Health Insurance: Plans, Costs & How to Get Covered

Updated April 2024 · BestQuote Editorial Team

Understanding Health Insurance

Health insurance helps cover the cost of medical care — from routine checkups and prescriptions to emergency surgery and hospital stays. Without it, a single hospitalization can cost $30,000–$100,000+.

In the U.S., you can get health insurance through your employer, the ACA Marketplace (Healthcare.gov), Medicaid, Medicare, or directly from private insurers. The right option depends on your income, age, employment status, and health needs.

Types of Health Insurance Plans

HMOHealth Maintenance Organization

Lower premiums, requires primary care physician and referrals for specialists. Best for those who want lower costs and don't mind a more managed approach.

Lowest premiums

PPOPreferred Provider Organization

Higher premiums, no referrals needed. See any in-network or out-of-network doctor. Best for those who prioritize flexibility and access.

Moderate-high premiums

EPOExclusive Provider Organization

Middle ground — no referrals needed but must stay in-network except for emergencies. Often cheaper than PPO with more flexibility than HMO.

Moderate premiums

HDHPHigh Deductible Health Plan

Very low premiums but high deductibles ($1,600+ individual). Pairs with a Health Savings Account (HSA) for tax-free medical savings.

Lowest premiums, high deductible

Key Health Insurance Terms

Premium

The monthly amount you pay for insurance, regardless of whether you use medical services.

Deductible

The amount you pay out-of-pocket before insurance kicks in. Higher deductible = lower premium.

Copay

A fixed amount you pay for a covered service (e.g., $30 for a doctor visit) after the deductible is met.

Coinsurance

Your share of costs after the deductible. With 20% coinsurance, you pay 20% of covered services; insurance pays 80%.

Out-of-Pocket Maximum

The most you'll pay in a year. After reaching this limit, insurance covers 100% of covered services.

Network

The group of doctors, hospitals, and facilities that have agreements with your insurer for discounted rates.

Average Health Insurance Costs in 2024

Individual Coverage

$456
per month
$5,472/year · Average marketplace plan

Family Coverage

$1,152
per month
$13,824/year · 2 adults + 2 children

With ACA Subsidy

$179
per month
$2,148/year · Average subsidized amount

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Frequently Asked Questions

What is the difference between HMO and PPO health insurance?

An HMO (Health Maintenance Organization) requires you to choose a primary care physician and get referrals to see specialists. It has lower premiums but less flexibility. A PPO (Preferred Provider Organization) lets you see any doctor without a referral, with higher premiums but more flexibility.

What is a deductible in health insurance?

A deductible is the amount you pay out-of-pocket before your insurance starts covering costs. For example, with a $2,000 deductible, you pay the first $2,000 of covered medical expenses each year. After meeting your deductible, you typically pay a coinsurance percentage until reaching your out-of-pocket maximum.

How much does health insurance cost per month?

Average individual health insurance premiums in 2024 are around $456/month. For family coverage, the average is $1,152/month. Costs vary significantly by state, age, plan type, and whether you qualify for ACA subsidies, which can reduce premiums by $500+ per month.

Can I get health insurance outside of open enrollment?

Yes, if you experience a qualifying life event such as losing employer coverage, getting married, having a baby, or moving to a new state. This triggers a Special Enrollment Period (SEP) lasting 60 days. Medicaid and CHIP enrollment is available year-round.

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