Health Insurance Costs: Premiums, Deductibles and 2027 Limits

The four costs that make up your bill

• Premium: what you pay every month to have coverage, whether or not you use it.
• Deductible: what you pay for covered care each year before the plan starts sharing costs.
• Copays and coinsurance: your share after the deductible, either a flat fee or a percentage.
• Out-of-pocket maximum: the most you pay for covered in-network care in a year.

The cheapest premium is not always the cheapest plan. A low premium usually comes with a higher deductible, so compare a full year of premiums plus what you expect to spend on care.

Employer health insurance costs

Source: KFF, 2025 Employer Health Benefits Survey, Summary of Findings (Oct. 2025). Monthly figures are our division of the annual amounts.

Premiums grew faster than pay in 2025. Family premiums rose 6% while wages rose 4% and inflation was 2.7%. Over five years the picture is closer: family premiums rose 26%, against wage growth of 28.6% and inflation of 23.5%.

Deductibles and copays

For workers whose plan has a deductible, the average for single coverage was $1,886 in 2025. It is up 17% over five years and 43% over ten. Firm size matters a lot: the average was $2,631 at firms with 10 to 199 workers and $1,670 at larger firms. About 34% of covered workers had a single deductible of $2,000 or more, rising to 53% at small firms.

For office visits, the average copay was $27 for primary care and $45 for a specialist. Workers with coinsurance paid 19% on average.

Example: a single worker at an average employer pays $1,440 a year in premiums. If they have a moderate health problem that uses up the $1,886 average deductible, they spend $3,326 before coinsurance starts.

ACA Marketplace costs for 2026 and 2027

What happened in 2026

Benchmark silver premiums rose 26% on average for 2026, according to KFF. The biggest jumps were in Arkansas (69%), Washington (41%), Tennessee (38%), Mississippi (37%) and Illinois (36%). Alaska was the only state where the average fell.

At the same time, the enhanced premium tax credits expired at the end of 2025. Before they expired, KFF estimated that subsidized enrollees' average yearly premium payment would rise 114%, from $888 in 2025 to $1,904 in 2026. CMS reported that Bronze plans rose to 40% of 2026 sign-ups, with Silver at 43% and Gold at 17%.

What to expect for 2027

Insurers proposed a median increase of 15% for 2027, based on KFF's review of 276 insurers in all 50 states and D.C. Fifty-one insurers asked for 25% or more. Insurers pointed to medical and drug costs, including demand for GLP-1 drugs, federal rule changes and the loss of the enhanced credits. Proposed rates are often revised before final approval, so check actual 2027 prices when open enrollment begins on November 1, 2026.

Subsidies now follow the original ACA rules:

• No premium tax credit if your income is above 400% of the poverty level: $62,600 for one person and $128,600 for a family of four for 2026 coverage.
• Below that, you are expected to pay 2.15% to 10.22% of income for the benchmark silver plan in 2027, with the credit covering the rest.
• From tax year 2026, there is no cap on repaying excess advance credits if your income turns out higher than you estimated.

For subsidized enrollees, much of a premium increase is absorbed by a larger credit. Unsubsidized buyers, including everyone over the 400% line, pay the full increase.

Worked example: what a single buyer might pay in 2027

Say you are single and expect income of $50,000 in 2027, below the 400% cutoff. The top expected contribution for 2027 is 10.22% of income. At that rate you would pay at most about $5,110 a year, or about $426 a month, for the benchmark silver plan, and the tax credit would cover the rest. Your exact percentage depends on where your income falls relative to the poverty level. You can apply the credit to a cheaper Bronze plan and pay less in premiums, but you take on a higher deductible. If your income ends up above the 400% line, you lose the credit entirely and would have to repay any advance payments.

Prescription drug costs

Drug costs are one reason premiums keep rising. In KFF's 2025 survey, 19% of firms with 200 or more workers covered GLP-1 drugs for weight loss, and 43% of the largest firms (5,000 or more workers) covered them in their biggest plan, up from 28% in 2024. If you rely on an expensive drug, check each plan's formulary before choosing, because the cheapest premium may cover your drug poorly.

Out-of-pocket limits and HSA limits

Source: CMS 2027 cost-sharing guidance via WTW (Feb. 2026); IRS figures via the International Foundation of Employee Benefit Plans (2025 and June 2026, Rev. Proc. 2026-24).

The ACA cap rose 13.2% for 2027, so a family's worst-case in-network spending can go up by $2,800. HSA-eligible plans have their own, lower cap. People 55 and older can add a $1,000 HSA catch-up contribution.

If your employer offers a health flexible spending account instead, the 2026 limit is $3,400. Unlike an FSA, an HSA stays with you if you change employers, according to IRS Publication 969.

Ways to cut your health insurance costs

1. Use a health savings account if you qualify

If you have an HSA-eligible high-deductible plan, IRS Publication 969 lists the tax breaks: contributions are deductible (or excluded from pay if made by your employer), earnings grow tax-free, and withdrawals for qualified medical expenses are tax-free. The account stays with you if you change jobs. Since January 2026, Bronze and catastrophic Marketplace plans have also counted as HSA-eligible under the 2025 tax law. Withdrawals for other purposes are taxed, plus a 20% additional tax before age 65 unless you are disabled.

2. Check for cost-sharing reductions

If your income is up to 250% of the poverty level (up to $39,125 for one person for 2026 coverage), a Marketplace Silver plan comes with lower deductibles and copays. The plan's actuarial value rises from about 70% to as high as 94% for the lowest incomes. You only get this on a Silver plan, so a cheaper Bronze plan can cost more in the end.

3. Estimate your income carefully

Your credit is based on projected income. Update the Marketplace if your income changes during the year, since excess credits must now be repaid in full.

4. Use free preventive care and stay in network

Most plans, including Marketplace plans, must cover a set of preventive services such as immunizations and screenings with no copay or coinsurance when you see an in-network provider, even before the deductible. HealthCare.gov notes that $0 cost isn't guaranteed in every case, so ask first.

5. Compare employer plan options each year

A plan with a higher deductible and an HSA can cost less overall if you are healthy, especially if your employer contributes to the account. A plan with a lower deductible may be cheaper if you expect surgery, a pregnancy or ongoing prescriptions.

6. Budget for the out-of-pocket maximum

Know your plan's cap and keep savings toward it. Our emergency fund guide and budgeting guide can help. For plan and insurer options, see our guide to the best health insurance options, and for dental, vision and other coverage, our health coverage hub.

Frequently asked questions

Sources

• KFF – 2025 Employer Health Benefits Survey, Summary of Findings
• KFF – Annual family premiums for employer coverage rise 6% in 2025
• KFF – ACA Marketplace premium payments would more than double if enhanced credits expire
• Becker's Payer Issues – Where ACA benchmark premiums are rising the most in 2026
• Fierce Healthcare – Insurers propose a median ACA rate hike of 15% for 2027
• CMS – Exchange coverage remains near record high: 23.1 million enroll in 2026
• WTW – CMS releases 2027 out-of-pocket expense limits
• IFEBP – IRS releases 2027 HSA, HDHP and HRA inflation-adjusted amounts
• IFEBP – IRS releases 2026 HSA, HDHP and HRA inflation-adjusted amounts
• IRS – Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans
• healthinsurance.org – Cost-sharing reductions
• healthinsurance.org – Will you receive an ACA premium subsidy?
• HealthCare.gov – Preventive care benefits
• BenefitChamps – What changed for 2027 open enrollment

Rates, fees and terms change often. Figures were checked in October 2026; confirm current details with the provider before you apply.