What is the cost of health insurance for a family of 4?
The cost for health insurance for a family of 4 varies depending on the clients age, gross household income, pre-existing conditions & if any prescriptions are being taken. If your family is seeing doctors multiple times per year and or taking multiple prescriptions than you’re going to have to get on a marketplace plan on www.healthcare.gov now the price for a family of 4 on a marketplace plan will depend on your gross household income if your family is bringing in over $100,000 a year you most likely won’t get any subsidy or it won’t be any substantial amount to change the premium. So the cost of health insurance for a family of 4 on the marketplace will be $1000 to $3000 per month depending on if you choose bronze, silver or gold. The bronze plans are usually high deductible plans on hmo networks and the amount of subsidy you may or may not qualify for. So, if you have to get a marketplace plan aka ObamaCare we always recommend getting a silver plan so you have at least some coverage without having to meet a giant deductible.
Now if your household income is under $100k per year you may be able to get a substantial subsidy on your monthly premium. There is a tiered system based on your income, so for example a family of 4 with total household income between $85,000-$100,000 will get some subsidy, $70,000-$85,000 will get even more of a subsidy and so on. So if your gross income is between $50,000-$80,000 you can get a huge subsidy and obtain a marketplace insurance plan for maybe $300 a month or less depending on what plan you choose.
When you’re shopping for health insurance for your family of four, there are a lot of moving parts: age, location, health status, metal tier (Bronze, Silver, Gold, etc.), and whether you’re buying through the ACA marketplace (on-exchange) or off the exchange through a private broker. Below, we break it down so you know what to expect — and when an off-exchange private PPO might make sense instead of choosing a “full-price” ACA plan.
Table of Contents
Key Cost Drivers
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Your location & age — Insurance premiums vary massively by ZIP code, state, and the age of each family member.
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Plan type & network — PPOs with broader networks cost more than HMOs or EPOs.
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Subsidies & tax credits — If you qualify for premium tax credits via the marketplace, your net cost can drop significantly.
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Out-of-pocket features — Deductibles, co-pays, coinsurance, and maximum out-of-pocket caps all affect your real cost.
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Renewal dynamics — Marketplace plans are community-rated; off-exchange private plans often use individualized underwriting, which sometimes leads to more stable renewals (if your health profile is favorable).
Sample Cost Benchmarks: Marketplace & Off-Exchange Plans
To make things more concrete, here are a few recent data points:
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According to KFF’s Employer Health Benefits survey, the average premium for family coverage (non-subsidized) was around $25,572 per year in 2024 (which works out to about $2,130 per month) KFF.
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eHealth reports that in 2023, the average cost for a family of four in the individual market place with the ACA was approximately $23,968 per year, or about $1,998 per month ehealth.
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Another benchmark: many unsubsidized family-of-4 plans are priced in the ballpark of $1,437 per month — a figure cited as an average in industry commentary Anthem+1.
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On the PPO front, ValuePenguin reports that the average cost of a PPO health insurance plan (for an individual) is about $662 per month, which suggests that when scaled to family-level PPO plans, costs can become quite steep depending on the number of covered lives and their ages ValuePenguin.
- Private Health Insurance off the exchange that is available in 33 states would be around $750-$1200 for a family of 4 depending on your age. The catch with these off exchange health plans is that you have to get approved with no major health issues. This is why the cost is near half of a full price marketplace plan.
These numbers reflect a wide spectrum: unsubsidized, marketplace, off-exchange, PPO and non-PPO, and varying geographies. But they serve to illustrate that for many families of four, the sticker price on a marketplace plan (without subsidies) often runs well over $1,000 per month — sometimes much more.
Because off-exchange private plans are underwritten differently, some families (especially those in fairly good health) can sometimes beat these averages by going off-exchange. But that path usually comes with trade-offs: you lose eligibility for marketplace tax credits, and you may face tighter underwriting.
Why the Choice Matters More This Year
We’re entering a particularly volatile period. The enhanced COVID-era subsidies (premium tax credits) that have made many ACA marketplace plans more affordable are slated to expire at the end of this year unless Congress acts (when funding the government or negotiating a budget). Without those enhancements, many families currently paying moderate premiums could see their costs skyrocket in 2025.
This makes open enrollment more critical than ever. If you’re self-employed or run a very small business, and you don’t qualify for robust subsidies, comparing on-exchange and off-exchange options side by side is not optional — it’s essential.
How to Use This Info
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Use the benchmark numbers above to sanity-check any quotes you receive. If a plan for your family of four is far outside those ranges (much lower or much higher), dig deeper into the network, underwriting, or omitted rider charges.
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Always compare net cost after tax credits for marketplace plans vs. gross cost for off-exchange plans. Some off-exchange offers look cheaper — until you factor in what you’re giving up (i.e. the subsidy).
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Ask your broker or agent: “What would this cost both on the marketplace (if I were subsidy-eligible) vs. off-exchange?” Insist on apples-to-apples comparisons (same network, deductible levels, co-insurance, etc.).
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Keep in mind underwriting: with off-exchange you may need good health to qualify for the better rates.
What is the cost for private health coverage for my family of 4?
Now your other option is if your family rarely goes to the doctor, doesn’t take many if any prescriptions and household income is over $100,000 a year than getting a private plan will be your best option. Private health insurance gives your family the coverage you need for “Major Medical Claims” god forbid something serious happens and because the insurance company underwrites the plan prior to accepting you, they’re willing to give you a much better plan at way lower rates because they know your less of a risk to them. Private health insurance is tailored to the self employed, real estate agents, traveling nurses basically any family of 4 that is over the income level so they can’t get any subsidies and at the same time are maybe going to the doctor once per year just for a check up. The best part of the private insurance plans we sell is that they are on name brand PPO Networks like the United Health Care Choice Plus PPO Network as well as the Cigna PPO Network in South & North Carolina. It’s always better to be covered on a PPO rather than HMO so you know you have benefits no matter where you are in the country. If your plan is on a HMO Network you’re only going to be covered in your county in your state. So if you’re traveling or if your kids are college age and they go to school out of state than you won’t have any coverage. The average cost of private health insurance for a family of 4 is $600 to $1050 per month depending on the age of the adults on the plan and if you can get approved with no major health conditions. If the parent”s on the plan are in there 20’s it will be closer to $700 a month for the family of 4 and if parent’s are over 50 you will be around $1000-1100 monthly. These rates are for the off exchange health insurance plans and are based of age and health history. Clients have to get approved for these plans with no major health conditions and can not be taking multiple medications. Usually 4 or more would be a decline and the only option would be the marketplace exchange. My Private Health Insurance is a nationwide broker that specializes in off exchange health insurance plans for self employed business owners.