What is a health insurance premium?

Everything there is to know about how health insurance premiums work.

What you need to know

Your health insurance premium is your monthly payment to access your health insurance plan. You need to pay your monthly premium in order to keep your health insurance plan active.

You may also qualify for a premium tax credit, which, if you take it in advance, can reduce your monthly premium payment. You can also choose to take the tax credit when you file your annual tax return.

While some people think of the premium as the "cost" of your health insurance plan, there are other costs that go into how much you'll spend out-of-pocket for health services. Deductibles, copayments, and coinsurance all affect the true monthly cost of your health insurance plan and your care.

Plans with low monthly premiums may not be the best fit for you if they have a high deductible, copayment, or coinsurance. If you frequently utilize health services and choose a policy with a low premium, you may end up paying more out-of-pocket because of high deductibles and other out-of-pocket costs. Carefully weigh the different costs before choosing your plan.

Under the Affordable Care Act, there are only five factors that go into setting your premium:

  1. Your age
  2. Your location
  3. Whether or not you use tobacco
  4. Individual v.s. a family plan
  5. Your plan category (Bronze, Silver, Gold, Platinum, or catastrophic)

Health insurance companies are not allowed to take your gender or your current or past health history into account when setting your premium.