans (HDHPs) have become more common as employers look to reduce their health costs. HDHPs have lower premiums than PPOs and HMOs, but much higher deductibles. A deductible is what you have to pay for health care services before your health plan chips in money. Once you reach your deductible, the health plan pays a portion and you pay your share, which is called coinsurance.
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Exclusive provider organization (EPO)

  • Restricted network of providers with lower premiums
  • You don't want to choose a primary care physician
  • You don't want to get a referral
  • You don't care about the ability to get out-of-network care
Exclusive provider organization (EPO) plans offer the flexibility of a PPO with the restricted network found in an HMO. EPOs don't require that members get a referral to see a specialist. In that way, it's similar to a PPO. However, an EPO requires in-network care, which is like an HMO.
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Individual insurance/Affordable Care Act
The Affordable Care Act created insurance exchanges that allow people to compare plans. The health law also requires insurers to accept everyone and not charge them exorbitant rates. People who make below 400% of the federal poverty level qualify for subsidies to help pay for an ACA plan.
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Individual insurance/Affordable Care Act
The Affordable Care Act created insurance exchanges that allow people to compare plans. The health law also requires insurers to accept everyone and not charge them exorbitant rates. People who make below 400% of the federal poverty level qualify for subsidies to help pay for an ACA plan.
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People who would prefer to pay lower premiums with a higher deductible may want the below plans
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Silver is the second most popular plan in the ACA exchanges, with 35% of people with a Silver plan. Silver has lower premiums than any plan except for Bronze. However, it has lower out-of-pocket costs than Bronze. Silver plans pick up 70% of the costs, while members pay 30% The average single coverage in a Silver plan is $481 monthly and $1,179 for a family plan.

Bronze is the most popular type of plan in the ACA exchanges, with 41% of members with a Bronze plan. These plans have the lowest premiums, but also the highest out-of-pocket costs in the exchanges. Bronze plans pick up 60% of the costs, while members pay 40%. The average single coverage monthly cost in a Bronze plan is $440 and $1,080 for a family plan.

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Individual insurance/Affordable Care Act
The Affordable Care Act created insurance exchanges that allow people to compare plans. The health law also requires insurers to accept everyone and not charge them exorbitant rates. People who make below 400% of the federal poverty level qualify for subsidies to help pay for an ACA plan.
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People who would prefer to pay higher premiums with a lower deductible may want the below plans
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Platinum plans have the highest premiums but the lowest out-of-pocket costs. So, you pay more for the coverage initially but less than other plans when you need health care services. Platinum plans pick up 90% of the costs, while members pay 10%, Not many health insurers offer Platinum plans. Only 2% of members in ACA plans have a Platinum plan, so you may have trouble finding one. The average monthly premiums for single coverage in a Platinum plan is $706 and the average family coverage costs $1,460.

Gold plans have lower premiums than Platinum, but higher premiums than Silver and Bronze. Gold also has lower out-of-pocket costs than Silver and Bronze, but higher than Platinum. Gold plans pick up 80% of the costs, while members pay 20%. The average monthly premium for a single Gold plan is $596. Family coverage averages $1,426 per month.

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Health insurance options beyond the health insurance exchanges

For many people, ACA marketplace plans are the easiest and cheapest way to get coverage, especially those that qualify for subsidies. However, if you qualify for other health plans, there might be a cheaper option, and it might even offer better coverage.

Your employer or your spouse’s employer

Employer-sponsored health insurance remains the most common way Americans get coverage. It’s usually cheaper than getting individual insurance or family coverage from the exchanges.

If both you and your spouse have insurance options, compare each plan to see which one is best for you. Make sure to check that your doctors and physicians are part of the network.

Also, remember that children can stay on their parents’ health insurance until the age of 26, so you’ll want to take into account their health needs when making a decision.

A government health insurance plan

If you qualify, public plans like Medicare, Medicaid and the Children's Health Insurance Program (CHIP) are more inexpensive ways to get covered.

Medicare is usually for people 65 and older. It’s also for people with a disability or with end-stage renal disease.

Medicaid is another option for many Americans. The ACA allowed states to expand Medicaid up to 138% of the federal poverty level.

A direct individual or family plan from a health insurer

Rather than buy a plan through the ACA exchanges, you can also sign up for a health plan from the regular individual insurance market. Some insurers that don’t offer plans in the exchanges provide coverage through individual insurance, so you have that option, too.  

These plans are usually significantly more expensive than employer-sponsored coverage, but they’re an option to get full coverage if you’re not eligible for an employer-sponsored plan.

Source:

Kaiser Family Foundation. "Marketplace Average Benchmark Premiums." Accessed January 2024.