The Cheapest District Of Columbia Health Insurance for Individuals and Families
The cost of health insurance in the District of Columbia on the private market varies depending on your chosen medical coverage. There are four different metal tiers available in the private market, including Bronze, Silver, Gold and Platinum. Silver plans are the median between high and low cost plans and offer the best balance of cost and coverage. On average, a Silver-tier plan in the District of Columbia costs $419 monthly. The cheapest silver plan, KP DC Silver 3200/30%/HSA/Vision, offered by Kaiser Permanente, costs an average of $384 monthly.
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The District of Columbia insurance exchange has private health insurance plans for people in the state who do not have a health insurance plan from their employer or state programs like Medicare or Medicaid. Expensive plans like Platinum typically have lower deductibles and out-of-pocket maximums, so lower out-of-pocket medical expenses offset the high monthly premiums. However, if you choose a low-cost plan, your deductibles and out-of-pocket maximums will be much higher.
MoneyGeek analyzed the cheapest plans in the District of Columbia for different ages and plan types to help you find the best health insurance in the District of Columbia. This study is based on health insurance plans purchased through the District of Columbia insurance marketplace.
The Cheapest Health Insurance in District Of Columbia by Metal Tier
In the District of Columbia, the metal tier system determines the type of medical coverage you get based on your pay’s monthly premiums. Low-cost plans that have lower monthly premiums offer less medical coverage compared to plans with higher monthly premiums.
District of Columbia residents can choose from four different tiers, including Bronze, Silver, Gold and Platinum. Depending on which of the four tiers you choose, the average cost of your health insurance per month will be:
- Bronze: $363 per month
- Silver: $419 per month
- Gold: $498 per month
- Platinum: $615 per month
If you have high medical expenses, a Platinum or Gold plan will offer better medical coverage since the out-of-pocket maximums are lower. This means that you will pay less out of pocket to cover your medical expenses.
You can use the table below to look up the cheapest options by the monthly premium for each metal tier. In the District of Columbia marketplace, premiums, deductibles and out-of-pocket maxes may vary significantly within a metal tier.
In the District of Columbia, if you have a low income, you may be eligible for cost-sharing reductions (CSR). These reductions make a Silver plan even more affordable by reducing your deductibles.
For this analysis, MoneyGeek used plans based on a sample profile of a 40-year-old male for both HMO and PPO plans. These are the two plan types available in the District of Columbia, with HMO plans being the most common plan type.
Cheapest Health Insurance in District Of Columbia by Metal Tier
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- Metal TierPlanCompanyMonthly CostOOP Max
- BronzeBlueChoice HMO HSA Standard Bronze $6,350CareFirst BCBS$337$6,900
- SilverKP DC Silver 3200/30%/HSA/VisionKaiser Permanente$384$6,650
- GoldKP DC Gold 1600/25%/HSA/VisionKaiser Permanente$431$5,000
- PlatinumKP DC Standard Platinum 0/20/VisionKaiser Permanente$534$2,000
The Cheapest Health Insurance in District Of Columbia by Age and Metal Tier
In the District of Columbia, your age will significantly impact the cost of your health insurance. Health insurance premiums for older people tend to be higher compared to those of younger people. For example, on average, a 26-year-old living in the District of Columbia will pay roughly $313 monthly for a Silver plan, while a 60-year-old will pay an average of $903 per month. These average rates are based on HMO and PPO plans.
Health Insurance Costs in District Of Columbia by Age and Metal Tier
For this analysis, MoneyGeek used sample ages that may not be the same as your specific age and income combination. You can get an exact quote by applying for a personalized quote based on your income and age. Due to tax premiums and other regulations, older people may find that their health insurance rates can be much lower in the District of Columbia Marketplace.
You can use the table below to toggle between metal tiers and ages to look up costs for different ages and plan types. You can also look at our guide on health insurance in the District of Columbia to find the best metal tier to purchase for your needs.
Cheapest Health Insurance in District Of Columbia by Age And Metal Tier
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- PlanCompanyMonthly Rate
- BronzeHMOCareFirst BCBS$226
- BronzeHMOCareFirst BCBS$230
- BronzeHMOKaiser Permanente$234
- BronzeHMOKaiser Permanente$236
- BronzeHMOKaiser Permanente$251
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The Cheapest Health Insurance in District Of Columbia by County
The District of Columbia only has one rating area since it has one county. This means that where you live will not affect the cost of your health insurance. However, your health insurance premiums will be affected by other factors such as age and income.
The most affordable Silver plan in the District of Columbia is KP DC Silver 3200/30%/HSA/Vision, offered by Kaiser Permanente at an average of $384 monthly.
You can use the table below to look up the cheapest options for all metal tiers in the District of Columbia.
These plans are for a sample 40-year-old male in the District of Columbia purchasing a health plan in that county.
Cheapest Health Insurance Plans in District Of Columbia by County
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- Metal TierCompanyCheapest PlanMonthly Premium
- District of ColumbiaBronzeCareFirst BCBSBlueChoice HMO HSA Standard Bronze $6,350$337
- District of ColumbiaSilverKaiser PermanenteKP DC Silver 3200/30%/HSA/Vision$384
- District of ColumbiaGoldKaiser PermanenteKP DC Gold 1600/25%/HSA/Vision$431
- District of ColumbiaPlatinumKaiser PermanenteKP DC Standard Platinum 0/20/Vision$534
The Cheapest Health Insurance in District Of Columbia With High Out-of-Pocket Maxes
For young people in the District of Columbia, a low-cost plan with high out-of-pocket maxes may be the best option since they have fewer medical expenses. With a low-cost plan, you will pay low monthly premiums, but your out-of-pocket costs may be high in case of a medical emergency, so this type of plan is ideal for those with low medical expenses.
The most affordable plan with high out-of-pocket maxes for a 26-year-old in the District of Columbia is BlueChoice HMO Standard Bronze $7,500 offered by CareFirst BCBS at around $256 monthly.
MoneyGeek defines a plan as having a high out-of-pocket max when it has max out-of-pocket expenses of $8,250 or higher.
CareFirst BCBS offers the cheapest plan in the District Columbia for young people who want a low-cost plan with high out-of-pocket maxes.
The Cheapest Health Insurance in District Of Columbia With Low Out-of-Pocket Maximums
For residents of the District of Columbia who have high medical expenses, a high-cost plan with low out-of-pocket maxes is the most suitable option. This is because although the premiums may be higher, the out-of-pocket max is low, meaning your insurance will cover any costs above the maximum limit. As a result, you will pay less out of pocket for medical expenses.
The cheapest plan with low out-of-pocket maximums In the District of Columbia is KP DC Standard Platinum 0/20/Vision offered by Kaiser Permanente. This Platinum plan costs $534 monthly.
The KP DC Standard Platinum 0/20/Vision plan has a $2,000 out-of-pocket maximum. MoneyGeek defines a low out-of-pocket max as a plan that has out-of-pocket maximums of below $4,250.
Kaiser Permanente offers the most affordable option for low out-of-pocket maxes in its Platinum plan, KP DC Standard Platinum 0/20/Vision. When you buy high-cost plans like Platinum and Gold, you have much lower out-of-pocket maxes. This means that you will reach your out-of-pocket limit quicker, and your insurer will cover any medical expenses above the maximum.
Cheapest HMO/PPO Health Insurance Plan in District Of Columbia
When choosing a healthcare plan in the District of Columbia, the most suitable option will depend on your needs and preferences. In the District of Columbia insurance marketplace, HMO plans are the most common. However, you can also opt for a PPO plan which is the other plan type available in the District of Columbia.
Health Maintenance Organization (HMO) plans are typically the most affordable option. However, if you choose an HMO plan, you are restricted to a specified provider network, and you will need a referral to see a specialist.
Preferred Provider Organization (PPO) plans are more costly than HMO plans, but they offer greater flexibility in terms of providers. You also do not need a referral to see a specialist if you are on a PPO plan.
For a Silver-tier plan, the cheapest health insurance in the District of Columbia for all available plan types are:
- Cheapest HMO Silver plan: KP DC Silver 3200/30%/HSA/Vision offered by Kaiser Permanente at $384 monthly.
- Cheapest PPO Silver plan: BluePreferred Standard Silver $4,000 offered by CareFirst BCBS at $459 monthly.
Cheapest Plan in District Of Columbia With an HSA
In the District of Columbia, people with few medical expenses can opt for a Health Savings Accounts (HSAs) plan. An HSA plan allows you to make pre-tax contributions to your HSA plan. Your contributions will go towards savings and will only be used if you incur a health expense. HSA plans are cheaper and allow you to build a nest egg over time if you are in good health and have limited medical expenses.
The cheapest healthcare plans with a Health Savings Account (HSA) for all metal tiers are:
- Cheapest HSA Bronze plan: BlueChoice HMO HSA Standard Bronze $6,350 offered by CareFirst BCBS at $337 monthly.
- Cheapest HSA Silver plan: KP DC Silver 3200/30%/HSA/Vision offered by Kaiser Permanente at $384 monthly.
- Cheapest HSA Gold plan: KP DC Gold 1600/25%/HSA/Vision offered by Kaiser Permanente at $431 monthly.
While HSA plans are affordable, the high deductibles mean that the out-of-pocket costs will be quite high if you incur high medical expenses.
What to Know About Health Insurance in District Of Columbia
MoneyGeek’s analysis used sample rates based on private plan data from the District of Columbia insurance marketplace. You may be able to find even cheaper rates when you apply for a plan on the health insurance exchange. In addition, if you are an older District of Columbia resident or have a low income, you may be eligible for state programs like Medicaid or Medicare programs which are more affordable than Marketplace plans.
Private Health Insurance on the District Of Columbia Marketplace
In the District of Columbia, health insurance plans are available in different metal tier plan types. Each of these tiers has its unique features and also differs in terms of cost. The four available tier options in the District of Columbia are:
- Bronze: Bronze plans are the most affordable plan type in the District of Columbia. This plan type has low monthly premiums, but the out-of-pocket maximums tend to be high. This means that this option is best for those in good health and incur low medical expenses.
- Silver: The Silver tier is a median tier plan that balances costs and coverage. This type of plan is the best option for the average person who needs adequate coverage at an affordable cost. Silver has lower out-of-pocket maxes than the Bronze plan, which means your out-of-pocket costs in case you incur high medical expenses will be moderate. A Silver plan costs less than Gold and Platinum plans.
- Gold: A Gold plan is a high-cost option that has high monthly premiums but low out-of-pocket maximums. This means that a Gold tier plan may be a more cost-effective option for people who incur high medical expenses than lower-cost alternatives. Although the monthly premiums for this tier are high, you will pay less out of pocket for medical expenses.
- Platinum: The Platinum tier is the most costly option in terms of monthly premiums. However, the Platinum tier has low out-of-pocket maxes, meaning that this plan type may be more cost-effective for people with high medical expenses. If your medical expenses are high, you will reach the out-of-pocket max quickly and your insurer will cover any medical costs above the maximum.
You may be able to get even cheaper plans or higher coverages depending on your income level and other qualifying factors. People in the District of Columbia with incomes between 100% and 400% of the federal poverty level may qualify for premium tax credits. For example, a two-person household in the District of Columbia with an income ranging from $17,420 to $69,680 is eligible for health insurance premium tax credits.
Open enrollment is the window during which you can enroll for a new health insurance plan or renew your existing plan from the District of Columbia Insurance Marketplace. Although the open enrollment period typically runs from November to December, this period has been extended due to the COVID-19 pandemic. In addition, if you have recently moved to the District of Columbia from another state or changed employers, you may qualify for special enrollment outside of the open enrollment period.
If your income level ranges from $24,040 to $43,550, 138% and 250% of the federal poverty level, you can get cost-sharing reductions if you buy a Silver plan. These reductions can lower your deductible, coinsurance and out-of-pocket maximum. This means that you can get Gold plan coverage at Silver plan rates if you qualify for these deductions.
Medicaid in District Of Columbia
Since Medicaid is free, it is the cheapest health care plan for District of Columbia residents who qualify for it. In addition, the District of Columbia is a Medicaid expansion state which means you can be eligible for Medicaid based only on your income. In expansion states, if your income is below 138% of the federal poverty level, you qualify for Medicaid.
Medicare in District Of Columbia
For District of Columbia residents who are 65 or older or have a qualifying disability or illness, you may be eligible for Medicare. Medicare is a federal government program that is not entirely free like Medicaid, but it is still cheaper than the options available in the private insurance marketplace.
A Medicare plan offers coverage in three essential parts including:
- Medicare Part A or Hospital Insurance: This part of Medicare covers medical expenses from inpatient hospital stays, hospice care and certain types of home health care. In most cases, you will not be required to pay any premium for this coverage.
- Medicare Part B: Part B of medical care covers medical expenses arising from outpatient care, preventive services, doctor services and costs related to medical supplies. This part of Medicare requires a monthly premium.
- Medicare Part D: Prescription drugs are covered under part D of Medicare.
MoneyGeek's research is based on estimates, and the cheapest plan for you will depend on your individual needs and characteristics. This analysis is intended to serve as a guide and no single plan is guaranteed to be the cheapest in District Of Columbia for you
MoneyGeek collected plans and premiums for health insurance in District Of Columbia from the Health Insurance Exchange Public Use Files (Exchange PUFs) for all available metal tiers and across several age groups.
Health insurance premiums on this page are an estimate and exclude potential premium tax credits and cost-sharing subsidies that users may be eligible for.
About the Author
- Medicare.gov. "What is medicare?." Accessed July 19, 2021.