Best Affordable Health Insurance

Benzinga readers often turn to UnitedHealthcare for affordable health insurance.

The health insurance marketplace breaks plans into four categories: bronze, silver, gold and platinum. The categories relate to how you and the plan split your healthcare bills. When looking for the most affordable health insurance, the most cost-effective plan based on the monthly premium is a bronze plan, though you’ll pay more when you need care. Benzinga provides bronze plan comparisons for some of the leading health insurance companies available in most areas.

Quick Look: Best Affordable Health Insurance

• Best for Same-Day Coverage: UnitedHealth Group
• Best for Extensive Network: Blue Cross Blue Shield
• Best for Specialist Access: Kaiser Permanente
• Best for Travelers: Cigna
• Best for No Enrollment Period: Sidecar Health
• Best for Short-Term Health Plans: Pivot Health

6 Best Affordable Health Insurance

Review the best affordable health insurance options on the marketplace when comparing bronze plans. Find details about who they are best for and weigh the pros and cons to see whether it might be right for you.

1. Best for Same-Day Coverage: UnitedHealthcare

If you want the largest provider network and availability nationwide, UnitedHealthcare is an outstanding option. While you’ll pay a bit more for your premiums and have a higher plan deductible, you’ll have the freedom to see providers that you’re used to in 22 states. Plans come with a digital fitness class subscription to help you feel your best. Some plans are eligible for a health savings account (HSA), and you’ll get lower prescription costs with the potential for prescription delivery on some plans. Enjoy unlimited virtual visits, even for urgent care scenarios.

• Average cost for a bronze plan: $427
• Average bronze plan deductible: $7,500 individual/$15,000 family
• Network size: 1.5 million

2. Best for Extensive Network: Blue Cross Blue Shield

Consumers shopping for a preferred provider organization (PPO) should evaluate a Blue Cross Blue Shield plan because it is one of the few organizations with a PPO option in the marketplace. Members can join Blue365 for health and wellness discounts on products like Fitbit, optical and meal boxes. While plans are slightly more expensive than competitors, the extensive network size and availability of the plans in all 50 states help make up for the monthly premium costs.

• Average cost for a bronze plan: $458
• Average bronze plan deductible: $7,173
• Network size: 1.7 million providers

3. Best for Specialist Access: Kaiser Permanente

For a high-quality HMO or EPO, look into Kaiser Permanente. It has one of the highest ratings from the National Committee for Quality Assurance and the lowest number of complaints. The challenge is that you’ll have to reside in one of the eight states where it is available: California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia or Washington. The company is the largest healthcare nonprofit nationwide. The average cost for a plan is well below the overall average on the marketplace, meaning you’ll get good coverage at an affordable cost.

• Average cost for a bronze plan: $373
• Average bronze plan deductible: $5,400 Individual/$10,800 Family
• Network size: 24,605 physicians

4. Best for Travelers: Cigna

Cigna is one of the oldest and largest insurance companies nationwide. Plans come with nice perks, such as the option to talk to a board-certified doctor at any time. You’ll also get prescription drugs for $3 or less. Pay nothing out of pocket for telehealth and preventative care visits. Earn rewards for completing activities, such as preventative exams or shots. Rates are highly competitive for the average plan participant. Complaints against the company are higher than average though.

• Average cost for a bronze plan: $428
• Average bronze plan deductible: $7,471
• Network size: 1.5 million

5. Best for No Enrollment Period: Sidecar Health

Individuals who are young and generally healthy find Sidecar Health plans to be ideal to help bridge coverage gaps or serve as major medical coverage in case unforeseen circumstances arise. These plans are not traditional health plans, which means you can be denied coverage and you’ll still pay for preventative care.

• Average cost for a bronze plan: $300
• Average bronze plan deductible: $8,250 individual/$16,500 family
• Network size: Does not use a traditional network format

6. Best for Short-Term Health Plans: Pivot Health

When you’re looking for affordable short-term health insurance, Pivot Health is an outstanding option. With rates hovering in the $100 per month range, you’ll find the coverage you need with deductibles between $1,000 and $20,000. You’ll also get access to round-the-clock telehealth services with lifestyle benefits and discounts. While you’ll have the freedom to see the providers you want because it is an all-access plan, you’ll need to get approval for emergency services quickly after receiving them.

• Average cost for a bronze plan: $114
• Average bronze plan deductible: $6,741
• Network size: Plans are all-access with no network

Open Enrollment for the 2024 Marketplace

The Affordable Care Act of 2010 provided the foundation for states to create an exchange where families and individuals could compare healthcare plans. Depending on where you live, you might shop your state’s exchange or the federal exchange as some states chose not to create their own marketplace.

The marketplace makes it possible for private health insurance companies to compete against one another for individuals who need an insurance plan. Some consumers do not have the option to purchase health insurance through their employer, which means they need a suitable alternative.

Open enrollment starts in November and runs until December of the year before the coverage takes effect. However, if a person experiences a qualifying event, such as the loss of other insurance coverage, they can shop the marketplace for a plan.

You’ll find four tiers of plans on the marketplace: bronze, silver, gold and platinum. As the tiers go up your deductibles go down and you’ll get better coverage. But you’ll also pay higher monthly premiums for better coverage.

On the marketplace, you can compare plans not just based on price but also based on coverages, deductibles and network availability.

Average Cost of Health Insurance

The average cost of health insurance on the marketplace for an individual is $477 per month without any subsidies. Family coverage averages $1,152 per month.

When evaluating which tier of coverage might be right for you, review this table that shows how costs are shared between you and your health plan for the various options.

Factors that can affect premiums

Plan expenses vary based on your unique factors, such as:

• Location: Various states have differing regulations, and the cost of living and healthcare services in your area are factors when insurance companies set rates.
• Age: The older you are, the higher your premiums will be.
• Smoking: People who use tobacco products often pay 50% more than those who do not use these products
• Level of coverage: If you want a lower deductible in which the plan pays more of your expenses, you’ll pay more per month for it.
• Number of dependents: The more people you’re covering, the more the plan will cost.

Finding the Best Affordable Health Insurance

When looking at the affordability of a health insurance plan, consider these factors that can impact its total cost and your portion of those expenses.

Annual Costs, Premiums and Deductibles

The total cost of your health plan isn’t just what you pay each month in premiums. Look also at the deductible, meaning how much money you’ll have to pay for your healthcare services before the insurance company will pick up part of the expense. People who know approximately what their care costs each year based on their existing conditions will have an easier time calculating this. Regardless, you can look at what charges you’ve incurred and billed to insurance for the last several years to get an idea of the cost.

For example, you might have expenses that look like this:

Urgent care visit for broken bone: $2,000

Sick visit to primary care: $200

Minor outpatient operation: $5,000

Monthly prescription: $200

Specialist care: $3,000

Weekly physical therapy: $300 ($1,200 per month)

If you add that up, you get $24,800. A health plan with $500 per month premiums and a deductible of $8,000 would then provide a benefit of $10,800 that you would otherwise have spent out of pocket, though that does not factor in copays once you’ve met your deductible, which are generally 20%, meaning your total benefit might be closer to $8,640, assuming you see all in-network providers.

EPO, HMO and PPO

The plan type you select will also impact the total cost. You have three main options when reviewing plans:

• EPO: Exclusive provider organization plans only cover expenses when you see doctors and specialists that are in-network or get services from an in-network hospital, except in emergencies. You won’t need to get referrals from your primary care physician to see specialists.
• HMO: Health maintenance organization plans focus on prevention and wellness. You’ll get lower costs for your care, but the network is more strict and everything is coordinated through your primary care physician to better coordinate your care.
• PPO: With a preferred provider organization plan, you don’t have to select a primary care physician or get referrals for specialists. Select the provider that makes the most sense for you. While you have more freedom to choose your providers, you’ll pay more for these plans.

Metal Tiers

The health insurance marketplace uses metal names to denote the various tiers based on how much the plan pays. Here’s a breakdown of the characteristics of each metal tier:

• Bronze plans: You’ll pay the lowest monthly premiums with one of these plans, but you’ll also incur the highest cost for care when you need it. These plans are best for ensuring you have coverage for serious medical scenarios but provide minimal if any coverage for routine care.
• Silver plans: Enjoy moderate monthly premiums with moderate out-of-pocket costs when you need care. These plans are good for those who want some coverage for medical expenses but are comfortable with paying for most routine care.
• Gold plans: Prepare to pay high monthly premiums but low costs when you need care with a gold plan. This plan is a good choice when you want to know what your monthly expenses will look like because you’re mostly paying your healthcare costs through monthly premiums.
• Platinum plans: The most expensive monthly premium option is a platinum plan, but you’ll pay very little when you need care. People who need care regularly and like knowing their expenses will be mostly covered find these plans the best.

Out-of-Pocket Limits

Another data point you’ll want to evaluate is the out-of-pocket limit for your plan. This is the maximum amount you can spend on healthcare within a calendar year, excluding premium costs.

For example, if you need surgery that costs $30,000 and your plan has a $5,000 deductible and a $10,000 out-of-pocket maximum, you’ll start by paying the $5,000 deductible. That leaves you with a $25,000 bill. You have a 20% coinsurance, which means you still owe $5,000 of the remainder. You’ve now paid your out-of-pocket maximum, meaning you won’t pay coinsurance or any bills on further care for the year as long as you’re seeing in-network providers.

Premium Tax Credit

Some individuals and families qualify for a premium tax credit, which is a refundable credit that helps cover health insurance premiums for plans purchased through the Health Insurance Marketplace. To qualify, you’ll need to meet this criteria:

• No other healthcare coverage is available through an employer or the government.
• Your income falls within the 100% to 400% of the federal poverty line based on your family size.
• Someone else cannot claim you as a dependent on their tax return.
• If married, you’re filing a joint return.

Where to Buy the Most Affordable Health Insurance

When shopping for a health insurance plan, you can purchase it from various locations. The most affordable plan will vary based on your preferences, the type of plan you need and your existing medical conditions. Here’s a look at some of the places you can purchase health insurance.

Buy From the Marketplace

The federal marketplace serves 32 states. The other 18 states and Washington, D.C., have their own marketplaces. Using the marketplace, you can compare plans and their costs from various providers.

Private Health Insurance Plans

You don’t have to use the marketplace to shop for private health insurance plans. Instead, go out to the various private health insurance providers to learn more about what they offer. Or, you might know that you want a specific health insurance provider because you’ve heard good things about them in your area. If that’s the case, you can purchase a private plan with the specifications you want.

Indemnity Plans

These plans have no provider networks, which means you can see any doctor or visit any hospital that meets your needs. The providers do not have contracts with the insurance company for set rates. The providers have the freedom to set a fee for their services. Whatever the insurance company does not cover, the insured will pay the rest. The amount the indemnity plan will pay is predetermined based on the customary and reasonable charge for that service or procedure. Insureds can end up with large and unexpected bills in these scenarios, but they also have more freedom to select their providers.

Short-Term Health Insurance Providers

Sometimes you just need to fill a coverage gap, such as when you’re between jobs or when you are not yet eligible for coverage at a new job because of waiting periods. Short-term health insurance is a good solution in these cases. A short-term health insurance plan does not cover preexisting conditions but can help with major, unexpected medical expenses when you don’t have other coverage options. Look for these plans from private health insurance companies.

Healthshare Programs

Another health plan type is a healthshare. Nonprofits offer these plans where you share health costs with other plan members, meaning premiums are based on average total expenses that all plan members incur. In some years, you might pay more for premiums than the benefits you get while in other years, the coverage helps you avoid massive healthcare costs for major expenses. It isn’t a traditional health insurance plan, but it can help manage healthcare expenses.

Manage Healthcare Expenses with a Right-sized Insurance Plan

Every individual and household has differing health insurance coverage needs. An affordable health plan balances monthly premiums with ongoing medical expenses. When you know you’ll incur more medical expenses in a year, such as when you plan to welcome a new baby or know you need a medical procedure, paying for a higher-tier plan might make more sense. But in regular maintenance years, you might keep a lower-tier plan.

Frequently Asked Questions