United States · Health insurance

US Individual Health Insurance: What a Plan Actually Costs You

By Best Worst Insurance Editorial TeamUpdated September 19, 2026

The US marketplace publishes everything you need to compare health plans properly and then sorts them by the one number that only tells you half the story. A plan's premium is public; so is its deductible, its out-of-pocket maximum and the exact cost-sharing it filed for every covered service. What nobody publishes is the two together, per county, as data you can download and check. So we did — 409 counties across Florida, Texas and Ohio, 11,105 plans a 40-year-old can actually buy ^[1,2] — and priced each one twice, on premium alone and on premium plus what that plan charges for a year of real care. The answer is not one number. For a year containing a birth, the cheapest-premium plan loses in all 409 counties, by a median of $4,546 to $6,310 ^[1,2]. For a year with a broken arm and nothing else, it never loses by as much as $1,000 in any of them ^[1,2]. Everything below is built from the CMS plan year 2026 filings, and every table on this site can be downloaded as a CSV.

Best Worst Insurance Key Takeaways

"Cheapest" is a question about your year, not about the plan list. Ranking by premium never costs a fracture-only year $1,000 in any of the 409 counties, where the median gap is $0 in Texas, $179 in Florida and $125 in Ohio ^[1,2]. It costs a diabetes year $1,000 or more in 44% of them ^[1,2], and a birth year $1,000 or more in 96% ^[1,2].
For a birth, the most expensive tier is often the cheapest plan. Gold wins 40% of the 409 counties ^[1,2], and the winning plan carries a $0 deductible in 77% of them ^[1,2].
A subsidy does not change which plan to buy. The credit is set by your county's benchmark Silver plan, not by your choice, so it subtracts the same dollars from everything — the median penalty is identical to the dollar at full price, at $55,000 and at $40,000 ^[1,3,4]. It does change which *county* is cheapest, sometimes reversing it entirely ^[1,3,4].
The 400%-of-poverty cliff is back for 2026. The enhanced credits expired on 31 December 2025, so a single person earning over $62,600 now gets nothing at all ^[3,4].
We publish three states, not fifty, and the reason is structural. The CMS Public Use Files cover the federally-facilitated marketplace only; the 22 states and the District of Columbia running their own exchange — California, New York, Washington, Illinois, Georgia — publish no plan-level data through it ^[1].

How we know: We compile the CMS Qualified Health Plan and Benefits & Cost Sharing Public Use Files for plan year 2026 — 340 rating-area ledgers, 28 states, 23,544 plan rows ^[1], compiled on 3 September 2026 — and price the 409 counties of Florida, Texas and Ohio in full ^[1,2]. For each county we take every plan a single 40-year-old can buy, add twelve months of premium to the plan's own filed cost-sharing for a year of care, and compare the lowest-premium plan against the lowest-total plan. Subsidies are computed from the statute: the 2025 HHS poverty guidelines and the applicable-percentage table in IRS Rev. Proc. 2025-25 §3.01. Every table is published as a downloadable CSV, so the arithmetic can be checked rather than trusted. Full methodology →

What ranking by premium costs, by how much care you use

409 counties across Florida, Texas and Ohio, single adult aged 40, full price. The penalty is the extra annual cost of buying the lowest-premium plan instead of the lowest-total-cost plan available in the same county ^[1,2].

A year in which you…	Counties where the premium sort costs $1,000+	Median penalty (TX / FL / OH)	Verdict
break an arm, and nothing else	0 of 409 ^[1,2]	$0 / $179 / $125	Buy on premium. There is no trap here
manage type 2 diabetes for a year	179 of 409 — 44% ^[1,2]	$150 / $1,438 / $2,107	Check your county. 77% of Ohio, 58% of Florida, 28% of Texas
have a baby (normal delivery)	393 of 409 — 96% ^[1,2]	$6,310 / $5,017 / $4,546	Never buy on premium. It loses in every county we measured

1. The marketplace publishes everything except the answer

Healthcare.gov will tell you what a plan costs a month. It will also tell you the deductible, the out-of-pocket maximum, and — in the Summary of Benefits and Coverage — what the plan charges for an emergency room visit or a delivery. All of it is filed with CMS and all of it is public.

What nobody publishes is the two together, per county, as a table you can download. The premium sits at the top of every list; the cost-sharing sits three clicks away in a PDF. And the reason is understandable: joining them requires assuming how much care you will use, and a comparison tool that assumes wrong for you has made your decision worse rather than better.

So we ran it three times instead of guessing once — a year with a fracture, a year of managing type 2 diabetes, a year with a normal delivery — for every plan in 409 counties across Florida, Texas and Ohio ^[1,2].

2. What came back

For a fracture year, the standard advice is right. In no county does the cheapest-premium plan cost $1,000 a year more than the best plan, and in the median Texas county it is the best plan ^[1,2].

For a diabetes year it depends where you live — 77% of Ohio counties carry a gap of $1,000 or more, against 58% in Florida and 28% in Texas ^[1,2].

For a birth year it is wrong everywhere. The cheapest-premium plan loses in all 409 counties, by a median of $6,310 in Texas, $5,017 in Florida and $4,546 in Ohio ^[1,2] — more than many of these buyers pay in premium for the whole year. In 40% of counties the plan that beats it is a Gold plan ^[1,2], the tier with the highest premiums on the marketplace.

That is the whole finding, and it is why this section exists as tables rather than as advice.

3. Where to go next

Three states priced in full, county by county. Each page names both plans in every row and offers the whole table as a downloadable CSV.

If you want…	Go to
The cheapest plan in your Texas county — all 254 of them	Cheapest health insurance in Texas — the state where buying on premium holds up best, and where a birth year costs most to get wrong ^[1,2]
The cheapest plan in your Florida county — all 67	Cheapest health insurance in Florida — the largest plan field on the federal marketplace at 7,569, and a premium range of $5,121 to $11,389 ^[1,2]
The cheapest plan in your Ohio county — all 88	Cheapest health insurance in Ohio — the cheapest of the three states, and the worst premium trap of them at 77% of counties ^[1,2]
The whole argument, with the counterexample	What ranking by premium costs you — 409 counties, three care scenarios, including the case where sorting by premium is simply right
The plans that charge you twice for one visit	The cost-sharing nobody reads — 3,703 filed entries charging a copay AND a coinsurance for the same service, 95% of them from Blue-branded carriers ^[1]
A worked case: self-employed, $55,000, Texas	The numbers for that exact situation — including why San Antonio is cheaper than Houston after the credit and more expensive before ^[1,3,4]

4. How to check us

Every county table on this site publishes as a CSV, naming both plans in each row with their deductibles, premiums, out-of-pocket costs and totals. The three-state file — 1,227 rows — is the whole dataset behind these pages.

We do that because there is nowhere else to point. The CMS files are public domain and anyone can download them, but turning them into a comparable per-county answer takes a compiler, and ours is not a published product. Publishing the output is the substitute: the source is checkable, the arithmetic is checkable, and if we have it wrong the file is how you would find out.

Four limits apply across everything here. These price one buyer, a single 40-year-old at full price. The three care scenarios are CMS's own stylised courses, comparable across counties but not a forecast of your year. Catastrophic plans are excluded, because ACA §1302(e) sells them only to buyers under 30 or holding a hardship exemption, which our reference buyer is not assumed to have; so are the 418 Texas rows with no service area ^[1,2]. And none of it addresses networks or drug formularies — two plans at the same total cost are not the same plan if one of them does not cover your doctor.

Frequently asked questions

What is the cheapest health insurance on the US marketplace?

It depends on your county and on how much care you expect to use, and both halves matter. In the three states we price in full, the lowest premium for a 40-year-old runs from $4,226 a year in Cottle County, Texas ^[1,2] to $11,389 in Monroe County, Florida ^[1,2]. Whether that lowest-premium plan is the cheapest *plan* is a different question: for a year containing a birth it is not, in any of the 409 counties we measured ^[1,2].

Why do you only cover Florida, Texas and Ohio?

The CMS Public Use Files cover the federally-facilitated marketplace only, which is 28 states; the 21 running their own exchange — California, New York, Washington, Illinois and Georgia among them — publish no plan-level data through that route ^[1]. Of the states we can reach, Florida, Texas and Ohio are the three we judged highest-value to publish first. We publish the states we can stand behind rather than the ones that would make the map look complete.

Are these prices before or after a subsidy?

Before, unless a page says otherwise. Full price is the honest default because the credit depends on your household and your county, and because it barely changes which plan is cheapest — it is a fixed dollar amount set by your county's benchmark Silver plan, so it comes off every plan equally, until it exceeds the cheapest premium outright. At a $40,000 income that happens in 38 of our 409 counties, and reorders 34 of them ^[1,3,4]. Where we do apply it, we compute it from the statute rather than estimating.

How current is this data?

Plan year 2026, compiled from the CMS filings on 3 September 2026 ^[1]. Plan year 2027 rates publish with open enrolment on 1 November, at which point every figure here becomes last year's and we refresh it.

Can I download the underlying numbers?

Yes, and that is deliberate. Every county table on this site is published as a CSV naming both plans in every row with all their component figures — the three-state file is here, 1,227 rows. The source data is CMS's and is public domain; what we add is the arithmetic, which is exactly the part worth checking.

Do you sell insurance or take commission?

No. We publish comparisons and the data behind them. Nothing on these pages is a referral link, and no carrier pays to appear or to be ranked where it is ranked.

Sources

Every figure on this page is footnoted to one of the primary documents below. Reliability tiers: A = regulator, court or filed document; B = reputable publisher or carrier official page; C = user-generated (reported by users).

1.Centers for Medicare & Medicaid Services — Qualified Health Plan Landscape and Benefits & Cost Sharing Public Use Files, plan year 2026. https://www.cms.gov/marketplace/resources/data/public-use-filesTier A · Regulator / court / filed document · Published 2026-08-01 · Accessed 2026-09-03
2.Best Worst Insurance — Annual cost of every marketplace plan in 409 counties, ranked two ways (PY2026). https://bestworstinsurance.com/data/us-health/county-plan-costs.csvTier A · Regulator / court / filed document · Published 2026-09-19 · Accessed 2026-09-19
3.Internal Revenue Service — Revenue Procedure 2025-25 — Applicable Percentage Table for 2026. https://www.irs.gov/pub/irs-drop/rp-25-25.pdfTier A · Regulator / court / filed document · Published 2025-07-18 · Accessed 2026-09-19
4.US Department of Health and Human Services, ASPE — 2025 Poverty Guidelines. https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelinesTier A · Regulator / court / filed document · Published 2025-01-17 · Accessed 2026-09-19

Everything we’ve published on Individual Health Insurance

The full library behind this verdict — every page that went into it, and the working behind each one.

Comparisons & verdicts

Carrier-vs-carrier reads of the filed wordings, and who they leave exposed.

Answers

One question, answered from the policy documents.

Self-Employed in Texas on $55,000: The Cheapest PlanYour credit is $1,627 in Houston and $3,681 in San Antonio, which flips which city is cheaper. The worked numbers for six Texas counties.

Research

Original analysis of court records and market documents.