Best Affordable Health Insurance Plans for families

Average costs for a 27-year-old. Source: HealthCare.gov. Based on unsubsidized ACA plans.

Seeking Advice from Experts: Tips for Finding Affordable Health Insurance

 Patrick Padgett (Advisory Board Member)

“Leverage Available Subsidies

When acquiring a plan through the ACA marketplace, subsidies play a crucial role in determining your premium expenses, contingent upon your annual income. If you’re not yet 65 and retired, explore avenues to maintain your taxable income below the specified threshold to qualify for subsidies.”

Les Masterson (Insurance Editor):

“Shop Around for Quotes
If you’re purchasing a health plan via the ACA marketplace, it’s prudent to compare quotes directly on the marketplace website. Ensure you’re comparing costs for the same metal tier to accurately assess the plans.”

Jason Metz (Insurance Lead Editor):

“Explore HMO or EPO Options

For those seeking the most cost-effective health plan benefit structure, consider opting for a health maintenance organization (HMO) or exclusive provider organization (EPO) plan. While these plans necessitate remaining within the designated provider network, they typically offer lower premiums compared to preferred provider organization (PPO) plans.”

Factors to Consider When Seeking Affordable Health Insurance

When in pursuit of an economical health insurance plan, it’s essential to evaluate your family’s current and upcoming healthcare requirements. Consider factors such as potential family expansion, ongoing prescription needs, or anticipated medical procedures, like addressing a persistent knee issue.

These considerations aid in determining whether opting for a high-deductible health plan (HDHP) is suitable. While HDHPs typically feature lower premiums, they entail higher out-of-pocket expenses when healthcare services are needed.

Premiums:

The health insurance premium denotes the cost of maintaining insurance coverage and is a significant determinant of overall health insurance expenses.

Deductibles:

Deductibles influence both the amount paid for health insurance premiums and the out-of-pocket expenses incurred when accessing care. Prior to a health insurer covering healthcare services, you must fulfill your health insurance deductible.

Coinsurance:

Coinsurance pertains to the percentage of healthcare costs borne by you once the deductible has been met. Higher coinsurance implies greater out-of-pocket expenditure when utilizing healthcare services.

Metal Tiers:

ACA plans categorize into four “metal” tiers—bronze, silver, gold, or platinum—based on premiums and out-of-pocket costs. Bronze and silver plans typically feature lower premiums but higher out-of-pocket expenses, while gold and platinum plans exhibit higher premiums but lower out-of-pocket costs.

Premium Tax Credits:

Exclusive to ACA plans, premium tax credits are contingent upon household income. Depending on your income level, you may qualify for substantial savings on your ACA plan annually.

Provider Network:

Health plans typically encompass provider networks comprising contracted doctors and healthcare professionals. Staying within the network generally results in lower costs compared to seeking out-of-network care.

Out-of-Pocket Maximum:

This represents the maximum amount payable for healthcare services within a year. Deductibles, copays, and coinsurance for in-network services contribute towards this maximum. Once the out-of-pocket maximum is reached, your health insurance plan covers 100% of your in-network costs for the remainder of the year.

Methodology

In determining the best and most affordable health insurance companies, we conducted an analysis of 84 data points across seven major health insurance providers. Our ratings were based on the following criteria:

Complaints to State Insurance Departments (30% of score): Utilizing complaint data sourced from the National Association of Insurance Commissioners, we assessed the frequency and nature of complaints lodged against each insurer.

Plan Ratings from the National Committee for Quality Assurance (30% of score): The National Committee for Quality Assurance, an independent nonprofit organization, provided ratings based on various metrics including patient experience, prevention, treatment, overall health plan rating, and care rating.

Average Silver Plan Deductible (20% of score): The deductible, representing the amount individuals must pay for healthcare annually before the health plan begins coverage, was considered. Lower deductibles earned higher scores. Data source: HealthCare.gov.

Breadth of Health Plans (10% of score): We evaluated the diversity of plan benefit designs offered by each health insurance company, including PPO, HMO, EPO, and POS options. More plan types offered resulted in higher scores. Data source: HealthCare.gov.

Metal Tier Offerings (10% of score): Points were allocated based on the number of metal tier levels offered by each company in the ACA marketplace. Data source: HealthCare.gov.

Additional Health Insurance Companies Included in Our Evaluation

Affordable Health Insurance Frequently Asked Questions (FAQs)

Which Health Insurance Company Offers the Best Rates?

Based on our analysis of seven health insurers, Kaiser Permanente emerges as the most affordable health insurance provider.

Our investigation revealed that Kaiser Permanente consistently offers the lowest home insurance rates across various ages and metal tiers on the Affordable Care Act marketplace. For instance, a 40-year-old individual pays an average of $351 per month for an unsubsidized Bronze plan with Kaiser Permanente, compared to $378 with Aetna and $392 with Oscar.

Is Affordable Health Insurance Available Year-Round?

In most cases, you can only purchase a new health insurance plan or modify your existing coverage during the annual open enrollment period, unless you experience a qualifying life event. Typically, open enrollment for ACA marketplace plans occurs from November 1 to January 15 in the majority of states, although some states extend this period.

Qualifying life events, such as loss of health coverage, marriage, or childbirth, trigger a special enrollment period during which you can enroll in or adjust your health coverage.

Is It Possible to Negotiate Health Insurance Costs?

Generally, health insurance costs are not negotiable. However, the insurance company may present alternative plans that better suit your needs.

For example, they might propose a lower-cost bronze plan, suggest opting for a higher deductible, or recommend a more restrictive plan like a health maintenance organization (HMO). These options often feature lower premiums compared to more comprehensive coverage alternatives.

Best Affordable Health Insurance Companies for families

Blue Cross Blue Shield is our top choice for affordable health insurance. It excels in offering the lowest overall costs, providing excellent value with its Silver plans, boasting a diverse range of options, and receiving high-quality ratings. Additionally, Blue Cross Blue Shield’s plans are widely accessible and feature the largest provider network.

While considering the affordability of a health insurance plan, it’s crucial to look beyond just the premium. If you anticipate needing medical care beyond preventive services, prescription fills, or urgent care visits, it’s essential to consider the plan’s deductible and copays as well.

In our assessment of the best affordable health insurance companies, we scrutinized 40 criteria across nine major health insurance providers. These criteria encompassed cost, plan benefits, availability by state, customer satisfaction, plan types offered, availability of ACA metal level plans, and dental coverage.

To gauge plan quality and customer satisfaction, we relied on annual star ratings from the National Committee for Quality Assurance (NCQA). The NCQA, a private nonprofit organization, assesses health plans based on criteria such as patient care quality, patient satisfaction, and efforts to enhance health plan performance.

FAQ:Affordable Health Insurance Companies for families

How Much Does Health Insurance Cost?

Bronze plans offered on the Health Insurance Marketplace are among the most affordable health insurance options available (excluding Catastrophic coverage). The cost varies based on factors such as your location, age, chosen plan, and smoking status. The total cost includes your premium, deductible, copays for doctor visits and prescriptions, and coinsurance after meeting the deductible. Health insurance plans also specify an out-of-pocket maximum—the maximum amount you pay before your insurer covers 100% of your care.

What is the Premium Tax Credit?

The Affordable Care Act (ACA) introduced the advance premium tax credit to lower Marketplace health insurance premiums. Eligibility for the premium tax credit depends on factors such as your state of residence, family size, and adjusted gross income. You’ll determine your eligibility for this credit when applying for a Marketplace plan.

What is a Deductible in Health Insurance?

A deductible is the amount you must pay annually before your insurance starts covering your costs. For instance, if your health insurance plan has a $2,000 deductible, you generally pay the first $2,000 of covered services yourself. However, ACA plans cover specific preventive services before meeting the deductible. Some plans might have separate deductibles for healthcare and prescription drugs, along with copays for doctor visits before reaching the deductible.

What is a High-Deductible Health Plan?

A high-deductible health plan (HDHP) features relatively low monthly premiums in exchange for a high deductible. For 2024, the IRS defines an HDHP with a deductible of at least $1,600 for individuals and $3,200 for families. The maximum out-of-pocket limit for 2024 Marketplace self-only plans is $9,450. HDHPs must include a health savings account (HSA), allowing pre-tax contributions for qualified healthcare expenses.

Which Type of Health Insurance Is Least Expensive?

Blue Cross Blue Shield (excluding Anthem) is deemed the best value plan, while Kaiser Permanente offers the cheapest Bronze plans. However, the cost of your health insurance plan is determined by the coverage you select for yourself or your family.

What Qualifies as a Life Event for Special Enrollment?

Life events that qualify you for special enrollment on the Health Insurance Marketplace may include a change of residence, birth or adoption of a child, marriage, or loss of health coverage. Certain events, such as marriage or having a baby, might also qualify you for a special enrollment period for your employer’s health plan.

How We Selected the Best Affordable Health Insurance Companies for families

Our process involved analyzing business and market insight databases for families, examining health insurance company market share, and researching user-generated data from Google to discern public interest and trends in health insurance companies and plans.

We gathered data from the National Committee for Quality Assurance (NCQA), an independent organization rating healthcare plans based on quality and patient satisfaction. Additionally, data were collected from state and federal government insurance marketplace websites, company websites, media contacts, and existing partnerships.

We developed a quantitative model that scored each health insurance provider based on 27 criteria categorized into four major categories essential for evaluating the company’s offerings and benefits. The categories were weighted as follows:

– Plan Quality & Customer Satisfaction: 10%
– Plan Features: 30%
– Cost: 45%
– Availability: 15%

For a comprehensive understanding of our methodology for reviewing health insurance companies, please refer to our full methodology.