A major topic in the first presidential debate was healthcare; specifically what each candidate proposes to do with Obamacare. An Obamacare case will also be before the Supreme Court soon.
Health insurance can be a major expense, and if Obamacare goes away, there’s no question that people will have fewer healthcare options. Because health insurance costs vary greatly by state, you might be paying more than you would if you lived elsewhere.
To determine the best and worst states for health insurance costs, GOBankingRates ranked all 50 states based on two factors: the average monthly insurance premium and the average annual deductible with a silver plan. Please note that this study is based on 2018 data; while costs go up and down, the overall general picture is the same today. See where to find the best health insurance.
Last updated: Sept. 30, 2020.
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50. Alaska
Average monthly premium: $780 Average silver deductible: $3,750
Not only is Alaska one of the most expensive states to die, it’s also one of the most expensive to stay alive and healthy apparently.
Alaska has the highest health insurance premiums by state, which puts it at the bottom of this list. Fortunately, health insurance costs in the state are on the decline, Alaska’s KTOO Public Media reported.
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49. Wyoming
Average monthly premium: $662 Average silver deductible: $3,750
To help keep your costs down, find cheap ways to invest in your health — especially if you live in Wyoming.
Wyoming has the second-highest average monthly premium in the U.S., and those rates went up in 2018 for people with Blue Cross Blue Shield. The insurer announced in August 2017 that Wyoming residents who purchased an insurance plan through the federal health exchange would likely see their premium rates jump by 48 percent, the Casper Star Tribune reported.
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48. Indiana
Average monthly premium: $552 Average silver deductible: $6,763
Indiana has the second-highest average silver deductible in the country. Despite high deductibles, 168,223 Indiana residents signed up for health insurance through the Affordable Care Act during the 2018 enrollment period, which is only 3.7 percent fewer enrollees than the previous year, The Journal Gazette reported.
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47. New Hampshire
Average monthly premium: $542 Average silver deductible: $6,163
The average silver deductible in New Hampshire is the fifth-highest of all the states. Even with above-average deductibles, the New England state had a higher number of healthcare sign-ups per day in 2017 compared to 2016, the Concord Monitor reported.
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46. Illinois
Average monthly premium: $559 Average silver deductible: $5,325
Monthly premiums and deductibles are higher in Illinois than in most states. Unsubsidized monthly premiums through the Affordable Care Act marketplace in Illinois increased by 45 percent to 55 percent in 2016, and were expected to rise by another 43 percent in 2018, The State Journal-Register reported.
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45. Washington
Average monthly premium: $546 Average silver deductible: $5,763
Washington has the sixth-highest average silver deductible and one of the highest monthly premiums in the country.
Washington state insurance commissioner Mike Kreidler recently proposed a reinsurance program that he said will encourage more health plan options in the 2019 individual market and would lower premium increases by up to 10 percent, The Chronicle reported.
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44. Florida
Average monthly premium: $515 Average silver deductible: $6,913
Florida has the highest average silver deductible of any state, but that didn’t stop residents from enrolling. Out of all the states, Florida had the most residents sign up for ACA health insurance in 2017, with 1.7 million enrolled, according to the Centers for Medicare & Medicaid Services.
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43. West Virginia
Average monthly premium: $561 Average silver deductible: $4,925
West Virginia is one of the worst states for health insurance costs, with the eighth-highest average monthly premiums of any state. The state was the only one with a decline in marketplace sign-ups in 2017 compared to the same week in 2016, The Charleston Gazette-Mail reported.
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42. New York
Average monthly premium: $624 Average silver deductible: $2,175
New York is one of the costliest places to live in the U.S., and it has one of the highest average monthly premiums. On the flip side, it also has one of the lowest average silver deductibles.
Although premiums are high, the state did not see as sharp of an increase in costs in 2017 compared to the previous year as some other states did, WNYC reported.
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41. Ohio
Average monthly premium: $518 Average silver deductible: $6,625
Ohio has the third-highest average silver deductible in the nation. Even with its high deductibles, Ohio saw a 12 percent increase in healthcare enrollment from the previous year, Dayton Daily News reported.
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40. Vermont
Average monthly premium: $607 Average silver deductible: $2,225
Vermont has the fifth-lowest average silver deductible, but its high average monthly premium makes it one of the worst states for health insurance costs.
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39. North Carolina
Average monthly premium: $526 Average silver deductible: $5,500
North Carolina ranks among the 10 states with the highest deductible and among the 20 states with the highest monthly premium.
To get the most out of your insurance, try to take advantage of all the benefits your health insurance covers, which might include diet counseling, smoking cessation programs and massage therapy.
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38. Rhode Island
Average monthly premium: $564 Average silver deductible: $3,775
Average monthly premiums are relatively high in Rhode Island. Fortunately, you can take advantage of the various ways to survive rising healthcare costs, such as asking for generic prescriptions.
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37. South Carolina
Average monthly premium: $520 Average silver deductible: $5,613
South Carolina has relatively high average silver deductibles. However, one way to save money is to ask the pharmacy for deals on medication.
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36. Delaware
Average monthly premium: $541 Average silver deductible: $4,717
If you’re in a state like Delaware that has a high average health insurance deductible, try to take advantage of telemedicine when applicable. The online services might help you avoid co-pays and save on time spent in waiting rooms.
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35. Louisiana
Average monthly premium: $578 Average silver deductible: $2,925
People in Louisiana pay high average monthly premiums. To save money, head to a community health fair to receive free or low-cost health screenings.
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34. Montana
Average monthly premium: $555 Average silver deductible: $3,663
Emergency room visits can be a major expense on top of Montana’s high average monthly premiums. Save by visiting a walk-in clinic instead, as they often cost less than emergency room care.
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33. Georgia
Average monthly premium: $495 Average silver deductible: $6,188
In a state like Georgia that has a high average deductible, people can save money in some cases by paying in cash rather than using health insurance. The Association of American Physicians and Surgeons has a useful list of physicians who accept self-pay patients who choose to forgo insurance.
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32. New Jersey
Average monthly premium: $591 Average silver deductible: $2,075
New Jersey has one of the lowest average silver plan deductibles in the U.S., yet also one of the highest monthly premiums. Just like you can shop around for health insurance, you can also shop around for healthcare services. Take advantage of healthcare cost comparison sites to see the out-of-pocket expenses for certain services and doctors.
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31. South Dakota
Average monthly premium: $538 Average silver deductible: $3,763
After paying over $500 for monthly premiums, it can be a large financial burden for people in South Dakota to afford services that are not covered by insurance, such as in vitro fertilization. Consider using online lending for affordable financing plans for these services.
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30. Maine
Average monthly premium: $556 Average silver deductible: $3,000
If you haven’t hit your $3,000 deductible yet in Maine and are facing steep prescription costs, check around for options.
People who want to save on prescriptions might want to consider using health apps like GoodRx to check the price of prescriptions and get online coupons.
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29. California
Average monthly premium: $525 Average silver deductible: $4,138
To save on health costs, California residents should make sure they are only paying for prescriptions they really need. Medication needs can change with age and health.
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28. Wisconsin
Average monthly premium: $525 Average silver deductible: $4,063
Wisconsin residents might want to find ways to save money on their healthcare. Look for hacks that reduce healthcare costs, such as only using in-network providers.
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27. Connecticut
Average monthly premium: $530 Average silver deductible: $3,813
Connecticut ranks in the middle of states for the average silver plan deductible, but it’s still pretty steep. People who take regular prescriptions can save money by opting for 90-day over 30-day supplies, which usually cost less when broken down by month.
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26. Massachusetts
Average monthly premium: $554 Average silver deductible: $2,125
Massachusetts residents have one of the lowest average silver deductibles in the country, but a relatively high monthly premium. However, being active can help people save on healthcare costs.
On average, physically active adults have less health-related expenses than those who are sedentary. And it doesn’t cost a lot to work out if you opt for a cheap gym membership option.
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25. Arizona
Average monthly premium: $453 Average silver deductible: $5,625
If you live in Arizona and want to have lower health expenses, consider getting a dog. Having a pet can help you stay active, which can help reduce the frequency of doctors’ visits and obesity-related health risks.
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24. Texas
Average monthly premium: $480 Average silver deductible: $4,475
Texas residents have a higher average silver deductible than most states. But checking bills carefully is one way to potentially save on healthcare costs. Healthcare bills might contain errors that can save you money if caught and amended.
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23. Missouri
Average monthly premium: $462 Average silver deductible: $5,188
Although the average silver deductible is high in Missouri, you can spend less depending on which plan you choose. If you don’t take the time to shop around for a plan and keep the same plan year-to-year, even if your medical needs change, you might end up spending more than you need to on health insurance.
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22. Virginia
Average monthly premium: $475 Average silver deductible: $4,613
If you live in Virginia and your company offers a wellness program, take advantage of it. Not only can it improve your health, but some employers offer discounts on premiums or added contributions to FSAs or HSAs for participating.
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21. Maryland
Average monthly premium: $501 Average silver deductible: $3,438
People in Maryland have a relatively low monthly premium and deductible compare to other states. However, people who have a deductible higher than $1,300 and who have the option to use a health savings account might want to take advantage of it. HSA funds grow over time and can be used to cover medical expenses as needed.
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20. Nevada
Average monthly premium: $445 Average silver deductible: $5,513
Nevada residents who want to save on healthcare bills should consider negotiating them. Call the provider to see if there is wiggle room in the price, or ask for a payment plan if the expense is too high to pay at once.
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19. Colorado
Average monthly premium: $485 Average silver deductible: $3,638
If a medical procedure seems too costly to have done in Colorado or elsewhere in the U.S., consider having it done abroad.
However, it’s important to be aware of the best and worst medical procedures to have done in other countries to avoid serious risks.
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18. New Mexico
Average monthly premium: $494 Average silver deductible: $3,200
The average deductible is relatively low in New Mexico, so take advantage by bundling costs. Once you’ve reached your deductible, schedule any more elective medical procedures you are planning to have done for the same fiscal year to avoid having to pay the full deductible again the following year.
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17. North Dakota
Average monthly premium: $479 Average silver deductible: $3,763
For North Dakota residents who want to save on taxes, don’t forget to write off your medical expenses.
If your medical expenses are more than 10 percent of your adjusted gross income, or 7.5 percent if you’re age 65 or older, you can deduct them.
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16. Nebraska
Average monthly premium: $483 Average silver deductible: $3,500
Residents of Nebraska, or any other state, can avoid overpaying for blood work by going directly to a standalone lab. They usually charge less for testing than hospitals or some doctors’ offices.
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15. Kentucky
Average monthly premium: $437 Average silver deductible: $5,025
Health insurance is relatively affordable in Kentucky, so you could save money simply by having insurance. If you’re not enrolled, you will have to pay a steep tax fine, as the individual mandate is still in effect for 2018.
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14. Minnesota
Average monthly premium: $477 Average silver deductible: $3,075
Minnesota residents have a relatively low monthly premium compared to other states. However, if you’re married, consider comparing your employer’s health benefits to that of your spouse’s to determine which offers the best benefits at the lowest cost. Switching to one plan could save you money over being insured separately.
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13. Arkansas
Average monthly premium: $431 Average silver deductible: $4,788
If healthcare costs are a particularly major concern for you, consider moving from Arkansas to a state that has lower average monthly premiums and deductibles.
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11. Michigan
Average monthly premium: $467 Average silver deductible: $3,213
Health insurance costs are some of the lowest in the country in Michigan, where more people are opting for direct primary-care medicine, the Oakland Press reported.
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10. Iowa
Average monthly premium: $459 Average silver deductible: $3,500
Iowa is one of the best states for health insurance because of its relatively low average monthly premium, but costs have actually increased dramatically from the previous year. Premiums for individual health insurance policies in the state rose by at least 57 percent for 2018, the Des Moines Register reported.
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9. Kansas
Average monthly premium: $452 Average silver deductible: $3,500
Kansas’ low average monthly premiums make it the No. 9 best state for health insurance costs. Even though the open enrollment period in Kansas was cut in half from 2016 to 2017, more residents enrolled in 2017 than the previous year, The Kansas City Star reported.
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8. Oregon
Average monthly premium: $465 Average silver deductible: $2,813
Oregon has one of the lowest average silver deductibles in the U.S. As of January 2018, 95 percent of Oregon residents had some form of health insurance — among the highest rates in the country, Oregon Public Broadcasting reported.
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7. Pennsylvania
Average monthly premium: $490 Average silver deductible: $1,733
Pennsylvania has the lowest average silver deductible of any state. Even though health insurance costs are relatively low, the state saw a 7 percent dip in enrollment in 2017 compared to the previous year.
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6. Tennessee
Average monthly premium: $435 Average silver deductible: $3,938
Tennessee is one of the best states for health insurance costs because of its low average monthly premium. Prices increased between 2016 to 2017, but many Tennessee residents found that they were actually able to save money when shopping around for insurance, Nashville Public Radio reported.
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5. Alabama
Average monthly premium: $439 Average silver deductible: $3,600
Alabama has one of the lowest average monthly premiums, which makes it one of the best states for health insurance costs. During the 2017 open enrollment period, 170,023 Alabama residents signed up for health insurance, according to the Centers for Medicare & Medicaid Services.
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4. Idaho
Average monthly premium: $415 Average silver deductible: $3,663
Idaho has the second-lowest average monthly premium in the U.S. The state is currently working on providing more health insurance options for those who cannot afford it, Idaho’s KTVB reported.
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3. Utah
Average monthly premium: $423 Average silver deductible: $2,950
Utah has the third-lowest average monthly premium in the country, as well as one of the lowest average silver deductibles.
Despite low costs, the number of Utah residents who signed up for health insurance through the HealthCare.gov marketplace shrank slightly in 2017 compared to the previous year, the Associated Press reported.
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2. Oklahoma
Average monthly premium: $445 Average silver deductible: $1,863
Oklahoma has the second-lowest average silver deductible of all the states. In October 2017, a plan to make health insurance costs in Oklahoma even lower was denied by the federal government, Oklahoma City’s News 9 reported.
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1. Hawaii
Average monthly premium: $411 Average silver deductible: $2,750
Hawaii has the cheapest health insurance by state, with the lowest average monthly premium in the country. Premiums remain low despite the fact that most health insurance holders saw a 5.9 percent to 25 percent increase in rates in January 2018, West Hawaii Today reported.
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Most and Least Expensive States for Health Insurance
Where you live can greatly affect how much you pay for health coverage. The states with the lowest health insurance costs are:
The states with the highest health insurance costs are:
41. Ohio 42. New York 43. West Virginia 44. Florida 45. Washington 46. Illinois 47. New Hampshire 48. Indiana 49. Wyoming 50. Alaska
More from GOBankingRates
Methodology: GOBankingRates ranked all 50 U.S. states based on two factors: 1) average monthly insurance premium, based on data from United Benefit Advisors, and 2) average annual deductible, based on calculating the average of four popular silver deductibles from each state (used less than four if no more were available), using data from Stride Health. Findings are based on a single male (if asked), 40 years old, non-smoker, $51,640 annual income, which is the median income for individual males according to Census data. GOBankingRates looked at silver plans because they are the most popular nationally.
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