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The average lowest-cost Silver plan on the health insurance marketplace costs $486 per month in 2025 without any tax credits or subsidies, according to KFF, a health policy nonprofit[0]. That’s for an individual plan, priced for a 40-year-old person.
Across other metal tiers in the marketplace, the average lowest-cost Bronze premium is $381, and the average lowest-cost Gold premium is $507.
Premiums for family plans are higher, and the cost of health insurance overall depends on your age, income, location, employment status, family structure and health care needs, among other things.
Here’s how it all works.
Marketplace health insurance plans
If you’re not covered by employer-sponsored health insurance, you can buy a plan from your state marketplace or the federal marketplace, depending on where you live[0]. On these marketplaces, plans are available by tiers: Bronze, Silver, Gold and Platinum. There are also Catastrophic plans available, but only if you’re under 30 or qualify for a hardship exemption. Each tier covers a different percentage of your health care costs, although actual out-of-pocket impact may vary.
Marketplace health insurance plans by tier
Catastrophic plans cover preventive services and three primary care visits before you’ve met your deductible[0], but the deductible is quite high — $9,200 for an individual and $18,400 for family coverage. That means you pay out of pocket for all other covered care until you hit your deductible.
These plans are only available to people under 30 or those who can’t find an affordable marketplace plan. (“Affordable,” in this case, means a marketplace plan with a premium under 7.28% of your income.)
Marketplace premiums by state
See the lowest-cost Silver premium averages in every U.S. state.
What affects your marketplace premiums
Although health insurance companies can’t price a plan based on your medical history, there are things that will affect how much you pay, according to HealthCare.gov[0]:
Plan category: Marketplace plans are priced differently depending on their category: Bronze, Silver, Gold, Platinum or Catastrophic.
Number of enrollees: You’ll pay less for insurance just for yourself than if you’re covering a spouse and a child as well.
Smoking: If you smoke tobacco, insurance companies can charge you as much as 50% more.
City: Premiums can vary depending where you live.
Age: If you’re an older adult, insurance companies can charge as much as three times more.
Out-of-pocket costs
In addition to premiums, if you seek medical care or take regular prescription medication, there are out-of-pocket costs in the form of deductibles, copays and coinsurance[0]. These costs depend on your health insurance plan.
Here’s a primer on health insurance terms:
Premium: The monthly amount you pay for your health insurance plan.
Copay: A flat fee (such as $20) that you pay each time you receive a health care service or procedure.
Coinsurance: A percentage (such as 20%) of a medical charge that you pay; the rest is covered by your health insurance plan.
Deductible: The amount you pay for covered medical care before your insurance starts paying.
Out-of-pocket maximum: The most you’ll pay in one year, out of your own pocket, for covered health care. Once you reach this maximum, your insurance pays the rest.
Out-of-pocket costs: These are all costs above a plan’s premium that you must pay, including copays, coinsurance and deductibles.
Health insurance plan types
Among the metal tiers on the marketplace, there are several types of health insurance plans, and their structures vary:
HMO: health maintenance organization
Lower out-of-pocket costs and a primary doctor who coordinates your care for you, but less freedom to choose providers.
POS: point of service plan
More provider options and a primary doctor who coordinates your care for you, with referrals required.
Priced between HMOs and PPOs.
EPO: exclusive provider organization
Lower out-of-pocket costs and usually no required referrals, but less freedom to choose providers.
Priced between HMOs and PPOs.
PPO: preferred provider organization
More provider options and no required referrals, but higher out-of-pocket costs.
High-deductible health plans
All of the plan types above are also available as high-deductible health plans (HDHPs). These plans have lower premiums but higher deductibles, so you have to pay a big chunk of health costs up front before your insurance starts covering care[0]. Many HDHPs also allow you to use a health savings account (HSA), which lets you save pre-tax money for medical expenses.
HDHPs have advantages and disadvantages, so make sure you’ve weighed the pros and cons before deciding if one is right for you.
Premium tax credits
Some people are eligible for a premium tax credit if they buy health insurance from the federal or state health insurance marketplace[0]. (What’s available to you will depend on your state.) These tax credits are income-specific and you must meet certain criteria to qualify.
You may be eligible for a premium tax credit if:
You buy a Bronze, Silver, Gold or Platinum marketplace plan. (Catastrophic plans aren’t eligible.)
Your household income is equal to at least 100% of the federal poverty level for your family size.
You don’t have access to a qualifying employer plan, which would be health insurance that meets minimum coverage requirements and has a premium that is equal to or less than 9.02% of your household income in 2025.
You aren’t filing taxes as married filing separately. (There are exceptions.)
You can’t be claimed as a dependent on anyone else’s tax return.
How much is the premium tax credit?
The premium tax credit is computed based on certain numbers: Generally, it’s the premium for the second-cheapest Silver marketplace plan that would cover you and (if applicable) your family, minus a percentage of your household income. And you can’t receive more credit than you’re actually paying for your plan.
The credit depends largely on your income: If your income is lower, you’ll get a bigger credit to help you pay for health insurance coverage.
For instance, if you live in Orlando, Florida, you have two non-smoking 30-year-old adults in your family, and your modified adjusted gross income is $75,000, you may be eligible for up to $450 per month toward health insurance premiums.
Cost-sharing reduction
In addition to the premium tax credit, some people may also be eligible for a cost-sharing reduction that helps pay for out-of-pocket costs like copays and deductibles. You might see it referenced as “extra savings.”
You may be eligible for a cost-sharing reduction if:
You’re eligible for premium tax credits.
Your household income lands between 100% and 250% of the poverty level.
You’re buying a Silver marketplace plan. (This is the only plan eligible for these extra savings.)
How much is the cost-sharing reduction?
The amount of cost-sharing reduction is determined based on your income — the lower your income, the more cost assistance that’s available[0]. You can find out how much you’ll save when you apply for a Silver marketplace plan.
Off-marketplace health insurance plans
You may also be able to buy off-marketplace health insurance that’s sold outside of the federal and state marketplaces. These are plans you’d buy through an insurance company or broker. If you purchase one of these plans, you aren’t eligible for premium tax credits or other savings.
Employer-provided insurance tends to be cheaper than plans you’d purchase on the marketplace, since employers usually cover a portion of the premiums. But if you qualify for premium tax credits, you might pay less overall for a marketplace plan. (Note: If you have access to a qualifying employer-sponsored health insurance plan, you won’t qualify for premium tax credits on marketplace plans.)
In 2024, the average premiums for people covered by work health insurance were $746 per month for individual coverage and $2,131 per month for family coverage.
The bottom line
The cost for health insurance can vary dramatically based on whether you have access to employer-based coverage, whether you have a partner and/or children, where you live, how much you earn and how often you seek medical care, among other things.
If you don’t have access to health insurance through an employer, you can buy coverage through the federal or state marketplace, depending on your state, and you may be eligible for premium tax credits and a cost sharing reduction to help with the cost.
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