Health Insurance

Individual and Family Health Insurance Guide

Individual and Family Health Insurance Guide

Find Cheap Health Insurance Quotes in Your Area

Currently insured?

Individual and family health insurance plans are best for those who don't qualify for coverage through an employer or through government programs such as Medicaid or Medicare.

These private health insurance plans are sold directly to consumers, and they help pay for medical care, hospitalization and prescription drugs. Other coverage, such as dental and vision, is sometimes included.

The cost of an individual health insurance plan can be as cheap as $10 per month if you qualify for subsidies, or you could pay more than $500 per month if you choose the highest level of coverage.

What are individual and family health insurance?

Individual health insurance policies are available to individuals who currently are not enrolled in either a government program — Medicare or Medicaid — or a job-based policy.

Medical costs with health insurance
  • Deductible: The amount of health care you must pay in full before the plan's benefits begin
  • Copayments: Your portion of medical costs after your deductible
  • Out-of-pocket max: Your spending cap on medical costs, after which the plan pays 100%

A family policy works the same way as an individual plan, except that it will cover multiple people. Often, this will increase the deductible, out-of-pocket maximums and monthly cost.

By having an individual or family insurance plan, you'll have access to cheaper health care when you need it — such as a $20 copay instead of the full $100 bill.

You'll also have the peace of mind of knowing you'll be covered if you have a major illness or injury; for example, your medical costs could be capped at $6,000 even if you have a $200,000 surgery.

What's covered by a private insurance plan?

Individual and family health insurance plans are both required by the Affordable Care Act (ACA) to cover the 10 essential health benefits:

  • Hospitalization
  • Emergency services
  • Outpatient services
  • Prescription drugs
  • Preventative and wellness services
  • Pediatric services
  • Maternity and newborn care
  • Mental health and substance abuse care
  • Rehabilitative services
  • Laboratory services

By selecting individual health insurance, you are guaranteeing that you will at least be covered if you need one of the services above.

For example, if you become pregnant, then your health insurance policy is required by law to cover all things needed during your maternity. This includes pregnancy therapy and check-ins with your doctor, as well as the delivery in the hospital.

How to get private health insurance quotes and buy plans

If you don't get health insurance through an employer, there are four ways you can buy coverage.

  1. Shop online to compare rates: Requesting quotes from an online comparison tool is an easy way to discover what plans are offered in your area and compare policies from multiple companies.
  2. Buy directly from an insurance company: You can also directly purchase a plan from an insurer. This is only a good choice if you know exactly which insurer you want. There are no discounts for buying direct.
  3. Choose a marketplace plan: Healthcare.gov, or your state's health insurance marketplace, allows you to compare private health insurance plans from multiple companies. There are limitations on when you can enroll, and you can only purchase a plan during fall open enrollment or if you qualify for a special enrollment period because you've moved, lost other insurance coverage or had another qualifying situation. Plus, those who have low to moderate incomes may qualify for discounted health insurance because of the premium tax credit program.
  4. Shop through an insurance agent:If you have an agent who you work with for other types of insurance, they may also be able to help you choose the best private health insurance policy.

Find Cheap Health Insurance Quotes in Your Area

Currently insured?

Shop health insurance by state

State
Most popular individual insurer
Alabama private health insuranceBlue Cross and Blue Shield of Alabama
Alaska private health insurancePremera Blue Cross
Arizona private health insuranceHealth Net
Arkansas private health insuranceArkansas Blue Cross and Blue Shield
California private health insuranceKaiser Permanente
Show All Rows

Metal tiers of individual health insurance

Individual health insurance policies are broken down into five metal tiers, which specify how much of your medical costs are covered.

A higher-tier, such as a Gold or Platinum plan, will generally cover a greater portion of medical costs, making these more expensive plans a good choice for those who need ongoing or expensive medical care.

In contrast, a cheaper health insurance plan in the Bronzer or Catastrophic tier can help you keep your monthly bills low, but you could pay more when you go to the doctor.

Metal tier
Monthly cost
Catastrophic$313
Bronze$396
Silver$541
Gold$592
Platinum$678

Average cost for a 40-year-old

Every plan, regardless of tier, will cover the same critical health services. When comparing plans, focusing on how the cost of a plan relates to its coverage can help you choose the best plan for your situation.

Catastrophic and Bronze tier individual health insurance plans are the most affordable health insurance policies with the lowest monthly costs. However, this means that the benefits aren't as good as other options, and you could have a higher deductible, copay and spending limit.

For this reason, Catastrophic and Bronze individual plans should only be considered if you are young and healthy, or you only need basic medical care.

If you have a major health issue or accident, the plans will give you financial protection against extremely high medical bills, but you will generally pay more for medical care than if you had a higher-tier plan. Additionally, you can only enroll in a catastrophic health insurance plan if you're 30 years old or eligible for a financial hardship exemption.

Silver health insurance plans are the most popular option and have the best medical coverage for most people. They have moderate monthly costs, deductibles and out-of-pocket maximums. For this reason, a Silver plan will provide financial stability in the event that you or a family member experiences a serious medical problem, while not breaking the bank with the monthly fee.

If you have a low income, Silver plans can have an additional perk of cost-sharing reductions, which improves the plan's benefits to make medical care more affordable.

Gold and Platinum health insurance plans have the highest monthly costs and the best benefits, with low deductibles and out-of-pocket maximums. Paying for this level of coverage is typically only worth it for older individuals or those who may have health conditions that require monthly care or costly prescription drugs.

How much does private health insurance cost?

The average cost of individual health insurance is currently $541 per month for a 40-year-old.

However, your costs will vary depending on the state you live in, your age and the metal tier of coverage that you select.

For example, if you are 60 years old, then you would expect to pay upwards of 2.5 times more for your health insurance compared to a 21-year-old with the same policy. On the other hand, a 60-year-old in Texas may pay slightly less for the same Silver health insurance policy compared to a 60-year-old in New York.

Health insurance discounts

If you have a low to moderate income and shop for coverage on Healthcare.gov or your state marketplace, you may qualify for two programs to reduce your costs:

Subsidies, also called premium tax credits, can help reduce the monthly cost of a health insurance plan by scaling the amount you pay to your expected annual income. This discount is available for all plan tiers except Catastrophic.

A cost-sharing reduction (CSR) is only available for Silver plans and can improve your plan's benefits by lowering the deductible, copayments and out-of-pocket maximum. This reduces how much you could have to pay for medical care.

{"backgroundColor":"ice","content":"\u003C\/p\u003E\n\n\u003Ch3\u003EHealth insurance discounts\u003C\/h3\u003E\n\n\u003Cp\u003EIf you have a low to moderate income and shop for coverage on Healthcare.gov or your state marketplace, you may qualify for two programs to reduce your costs:\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cstrong\u003ESubsidies\u003C\/strong\u003E, also called premium tax credits, can help reduce the monthly cost of a health insurance plan by scaling the amount you pay to your expected annual income. This discount is available for all plan tiers except Catastrophic.\u003C\/p\u003E\n\n\u003Cp\u003EA \u003Cstrong\u003Ecost-sharing reduction\u003C\/strong\u003E (CSR) is only available for Silver plans and can improve your plan's benefits by lowering the deductible, copayments and out-of-pocket maximum. This reduces how much you could have to pay for medical care.\u003C\/p\u003E\n\n\u003Cp\u003E","padding":"double"}

The insurance company you choose can also affect how much you pay for coverage and the quality of your experience. There are pros and cons to each insurer, and shoppers frequently choose to pay a little more for an individual health insurance plan with better and more convenient service, which is a way to help avoid the stress and hassle of dealing with insurance claims.

Best overall individual health insurance

{"align":"left","buttonColor":"primary","buttonIcon":"lock","buttonText":"Apply Now","category":"life_insurance_companies","className":"","cloudinaryImageName":"referral_logos\/us\/insurance\/bluecrossblueshield-1","cssNamespace":"AffiliateTileBanner","context":"","disclaimers":[""],"isButtonSquare":true,"link":"https:\/\/www.bcbs.com\/","name":"BlueCross BlueShield ","showUnavailableText":false}
  • $414 per month
  • Half as many complaints as the industry average
  • Largest network of doctors

Blue Cross Blue Shield (BCBS) is one of the best health insurance companies because of its good customer satisfaction, low rate of complaints and variety of plans offered across all 50 states.

BCBS plans are sometimes more expensive than other health insurance companies, costing an average of $414 per month for a Bronze plan. However, they're a good choice for those who want high-quality benefits and access to a wide selection of medical providers.

Read our full review

Cheapest individual health insurance, but limited availability

{"align":"left","buttonColor":"primary","buttonIcon":"lock","buttonText":"Apply Now","category":"life_insurance_companies","className":"","cloudinaryImageName":"referral_logos\/us\/life_insurance\/kaiser-2","cssNamespace":"AffiliateTileBanner","context":"","disclaimers":[""],"isButtonSquare":true,"link":"https:\/\/healthy.kaiserpermanente.org\/shop-plans","name":"Kaiser Permanente","showUnavailableText":false}
  • $338 per month
  • Two-thirds fewer complaints than the industry average
  • Narrow network of doctors

Kaiser Permanente is one of the cheapest health insurance companies, with a Bronze plan costing $338 per month, on average.

Plans are only offered in eight states and Washington, D.C., including California, Colorado, Georgia, Hawaii, Oregon, Washington state, Maryland and Virginia. But its good ratings and few complaints make it a popular choice for those who can get it.

Read our full review

{"align":"left","buttonColor":"primary","buttonIcon":"lock","buttonText":"Apply Now","category":"life_insurance_companies","className":"","cloudinaryImageName":"referral_logos\/us\/life_insurance\/unitedhealthcare-2","cssNamespace":"AffiliateTileBanner","context":"","disclaimers":[""],"isButtonSquare":true,"link":"https:\/\/www.uhc.com\/","name":"UnitedHealthcare","showUnavailableText":false}
  • $468 per month
  • 50% more complaints than the industry average
  • Low-cost prescriptions and add-on coverage such as dental

UnitedHealthcare (UHC) is the largest health insurance company, with 12% of the market.

UHC is a great choice for those shopping for an individual or family plan because of the variety of available plans, access to add-on benefits and robust digital tools that make it easy to manage your coverage. The downside is that plans can be expensive, and UHC has a high rate of complaints, indicating issues with the service you'll get.

Read our full review

Frequently asked questions

Can I buy health insurance on my own?

Yes, you can buy an individual or family health insurance policy, which is a good choice for those who don't have a plan through an employer, Medicaid or Medicare. Plans are sold by private insurance companies, and you can choose the level of coverage that works for your budget and medical needs.

Can I buy private health insurance at any time?

Yes, you can buy health insurance at any time when you shop directly through an insurer, broker or agent. However, you can only shop on the health insurance marketplace, Healthcare.gov, during the open enrollment period (Nov. 1 through Jan. 15) or if your situation qualifies you for a special enrollment period.

What’s the best private insurance company?

Blue Cross Blue Shield (BCBS) is our top pick for the best health insurance company for individuals and families. It has high customer satisfaction, enrollees have access to a large network of medical providers, and plans are widely available.

Why is private health insurance so expensive?

The cost of health insurance is largely driven by how expensive medical care is. Plus, those who are buying private health insurance are paying the full cost of the policy. In contrast, those who get health insurance through their job split the policy cost with their employer.

What are the disadvantages of private health insurance?

Cost and access to care are the most common complaints about health insurance. Plans can be expensive, and you'll still have to pay a portion of your medical costs. Plus, insurance plans have networks of doctors and medical facilities, making it important to stay within the plan's network to get the best deal. However, the advantages of health insurance usually outweigh its disadvantages.


Sources and methodology

Our pick for the best health insurance company is based on average insurer performance ratings from the National Committee for Quality Assurance (NCQA).

The cheapest insurance company, along with the average cost per provider, was calculated from Public Use Files (PUF) from the Centers for Medicare & Medicaid Services (CMS). Costs are based on 2022 health insurance plans offered in Arizona, Georgia, Missouri, North Carolina, Ohio, Oregon, Texas and Wisconsin using quotes for a 40-year-old purchasing a full-price Bronze or Expanded Bronze plan.

The largest health insurance company is based on data from S&P Capital IQ, and the most popular individual insurer in each state is from S&P Global Market Intelligence data.

Insurer ratings are based on ValuePenguin's review methodology. Additional data about insurer complaints is from the National Association of Insurance Commissioners (NAIC).

Editorial Note: The content of this article is based on the author’s opinions and recommendations alone. It has not been previewed, commissioned or otherwise endorsed by any of our network partners.