Kaiser Permanente offers the cheapest Bronze, Silver, Gold and Platinum health insurance plans in Washington, D.C. Meanwhile, Blue Cross Blue Shield is the most affordable provider of Catastrophic plans.
You can get plans in Washington D.C. from different metal tiers with varying premiums, deductibles and maximum out-of-pocket (MOOP) costs. HMO is the baseline plan type, and premiums vary based on your age, income and coverage preferences.
If you are looking to balance monthly premiums with quality claims and coverage, MoneyGeek analyzed the best health insurance in Washington, D.C..
Most Affordable Health Insurance in Washington D.C.
Cheapest Health Insurance in Washington D.C. by Metal Tier
KP DC Silver Virtual Forward 4000 from Kaiser Permanente is the cheapest Silver plan in Washington, D.C., at $426 per month.
The higher the metal tier, the more expensive the associated health insurance plans typically are. However, they also offer more coverage. Here are the most affordable health insurance plans in Washington D.C. by metal tier with their average monthly premiums:
- Catastrophic: BlueChoice HMO Young Adult $9,100 ($155 per month for a 26-year-old)
- Bronze: KP DC Standard Bronze 6350/20%/HSA/Vision ($396 per month)
- Silver: KP DC Silver Virtual Forward 4000 ($426 per month)
- Gold: KP DC Gold 1600/25%/HSA/Vision ($495 per month)
- Platinum: KP DC Standard Platinum 0/20/Vision ($641 per month)
Choosing a higher metal tier — such as Platinum, Gold or Silver — will come with higher monthly premiums, but it also means more benefits and lower out-of-pocket maximums.
Metal tiers classify health insurance plans on the exchange based on the amount of coverage they provide. Generally, more valuable metal tiers such as Gold and Platinum have higher premiums but lower out-of-pocket expenses.
Young, healthy people or those who don't anticipate frequent medical care may select less valuable metal tiers. Meanwhile, those who expect high medical expenses or can afford higher premiums may opt for plans in more valuable metal tiers.
If you're looking for the best balance between monthly premium costs and coverage, Silver plans are the best option. Low-income individuals may also qualify for lower deductibles with this plan type.
Cheapest Silver Plans in Washington D.C.
Kaiser Permanente’s KP DC Silver Virtual Forward 4000 is the cheapest Silver plan in Washington, D.C., costing approximately $426 per month. The three most affordable Silver plans in D.C. are:
- KP DC Silver Virtual Forward 4000 ($426 per month)
- KP DC Silver 3300/30%/HSA/Vision ($428 per month)
- KP DC Silver 3200/30/Vision ($472 per month)
Silver health insurance plans provide a great balance between coverage and affordability. Additionally, qualifying policyholders can benefit from cost-sharing reductions that are exclusive to this plan tier, potentially lowering their monthly expenses.
MoneyGeek recommends HMO plans in this section because they are the most accessible to residents of Washington, D.C.
Cheapest Gold Plans in Washington D.C.
The most cost-effective Gold plan in Washington, D.C., is the KP DC Gold 1600/25%/HSA/Vision from Kaiser Permanente, with an average monthly premium of $495. Here are the most affordable Gold plans in Washington D.C.:
- KP DC Gold 1600/25%/HSA/Vision ($495 per month)
- KP DC Gold Virtual Forward 2000 ($506 per month)
- KP DC Gold 1000/20/Vision ($540 per month)
Gold tier health insurance plans typically have higher monthly premiums than lower metal tiers, but they provide more comprehensive coverage and lower out-of-pocket costs. They’re a good choice for individuals who require frequent medical care.
Cheapest Bronze Plans in Washington D.C.
If you’re looking for Bronze plans in Washington, D.C., your cheapest option is KP DC Standard Bronze 6350/20%/HSA/Vision from Kaiser Permanente at roughly $396 per month. Here are the most affordable options:
- KP DC Standard Bronze 6350/20%/HSA/Vision ($396 per month)
- KP DC Bronze 6500/65/Vision ($406 per month)
- KP DC Standard Bronze 7500/45/Vision ($417 per month)
Bronze health insurance plans have lower monthly premiums than most other tiers but have higher out-of-pocket costs and offer less coverage. They’re ideal for individuals who are young and generally healthy.
Cheapest Catastrophic Plans in Washington D.C.
Blue Cross Blue Shield’s BlueChoice HMO Young Adult $9,100 plan is the cheapest Catastrophic plan in Washington, D.C., costing approximately $155 per month for a 26-year-old. If you’re looking for similar plans, here are your cheapest options:
- BlueChoice HMO Young Adult $9,100 ($155 per month)
- KP DC Catastrophic 9100/0/Vision ($216 per month)
Catastrophic health insurance plans have the lowest monthly premiums but come with the highest deductibles and out-of-pocket costs. They are designed to cover emergency situations and are recommended for young, healthy individuals who are willing to take on a higher financial risk in exchange for lower premiums. They are only available for those under 30.
Cheapest Platinum Plans in Washington D.C.
KP DC Standard Platinum 0/20/Vision from Kaiser Permanente is the most affordable Platinum health insurance plan in Washington, D.C. Other cheap options include:
- KP DC Standard Platinum 0/20/Vision ($641 per month)
- BlueChoice HMO Standard Platinum $0 ($734 per month)
- BluePreferred PPO Standard Platinum $0 ($771 per month)
Although Platinum plans are the most expensive among the metal tiers, they also feature the best coverage and lowest out-of-pocket expenses. Consider getting this plan type if you require frequent or extensive medical care.
If you qualify for premium tax credits and your income is under a certain threshold, you may also be eligible for cost-sharing reductions (CSRs) on Silver plans. CSRs won't lower your monthly premiums, but they can help lower other expenses associated with your health care plan, like deductibles, out-of-pocket maximums and copayments. CSRs can make health care more affordable and accessible for you, especially if you have difficulty paying the out-of-pocket costs of your insurance plan.
Cheapest Health Insurance in Washington D.C. by Plan Type
Health Maintenance Organization (HMO) plans are the most common health insurance plan type in Washington, D.C., but Preferred Provider Organization (PPO) plans are also available.
Based on our research, the cheapest Silver PPO plan is Blue Cross Blue Shield’s BluePreferred Standard Silver $4,850, with an average cost of $542 per month.
PPO plans offer more flexibility when it comes to choosing health care providers and usually provide some amount of out-of-network coverage, but they tend to be more expensive than other plan types.
If you’re looking for health insurance in Washington, D.C., your options are limited to HMO and PPO plans.
- An HMO (Health Maintenance Organization) plan requires you to select a primary care physician (PCP) from the plan's network to coordinate your health care services and refer you to specialists as needed. Coverage for health care services outside of the HMO network may be limited, except in emergency situations.
- With a PPO (Preferred Provider Organization) plan, you have the flexibility to see health care providers both in and out of network without needing a referral from a PCP. However, seeing out-of-network providers may result in higher out-of-pocket costs.
Health Insurance Costs in Washington D.C. by Age and Metal Tier
Health insurance premiums vary significantly by metal tier. To give you an idea of the differences, we listed the average premium cost for each metal tier for a 40-year-old in Washington, D.C.:
- Catastrophic: $185 per month (for a 26-year-old)
- Bronze: $448 per month
- Silver: $502 per month
- Gold: $606 per month
- Platinum: $729 per month
If you require frequent health care services, it may be worth considering a more valuable metal plan. While a Bronze plan may suffice for young and healthy individuals, it could result in very high out-of-pocket expenses if you need ongoing or extensive medical care.
Age also impacts the cost of health insurance. For example, a Silver plan costs around $337 per month for an 18-year-old in Washington, D.C., while a 60-year-old pays roughly $1,081 per month.
What to Know About Washington D.C. Health Insurance
MoneyGeek collected data from private health insurance plans to identify the most affordable options available on the Health Insurance Marketplace. These plans are usually available during the open enrollment period each year and are designed to cater to different coverage levels and needs.
However, if you have a low income, Medicaid may be a more affordable option. Meanwhile, Medicare may be a better fit if you’re a senior or have a disability.
Private Health Insurance in Washington D.C. Marketplace
Private health insurance plans in Washington D.C. can be purchased during the open enrollment period. Open enrollment runs from November 1 to January 15, and individuals can enroll in or make changes to their health insurance coverage at any time during this period.
It's important to note that if you want your health insurance plan to start on January 1, you need to sign up on or before December 15. Otherwise, your coverage won't start until February 1.
If you miss the open enrollment period, you may still be able to enroll in a marketplace plan during a special enrollment period.
You may be eligible for special enrollment if you have experienced certain life events such as getting married, having a baby, losing health insurance or moving to a new area with different health insurance options. You typically have 60 days after the qualifying life event to enroll in a plan.
Medicaid in Washington D.C.
Washington, D.C., residents who qualify for Medicaid can take advantage of the program's no-cost coverage, making it the most affordable health insurance option.
Additionally, since Washington, D.C., has adopted Medicaid expansion, you may be eligible for Medicaid if your income is up to 138% of the Federal Poverty Level.
Medicare in Washington D.C.
If you’re a resident of Washington, D.C., aged 65 or older or have a qualifying illness or disability, you may be eligible for Medicare.
Unlike Medicaid, Medicare is not entirely free, but it still tends to be more affordable than many private health insurance plans. Medicare is divided into three main parts:
- Part A covers hospital expenses, hospice care and some types of home health care, usually without requiring any premium payments.
- Part B covers outpatient care, preventive services, doctor visits and medical supplies, and it requires a monthly premium.
- Part D covers prescription drugs.
Washington D.C. Health Insurance Frequently Asked Questions
If you're looking for health insurance, you may have questions regarding the cost and availability of plans. We responded to some frequently asked questions about health insurance in Washington, D.C., to help you as you research your options.
About Mark Fitzpatrick