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Employer health insurance costs
| 2025 averages | Single | Family |
|---|---|---|
| Total yearly premium | $9,325 | $26,993 |
| Worker’s share | $1,440 (16%) | $6,850 (26%) |
| Worker’s share per month | about $120 | about $571 |
| Change from 2024 | +5% | +6% |
Source: KFF 2025 Employer Health Benefits Survey.
Family premiums rose 26% over five years, slightly less than wages (28.6%) but more than inflation (23.5%). Workers at small firms often pay more toward family cover and face higher deductibles.
Deductibles and copays
- The average single deductible for workers with one was $1,886 in 2025: $2,631 at firms with 10–199 workers and $1,670 at larger firms.
- 34% of covered workers had a single deductible of $2,000 or more.
- Typical office visit costs: $27 primary care copay, $45 specialist copay, or 19% coinsurance.
- Deductibles rose 17% over five years and 43% over ten.
Example: a single worker paying the average premium share ($1,440) who meets the average deductible ($1,886) spends about $3,326 before coinsurance even starts.
Marketplace costs
Benchmark Silver premiums rose about 26% on average for 2026, with the biggest increases in Arkansas (69%), Washington (41%) and Tennessee (38%). For 2027, KFF’s review of 276 insurers found a median proposed increase of about 15%. Insurers cite rising hospital and drug costs, demand for GLP-1 weight-loss drugs and policy changes, including the expiry of enhanced subsidies.
What you actually pay depends heavily on subsidies. With the enhanced credits gone, someone at 300%–400% of the poverty level pays up to 10.22% of income for the benchmark plan in 2027; above 400%, there’s no help. See our subsidies guide.
Out-of-pocket maximums
| ACA out-of-pocket maximum | Self-only | Family |
|---|---|---|
| 2026 | $10,600 | $21,200 |
| 2027 | $12,000 | $24,000 |
Source: CMS 2027 guidance, via WTW (February 2026).
Once you hit this limit, the plan pays 100% of covered in-network care for the rest of the year. Premiums don’t count toward it.
Health savings accounts
| IRS limits | 2026 | 2027 |
|---|---|---|
| HSA contribution, self-only | $4,400 | $4,500 |
| HSA contribution, family | $8,750 | $9,000 |
| HDHP minimum deductible (self / family) | $1,700 / $3,400 | $1,750 / $3,500 |
| HDHP out-of-pocket max (self / family) | $8,500 / $17,000 | $8,700 / $17,400 |
HSAs are triple tax-advantaged: contributions are deductible, growth is tax-free and withdrawals for qualified medical expenses are tax-free. People 55 and older can add $1,000. The money is yours to keep if you change jobs or plans. Bronze and catastrophic Marketplace plans can now be paired with an HSA.
Ways to lower your costs
- Compare total yearly cost, not just premiums. A higher-premium plan can be cheaper if you use a lot of care.
- Use in-network providers and free preventive services.
- Fund an HSA or FSA to pay costs with pre-tax money.
- Ask for generic drugs and check formulary tiers.
- Re-check subsidy eligibility every open enrollment; see our Marketplace guide.
- Compare network types; see HMO vs. PPO.
Frequently asked questions
How much is health insurance per month?
Through an employer, the average worker paid about $120 a month for single cover and $571 for family cover in 2025. Marketplace prices vary widely by age, location and subsidy.
What is the average health insurance deductible?
$1,886 for single cover in employer plans in 2025, and higher ($2,631) at small firms.
What is the out-of-pocket maximum for 2027?
$12,000 for an individual and $24,000 for a family on ACA-compliant plans.
Why is health insurance going up in 2027?
Insurers cite rising medical and drug costs, GLP-1 drug demand and policy changes. Smaller subsidies mean many enrollees pay more of the premium themselves.
Is a high-deductible plan worth it?
Often for healthy people who can fund an HSA. If you expect high medical costs, a lower-deductible plan may cost less overall.
Sources
- KFF – 2025 Employer Health Benefits Survey: summary of findings
- KFF – Family premiums for employer coverage rise 6% in 2025
- Becker’s Payer – 2026 benchmark premium increases by state
- Fierce Healthcare – Preliminary 2027 ACA rate filings (Aug 2026)
- healthinsurance.org – Will you receive an ACA premium subsidy?
- WTW – CMS releases 2027 out-of-pocket limits (Feb 2026)
- IFEBP – IRS releases 2026 HSA and HDHP amounts
- IFEBP – IRS releases 2027 HSA and HDHP amounts
- IRS – Publication 969, HSAs and other tax-favored health plans
- BenefitChamps – What changed for 2027 open enrollment (Sept 2026)
- HealthCare.gov – Preventive care benefits
Insurance prices, discounts and rules change often and vary by state. Figures were checked in October 2026; confirm details with the insurer or your state insurance department.