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For individuals and families · Licensed in 20 U.S. states

Your health insurance
premium, in plain terms.

A premium is the amount you pay, usually each month, to keep your health insurance active, whether you use care or not. For Marketplace plans and other ACA plans, federal rules let only a few factors change what a company charges you, and your health history isn't one of them. Here's what goes into the number and how to compare it.

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What a premium is

The monthly bill
is only one part.

Three points from HealthCare.gov about premiums:

You pay it to stay covered.

The premium keeps your coverage in force. It's separate from the deductible, copays, and coinsurance you pay when you get care, and it doesn't count toward your out-of-pocket maximum.

A tax credit can lower it.

If you buy a Marketplace plan and qualify, a premium tax credit can be paid to your insurer each month so you pay less. The credit is based on the income you expect, and it's settled on your tax return.

The lowest price may not fit.

A plan with a low premium may have a high deductible and cost more when you get care. HealthCare.gov suggests comparing your estimated total yearly costs, not just the monthly price.

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The five rating factors

What an ACA plan may base your price on.

These limits come from 45 CFR 147.102 and HealthCare.gov, how plans set your premiums, read October 30, 2026. States can limit these factors further.

Age: for adults 21 and older, age can't change the rate by more than 3 to 1, so for the same plan the oldest adults pay at most three times what the youngest adults pay.
Where you live: Florida has 67 rating areas, one for each county, and prices can differ between them.
Tobacco use: up to 1.5 to 1, or 50% more, for regular use in the past six months, where state law allows it.
Individual or family: covering more people raises the total, and each person's age and tobacco use are rated on their own share.
The plan you choose: the metal level matters, and so do the network and the insurer. Insurers can't charge more because of your health history or your sex.

Federal rating limits

The limits on what
changes your price.

3 to 1

The widest age-based price difference allowed among adults 21 and older.

1.5 to 1

The most tobacco use can raise a rate, which means up to 50% more.

Rating areas in Florida, one per county, for the individual and small group markets.

Ratios from 45 CFR 147.102; Florida areas from CMS, Florida Specific Geographic Rating Areas. Both read October 30, 2026.

Paul DanielsLicensed health advisor · NPN 20986580

Working with Paul

We compare premiums
and what comes after.

Daniels Health Advisors is the independent brokerage Paul Daniels founded, licensed in 20 U.S. states. We quote premiums after any tax credit you qualify for, then set each one next to the plan's deductible and out-of-pocket maximum so you see the whole year. If you're self-employed, we can point you to the self-employed health insurance deduction; your tax professional decides whether it applies. We also show private PPO options. Some private plans ask health questions, and approval is not guaranteed. Some may not cover care for health problems you had before you enrolled.

Bring the ages and ZIP code of everyone on the plan, whether anyone uses tobacco, and your best estimate of next year's household income.

Premiums shown after any tax credit, next to total costs
Licensed in 20 U.S. states · Paul Daniels, NPN 20986580 · FL license G065122
You do not pay us for our help. We are paid by the insurance companies when you enroll. Your price for a plan is the same whether you use us or sign up on your own. Commissions can differ by company.

Your first call

Comparing premiums in three steps.

Share your household

Ages, ZIP code, tobacco use, and an income estimate.

We quote each plan

The monthly premium after any tax credit you qualify for.

Add the rest

Deductible and out-of-pocket maximum for a full-year view.

Book a 15-minute call

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What people say
about working with us.

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“Paul was very helpful in my search for business group insurance. He was able to explain my options and answer all the questions I had before signing up. Highly recommend working with him!”

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If you get a tax credit

Report income changes
during the year.

A Marketplace tax credit is based on the household income you expect for the coverage year, which can be hard to predict if you're self-employed. HealthCare.gov says to report income and household changes to the Marketplace right away, so the credit paid each month stays close to what you qualify for. If you received more than you qualify for, you may have to pay some or all of it back. Under current law, starting with 2026 taxes, there is no cap on that payback. After the call you will have:

Premiums for each plan after any tax credit
The deductible and limit behind each premium
A note on which changes to report
Who to pay your first premium to

A checklist for

Comparing premiums.

Quote every plan for the same household, ZIP code, and start date.
Compare premiums after any tax credit, not before.
Look at the deductible and out-of-pocket maximum behind each low premium.
Pay your first premium to the insurance company, not the Marketplace, to start coverage.

Premium questions

Health insurance premium FAQ.

What is a health insurance premium?

It's the amount you pay for your health insurance, usually every month, whether you use care or not. It's separate from the deductible, copays, and coinsurance you pay when you get care.

What affects the cost of a health insurance premium?

For ACA plans, five factors: your age, where you live, tobacco use, whether the plan covers just you or a family, and the plan category you choose. Insurers can't charge more because of your health history or your sex.

Does my health affect my premium?

Not for Marketplace plans and other ACA plans. Some private plans outside those rules ask health questions and may set the price or decide on approval based on the answers.

Do premiums count toward the deductible or out-of-pocket maximum?

No. Premiums are separate. What counts toward those amounts is what you pay for covered care, such as deductible payments, copays, and coinsurance.

Can I deduct my health insurance premiums?

Some people can. Self-employed people with a net profit may be able to deduct premiums, but not for any month they were eligible for an employer-subsidized plan, including through a spouse's job. Ask a tax professional.

Do I have to wait for open enrollment?

Not for every plan. A private plan (not from the Marketplace) can often be bought any time of year. Some private plans ask health questions, and approval is not guaranteed. Some may not cover care for health problems you had before you enrolled. Marketplace plans, and other plans that follow ACA rules, work differently. As of November 1, 2026, under current law, open enrollment for 2027 plans on HealthCare.gov runs from November 1, 2026, to January 15, 2027. To start coverage January 1, pick a plan by December 15. States that run their own Marketplace may set different dates, so check with your state's Marketplace. A federal appeal about these rules is pending (City of Columbus v. Kennedy, 4th Cir. No. 26-1938; argued October 30, 2026, with no ruling as of November 1, 2026), so confirm the dates before you enroll. Outside open enrollment, you need a special enrollment period, such as one after losing job-based coverage.

See premiums after
any tax credit.

Book a 15-minute call to compare premiums and total costs, or see quotes online.

Book a 15-minute call Get a quote online

By Paul Daniels, licensed insurance agent (NPN 20986580).

Disclaimer

Daniels Health Advisors LLC is an independent brokerage, not a carrier, HealthCare.gov, or CMS. Agent: Paul Daniels, NPN 20986580, Florida license G065122. This page explains premiums in general. It is not tax advice; ask a tax professional about deductions and tax credits. Prices vary by plan, age, and location. The limits are federal rating rules, not the price of any plan offered to you. Tax credits, plans, networks, and prices depend on your state, zip code, income, and household. We never guarantee approval, a doctor, or a price. Not medical, legal, or tax advice.

Your health insurancepremium, in plain terms.

The monthly billis only one part.