Average premiums by age, plan tier, and subsidy eligibility — everything you need to budget for coverage.
Health insurance costs can feel like a moving target. Your premium depends on your age, where you live, which plan tier you choose, your household income, and whether you get coverage through an employer or the ACA marketplace. This guide breaks down every major cost factor so you can set a realistic budget and find the best value for your situation.
The benchmark for individual marketplace coverage in 2026 is the Silver plan premium for a 40-year-old. Nationally, that averages around $477 per month before any subsidies. Actual costs vary widely by state — residents of Wyoming or West Virginia often pay more than twice what people in Massachusetts or New Mexico pay for comparable coverage.
| Age | Bronze Plan | Silver Plan | Gold Plan |
|---|---|---|---|
| 21 | $198 | $272 | $332 |
| 30 | $224 | $307 | $375 |
| 40 | $252 | $346 | $422 |
| 50 | $352 | $483 | $590 |
| 60 | $535 | $735 | $897 |
Source: KFF Health Insurance Marketplace Calculator, 2026 plan data. Premiums are national averages and vary significantly by state.
ACA marketplace plans are organized into four "metal" tiers. The tier determines how you split costs with your insurer — not the quality of care you receive. All plans at every tier cover the same 10 essential health benefits mandated by the ACA.
Bronze plans have the lowest monthly premiums but the highest out-of-pocket costs when you use care. The insurer covers roughly 60% of costs on average; you pay 40%. These plans suit people who are generally healthy and want protection mainly against major accidents or serious illness. Average deductibles run $6,000–$7,500 for an individual in 2026.
Silver plans hit the sweet spot for most buyers. The insurer covers about 70% of costs. More importantly, Silver is the only tier where you can qualify for cost-sharing reductions (CSR) — extra subsidies that lower your deductible, copays, and out-of-pocket maximum if your income is below 250% of the federal poverty level ($37,650 for a single person in 2026). For CSR-eligible enrollees, a Silver plan can deliver Gold- or Platinum-level value at Silver prices.
Gold plans cover about 80% of costs. Premiums are higher than Silver, but your deductible and out-of-pocket maximum are lower. If you use insurance regularly — for prescriptions, specialist visits, or ongoing treatment — Gold plans often save money overall when you add up premiums plus out-of-pocket spending.
Platinum plans have the highest premiums and the lowest cost-sharing (the insurer pays ~90%). Deductibles are often $0 or very low. These plans make financial sense mainly for people with high, predictable medical expenses — such as those managing chronic conditions requiring frequent hospitalizations or expensive specialty medications.
The Affordable Care Act provides two types of financial assistance for marketplace enrollees:
Premium tax credits cap what you pay for the benchmark Silver plan as a percentage of your household income. In 2026, anyone paying more than 8.5% of their income for the benchmark plan qualifies for a credit — there is no upper income ceiling. This means even households earning $80,000 or $100,000 may qualify for meaningful subsidies depending on state and age.
You can apply the credit to any metal tier — use it to make a Gold plan affordable, or to pay nearly nothing for a Bronze plan if your income qualifies.
CSR subsidies are automatically applied when you enroll in a Silver plan and your income falls between 100% and 250% of the federal poverty level. They can cut your deductible from $4,500 to as low as $500 at the highest subsidy tier (income under 150% FPL). You must enroll in a Silver plan to access CSR — they are not available on Bronze, Gold, or Platinum plans.
If your employer offers health insurance, it is almost always the most cost-effective option. Employers paid an average of $8,435 per year toward single coverage in 2025 (KFF Employer Health Benefits Survey). The typical employee share averaged $1,368/year — about $114/month — for a single plan. For family coverage, employers contributed roughly $21,000 annually; employees paid around $6,300.
A key advantage: your premium contributions are made with pre-tax dollars, reducing your taxable income. The employer's contribution is tax-free to you as well. This makes the true cost of employer coverage lower than the sticker price suggests.
If your employer's plan costs more than 9.02% of your household income (the 2026 ACA affordability threshold), you may still qualify for marketplace subsidies instead — even if your employer offers coverage.
Adding dependents increases your premium, but the ACA caps how much insurers can charge for children. Insurers can only charge for up to three children under 21, regardless of how many you have — the fourth and beyond are covered at no additional premium in the marketplace.
A typical family of four pays $1,800–$2,200/month before subsidies on a Silver marketplace plan. Families qualify for premium tax credits based on household income relative to household size, so a family of four earning $75,000 may qualify for substantial credits. See our guide to the best health insurance for families for strategies specific to family coverage.
Compare real plans and prices in your area — including subsidies you may not know you qualify for.
Get Your Free Quote NowThe national average for an individual ACA Silver plan is roughly $477/month before subsidies. After applying premium tax credits, most subsidized enrollees pay well under $200/month, and millions pay $0/month.
A family of four on an ACA Silver plan averages $1,800–$2,200/month before subsidies. With income-based tax credits, many families pay under $400/month total.
Yes. ACA rules allow insurers to charge adults 60+ up to 3x more than 21-year-olds. A 60-year-old enrollee typically pays roughly double what a 40-year-old pays for the same plan.
Bronze ACA plans have the lowest premiums but the highest deductibles and out-of-pocket costs when you need care. Medicaid is free or nearly free for those who qualify. Subsidized Bronze plans can cost $0/month for lower-income enrollees.