Why Is Health Insurance More Expensive for Single People? - Assurance IQ (2024)

Why Is Health Insurance More Expensive for Single People?

Family insurance tends to cost less per person because with family insurance plans, the risk of filing a claim is spread across multiple people, often including children and adults who are relatively young and healthy. Single policyholders paid anaverage annual premium of $7,911 for employer-sponsored health insurance. In contrast, annual premiums for family coverage (where “family” is defined as a family of 4) cost $22,463 on average, breaking down to around $5,616 per person.

Individual plans often have lower annual deductibles than family plans with per-person deductibles. People with single coverage paid an average annual deductible of $1,562 in 2022. Among families whose plans set separate deductibles for each beneficiary, average annual deductibles ranged from $1,506 to $3,325 per person depending on plan type.

That said, most family plans set aggregate — not per-person — deductibles. Insurance companies typically view plans with per-person deductibles completely fulfilled once two or three family members meet their deductible amounts.

Married couples without kids might be better off paying for single coverage. Joint health insurance is often more expensive per person than single coverage because insurance companies consider couples at higher risk.

Table of Contents

What Factors Impact the Cost of Health Insurance?

Health insurance premiums vary based on your age and location. Tobacco use and your chosen insurance plan category also impact your premium price.

Age

Insurers tend to set higher premiums for older individuals because health risks increase as you age. Premiums for older people can be up to three times as high as those for younger people. Some insurance providers even set age caps for individuals buying new health insurance policies.

Location

Cost of living, local regulations, and competition among health insurers impact premium prices, which vary depending on where you live. Insurance providers tend to see less competition in sparsely populated regions. For this reason, people in rural areas usually pay more for health insurance than people in urban settings.

Why Is Health Insurance More Expensive for Single People? - Assurance IQ (1)

Tobacco Use

The Affordable Care Act (ACA) allows insurers to raise health premium prices by up to 50% for tobacco users compared to non-tobacco users. California, Massachusetts, New Jersey, New York, Rhode Island, Vermont, and the District of Columbia prohibit tobacco surcharges, and several other states limit these surcharges. However, in most of the U.S., tobacco users pay more for health insurance.

Plan Category

You can choose from five categories of health insurance plans on the Health Insurance Marketplace:

  • Bronze
  • Silver
  • Gold
  • Platinum
  • Catastrophic

Bronze plans cost less but have higher deductibles, and you may pay more out of pocket for healthcare services. Platinum plans have lower deductibles and out-of-pocket costs but tend to come with higher premiums.

Plan categories and options do vary if you shop outside of the marketplace. Private health insurance companies may not offer the same categories of plans or offer fewer choices.

At a Glance: Healthcare Costs for Individuals vs. Families

Single enrollees typically pay higher annual premiums per person compared to family-coverages, but their deductibles also tend to be lower per person.

Note that for family health insurance, average deductibles vary depending on plan type and whether a plan uses an aggregate deductible (the most common option among family plans) or individual deductibles.

Most reputable sources do not differentiate between family and individual plans regarding average cost-sharing terms for copays, coinsurance, and prescription drug coverage.These numbers may differ depending on your plan type. For example, not all health insurance plans use tier-based cost-sharing for prescription drugs.

Avg. Total Cost for Singles

Avg. Total Cost for Families

Avg. Per Person Cost for Families

Annual Premium

$7,911

$22,463

$5,616

Annual Deductible

$1,763

$3,643 (aggregate deductible, all plan types)

$2,143 (per-person deductible, all plan types)

Copays

$27 (primary care)$44 (specialty care)

$27 (primary care)$44 (specialty care)

$27 (primary care)$44 (specialty care)

Coinsurance

19% (primary care)20% (specialty care)

19% (primary care)20% (specialty care)

19% (primary care)20% (specialty care)

Prescriptions

$11-$116 (copay, tier-based cost sharing)18%-27% (coinsurance, tier-based cost sharing)

$11-$116 (copay, tier-based cost sharing)18%-27% (coinsurance, tier-based cost sharing)

$11-$116 (copay, tier-based cost sharing)18%-27% (coinsurance, tier-based cost sharing)

Source: KFF’s 2022 Employer Health Benefits Survey

How Can Single People Reduce the Cost of Healthcare?

You can have both single coverage and affordable health insurance especially if you take advantage of cost-cutting plans and programs. Survey your options for health coverage and care to keep your healthcare expenses low.

Why Is Health Insurance More Expensive for Single People? - Assurance IQ (2)

Group Health Insurance

Group health insurance plans are usually employer-sponsored and are only available to groups. In other words, an individual cannot purchase coverage through a group plan. Group health insurance tends to cost less because the risk of filing a claim is distributed among more people. Types of group health insurance include health maintenance organizations (HMOs), Preferred Provider Organizations (PPOs), and High-Deductible Health Plans (HDHPs).

Preventative Care

Most health insurance plans cover preventative care, which aims to prevent illnesses, diseases, and injuries rather than treating such conditions after the fact. Intervening before or early on once a condition develops can reduce expenses in the long term for both the policyholder and the health insurance provider.

Medicaid

Medicaid is a government-sponsored program that provides low-cost health coverage for low-income individuals and other qualifying people. Eligibility criteria for Medicaid vary by state. However, most states require candidates to qualify based on financial factors (determined by modified adjusted gross income) and non-financial factors (such as U.S. citizenship and state residency status).

Generic Medications

A generic medication is a prescribed drug that imitates a name-brand drug by following the same active ingredient formula. Since name-brand drugs have undergone stringent clinical studies to gain approval by the Food and Drug Administration, their generic counterparts do not need the same level of research. For this reason, generic drugs are usually cheaper.

Medicare

Single people aged 65 or older may qualify for Medicare, a federal program providing low-cost health coverage. People with certain disabilities or terminal illnesses may also be eligible for Medicare even if they are younger than 65. Original Medicare comprises two parts: Part A and Part B. Most people do not pay a premium for Part A. As of 2022, Part B costs about $165 per month for most people. Medicare also has a low annual deductible of $226 as of 2023.

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Why Is Health Insurance More Expensive for Single People? - Assurance IQ (2024)

FAQs

Why is health insurance so expensive for individuals? ›

Healthcare system complexity

This complexity often results in administrative inefficiencies, increased paperwork, and higher operational costs for both healthcare providers and insurers. These added expenses are eventually passed on to consumers in the form of higher insurance premiums, deductibles, and copayments.

Why is health insurance so expensive for self-employed? ›

Generally, self-employed individuals can expect to pay higher premiums compared to those with employer-sponsored coverage, as they're responsible for the full cost of the plan. However, you may be eligible for subsidies or tax credits to help offset the cost of health insurance through the Health Insurance Marketplace.

Why is health insurance more expensive with a spouse? ›

You may also be subject to the “spousal surcharge,” where an employer will charge more for a family health insurance plan if it knows that a spouse has a health insurance plan available at his or her own employer. This fee may eliminate any cost savings that you might have experienced by combining plans.

Why is group insurance generally less expensive than individual policies? ›

The cost of group health insurance is usually much lower than individual plans because the risk is spread across a higher number of people. Simply put, this type of insurance is cheaper and more affordable than individual plans available on the market because more people buy into the plan.

Is it cheaper to get health insurance as a couple or individual? ›

If you and your spouse do not receive coverage through an employer, purchasing an individual health insurance plan as a married couple will save you some serious dollars. Combining health insurance will make it easier to make your deductible. One doubtful may be if one spouse has a serious health condition.

What is generally the most expensive way for an individual to obtain health insurance? ›

An ACA plan purchased on the healthcare exchange is generally far more expensive than a plan you get through your employer or a government program such as Medicare or Medicaid.

Why is health insurance more expensive for females? ›

The medical services women access generally surpass the typical deductible, resulting in higher costs. On top of this, analysis suggests that the actuarial value of the coverage offered to women – the percentage of average costs that a plan will cover – was less than to men.

Why do married people pay less for insurance? ›

Married people usually pay less for auto insurance because they're statistically less likely to file claims. However, if your spouse has a bad driving record or poor credit, you might save money by maintaining separate car insurance policies.

Why is life insurance more expensive for females? ›

“The price of life insurance is based on actuarial data,” Burgett says. “Statiscally, women live longer than men and are more likely to live past a [life insurance policy's] term length.

Why insurance is too expensive? ›

Auto insurance premiums are determined by factors you can control — such as where you live, the type of car you drive and how much coverage you buy — and those you can't, such as your age or inflation. Poor credit can significantly raise your rates in many states, as can accidents or DUI violations.

How does the cost of group life insurance generally compare to the cost of individual life insurance? ›

Group life insurance is generally less expensive than individual life insurance because your employer pays all or most of the cost. It's often easier to qualify for group life insurance because there's no medical exam required—unless you want to buy extra group life.

What is one advantage of individual insurance over group insurance? ›

Advantages of an individual plan: You can choose the insurance company, the plan and the options that meet your needs. You can renew or change health insurance plans, options and health insurance companies during the annual Open Enrollment period.

What to do when health insurance is too expensive? ›

There are two types of subsidies: premium tax credits and cost sharing subsidies. Premium tax credits are the most common type of subsidy and help you save on your monthly premium. Cost-sharing subsidies help offset the costs of out-of-pocket expenses such as deductibles and copays.

Why do people not pay for health insurance? ›

uninsurance has been attributed to a number of factors, including rising health care costs, the economic downturn, an erosion of employer-based insurance, and public program cutbacks. Developing effective strategies for reducing uninsurance requires understanding why people lack insurance coverage.

What is the average cost of health insurance per person in the US? ›

Individuals enrolled in group health plans paid an average annual premium of $8,435 in 2023 (about $703 per month), according to data from independent health and medical research firm KFF. For families, the total annual premium averaged at $23,968 — or about $1,997 per month.

Is it cheaper to not have health insurance in the US? ›

Medical Care Costs

These costs are a bargain compared to what you might pay without insurance. Most people who are uninsured don't receive their care for free or even at a lesser charge, according to the Kaiser Family Foundation (KFF). In fact, just 27% of the uninsured receive such price breaks.

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