Since health insurance is an ongoing monthly cost, your estimate weighs the monthly premium you enter against your income and any existing debt, showing how much room it would leave in your budget.
These key factors affect health insurance affordability
Premiums vary widely by source of coverage
Employer-sponsored plans typically require the employee to pay only a portion of the premium, often around $100 to $200 a month for self-only coverage, since the employer covers the rest. Marketplace plans and COBRA continuation coverage don't have that subsidy in the same way - COBRA specifically requires paying the full premium plus a 2 percent administrative fee, which can push the monthly cost to $600 or more.
Subsidies can change the real cost significantly
ACA marketplace premium tax credits are based on household income and can reduce the sticker price of a plan substantially, sometimes to near zero for lower-income households, so it's worth checking your subsidy-adjusted price rather than the full listed premium. The amount you enter here should reflect what you'd actually pay after any subsidy, not the unsubsidized rate.
Deductibles and out-of-pocket maximums matter too
A lower monthly premium often comes with a higher deductible and out-of-pocket maximum, meaning the true cost of a plan depends on how much care you expect to use, not just the premium alone. It's worth weighing a plan's total potential annual cost, premium plus expected out-of-pocket spending, rather than optimizing for the lowest monthly number in isolation.
How to use your results
- If the result shows high risk, check whether you qualify for ACA marketplace subsidies, which can lower your effective premium considerably
- Compare the total annual cost of a plan, premium plus expected deductible spending, rather than just the monthly premium alone
- If you're on COBRA, check the marketplace for a comparable plan first, since COBRA is often the most expensive way to maintain coverage
Ways to make health insurance more affordable
- Check HealthCare.gov or your state marketplace for premium tax credits, which many people qualify for without realizing it
- Compare a high-deductible health plan paired with an HSA if you're generally healthy, since the premium savings and tax advantages can add up
- Ask your employer about any wellness program discounts or premium reductions tied to health screenings
- If you recently lost a job, look into marketplace special enrollment before defaulting to COBRA, since marketplace plans are usually cheaper
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