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Obamacare, officially known as the Affordable Care Act (ACA), created the health insurance marketplace, which lets you compare available plans in your area.
Obamacare plans can play a vital role in helping Americans get the best health insurance when they aren’t eligible for coverage through an employer. But ACA plans can be pricey if you don’t qualify for subsidies or premium tax credits.
Key Takeaways
- The average Obamacare plan costs $453 monthly for a 30-year-old, $509 for a 40-year-old and $712 for a 50-year-old.
- Age, location, type of plan, smoking status, and metal tier all affect ACA plan costs.
- People with household incomes below 400% of the federal poverty level qualify for premium tax credits, which lower ACA costs
How Much Is Obamacare per Month?
The average Obamacare plan costs $509 per month for a 40-year-old individual, based on our analysis. The exact cost depends on your age, your location, type of plan and metal tier level and other factors.
Those costs don’t account for premium tax credits that can reduce Affordable Care Act plan costs if your household income qualifies. You can compare ACA plans at HealthCare.gov.
Average Obamacare Costs by Age
Average Obamacare Costs by Health Insurance Company
Average Obamacare Costs by Metal Tier
Average Obamacare Costs by Plan Type
Which Factors Affect Obamacare Costs?
Obamacare costs are based on multiple factors—but, importantly, not your health.
 | Age
|
 | Location
|
 | Smoking Status
|
 | Metal Tier
|
 | Family Size
|
 | Plan Type
|
 | Income
|
What Is 400% of the Federal Poverty Level?
| Family size | 400% of the federal poverty level |
|---|---|
One person | $60,240 |
Two people | $81,760 |
Three people | $103,280 |
Four people | $124,800 |
Five people | $146,320 |
Source: U.S. Department of Health and Human Services
EXPERT TIPS
How Can You Save on Obamacare?
Les Masterson
Insurance Editor
Amy Danise
Insurance Managing Editor
Michelle Megna
Insurance Lead Editor
Ashlee Valentine
Insurance Editor
Jason Metz
Insurance Lead Editor
Take Advantage of Tax Credits if You Qualify
More than 14 million Americans with ACA plans receive advanced premium tax credits based on their income. The average monthly savings is $527, according to the Kaiser Family Foundation. Those eligible for tax credits have a household income of 400% of the federal poverty level or below. I’ve found that the ACA marketplace makes it easy to figure out if you qualify. You enter your household income information into the ACA marketplace website at HealthCare.gov and it shows how much you may save for each type of plan in your area.
Les Masterson
Insurance Editor
Choose an HMO or EPO
HMOs and EPOs are generally cheaper than a PPO or POS plan. PPO and POS plans offer more flexibility, such as allowing out-of-network care, but that typically comes at a higher cost. Our analysis of ACA marketplace costs found that a 40-year-old can save nearly $100 on average monthly by choosing an HMO rather than a PPO.
Amy Danise
Insurance Managing Editor
Select a High-Deductible Health Plan
A high-deductible health plan (HDHP) is one way to save on premiums. HDHPs typically have cheaper health insurance premiums, but higher deductibles mean you may pay more for healthcare services during the year. An HDHP is a plan with a health insurance deductible of at least $1,600 for single coverage and $3,200 for family coverage. I’ve found that bronze and silver plans are generally HDHPs.
Michelle Megna
Insurance Lead Editor
Set up a Health Savings Account
I recommend health savings accounts (HSAs) as a way to help you save money tax-free for future healthcare costs. HSAs are paired with an HDHP. You own the HSA, and it lets you carry over any money into the next year.
Ashlee Valentine
Insurance Editor
Get a Catastrophic Plan if You Qualify
Catastrophic health insurance is an ACA marketplace option only for people under 30 or those facing severe economic issues, such as homelessness. I’ve found that these plans offer many of the same protections found in Obamacare plans. Catastrophic health plans have low premiums, but unlike Obamacare plans, they don’t qualify for advanced premium tax credits or subsidies.
Jason Metz
Insurance Lead Editor
What Are the Obamacare Plans?
Obamacare plans are divided by costs into four metal tiers: bronze, silver, gold and platinum health plans.
Bronze and silver plans have cheaper premiums but more out-of-pocket expenses, while gold and platinum plans have higher premiums but fewer out-of-pocket costs like deductibles and coinsurance when you need care.
Here’s the difference between the plans by how much of the medical bills you have to pay when you get care.
How Much Obamacare Health Plans Cover by Metal Tier
| Plan category | Insurance company pays | You pay |
|---|---|---|
Bronze | 60% | 40% |
Silver | 70% | 30% |
Gold | 80% | 20% |
Platinum | 90% | 10% |
When choosing a metal tier, consider your current healthcare needs and what’s expected in the coming year. A bronze or silver plan may make sense if you’re healthy and don’t expect to need many healthcare services over the next year. A gold or platinum plan may be better if you need surgery in the next year, expect to have a child, regularly see a doctor or are on multiple prescription drugs.
Featured Health Insurance Partners
1
Aetna
Coverage area
Offers plans in all 50 states and Washington, D.C.
Number of providers in network
About 1.2 million
Physician copays start at
$20
2
Blue Cross Blue Shield
Coverage area:
Offers plans in all 50 states and Washington, D.C.
Number of providers in network
About 1.7 million
Physician copays start at
$10
3
Cigna
Coverage area
Offers plans in all 50 states and Washington, D.C.
Number of providers in network
About 1.5 million
Physician copays start at
$0
Affordable Care Act Requirements
The ACA includes multiple requirements for health insurance companies, including:
- Prohibits lifetime monetary caps on coverage
- Sets annual in-network out-of-pocket maximums
- Requires that insurers in the ACA marketplace cover at least the 10 essential health benefits, including hospitalizations, outpatient care, emergency services and maternity and newborn care
- Doesn’t allow health insurers to cancel health insurance unless there’s fraud
- Forbids insurance companies from denying coverage based on preexisting conditions
- Demands that insurers use a minimum percentage of premiums to pay for member medical services
Obamacare Cost Frequently Asked Questions (FAQs)
Is Obamacare completely free?
Obamacare typically has monthly health insurance premiums, but you may qualify for premium tax credits that reduce your costs significantly. How much you save depends on your household income.
More than 14 million people receive advanced premium tax credits for Affordable Care Act plans, according to Kaiser Family Foundation.
What is the lowest income to qualify for Obamacare subsidies?
You’re eligible for Obamacare premium tax credits and subsidies if your household income is at the federal poverty level or up to 400% of that level. The poverty level is $14,580 for an individual, $19,720 for a two-person family, $24,860 for a three-person family and $30,000 for a four-person family.
People at the poverty level are also generally eligible for Medicaid. Most states expanded Medicaid eligibility over the past decade. The exact household income levels vary by state and situation, but you may be eligible for Medicaid if you have a household income at 138% of the federal poverty level, which is $20,783 for an individual, $28,208 for a two-person family, $35,632 for a three-person family and $43,056 for a four-person family.
What is the highest income to qualify for Obamacare?
Income doesn’t influence whether you qualify for Obamacare. Household income instead factors into whether you qualify for premium tax credits or cost-saving subsidies.
Is Obamacare the same thing as the Affordable Care Act (ACA)?
Yes, Obamacare is another name for the Affordable Care Act, which Congress enacted in 2010.
The ACA created the health insurance marketplace, but there is more to the ACA than the marketplace. The health law also expanded Medicaid eligibility, which opened the door to that coverage for millions of Americans. States decide whether to expand eligibility and for which situations. For instance, some states may have more lenient income eligibility restrictions for pregnant women and dependent children.
Is the cost of Obamacare based on income?
Yes, Obamacare costs are influenced by your household income and family size. Those with household incomes of under 400% of the federal poverty level qualify for savings on the marketplace.
If you qualify for premium tax credits, you can save over $500 monthly on average on an ACA health insurance marketplace plan, according to the Kaiser Family Foundation.
