Private Health Plan Prices: What We See in Our Plan Catalog (Fall 2026)
We sorted the monthly premiums in our fall 2026 broker plan catalog by plan type and household. The spread is wide because these plans aren't alike: some are group plans with high deductibles, others cap benefits or pay set dollar amounts. Here's what each category costs, what the premium leaves out, and how it compares with ACA costs for 2027.
Compare Your Options ↓How Much Is Private Health Insurance per Month?
Private health insurance prices depend first on what kind of plan you buy, then on your age, state, household and network. This report shows the monthly premium ranges we see in FreedInsure's broker plan catalog for fall 2026. It covers plans sold outside the ACA Marketplace, grouped into four categories by benefit design rather than by product name.
A note on words: Marketplace plans are private insurance too, because private insurers sell them. On this page, “private health plans” means the non-Marketplace plans in our catalog. For ACA costs, we use the IRS's 2027 tax-credit formula rather than quotes; see the ACA 2027 comparison below.
FreedInsure LLC (NPN: 20230457) is an independent broker licensed in 42 states, and our help is free to you: (844) 788-3733.
Quick answer: Private health insurance prices depend on the plan category. In FreedInsure's fall 2026 catalog of plans sold outside the ACA Marketplace, group-style PPO/EPO plans we see often run roughly $500–$950/month for a healthy single adult and $1,600–$2,300/month for a family, depending on age, state, network and underwriting; limited-benefit copay plans, which cap visits and hospital stays, run roughly $375–$600/month for a single adult. Premiums don't include care costs: stated in-network deductibles in the group-style plans we reviewed ran about $5,000–$9,000 for one person. If you qualify for a tax credit, an ACA plan bought on the Marketplace may cost less.
Price ranges are examples of monthly quotes we commonly see as of fall 2026, not offers or guarantees. Your rate depends on age, state, household size, network, plan design and each plan's eligibility and underwriting rules. Premiums are separate from what you pay when you get care (deductibles, copays and coinsurance). Some quotes in this range include a separate hospital and accident gap policy.
Last updated: October 5, 2026
Private Health Insurance Prices by Plan Category and Household
Each row is one category of plans sold outside the ACA Marketplace, and each column is a household rate tier. We don't publish one price range across all four categories, because a fixed-indemnity plan and a group PPO plan are different products, not cheap and expensive versions of the same thing.
Notice for Category 4 (fixed-indemnity) plans:
THIS IS A SUPPLEMENT TO HEALTH INSURANCE AND IS NOT A SUBSTITUTE FOR MAJOR MEDICAL COVERAGE. LACK OF MAJOR MEDICAL COVERAGE (OR OTHER MINIMUM ESSENTIAL COVERAGE) MAY RESULT IN AN ADDITIONAL PAYMENT WITH YOUR TAXES.
| Plan Category (Per Month) | Single Adult | Couple | One Adult + Child(ren) | Family |
|---|---|---|---|---|
| Category 1: group PPO, standard cost sharing | $500–$775 | $1,000–$1,475 | $950–$1,425 | $1,600–$2,075 |
| Category 2: group EPO/PPO with integrated gap benefit | $700–$950 | $1,550–$1,800 | $1,450–$1,700 | $2,150–$2,300 |
| Categories 1 + 2: group-style PPO/EPO, combined | $500–$950 | $1,000–$1,800 | $950–$1,700 | $1,600–$2,300 |
| Category 3: limited-benefit copay | $375–$600 | $725–$1,075 | $750–$1,075 | $950–$1,400 |
| Category 4: fixed indemnity (not major medical; includes $24.95/mo association fee) | $140–$500 | $300–$1,020 | $300–$770 | $450–$1,300 |
Pricing note: Price ranges are examples of monthly quotes we commonly see as of fall 2026, not offers or guarantees. Your rate depends on age, state, household size, network, plan design and each plan's eligibility and underwriting rules. Premiums are separate from what you pay when you get care (deductibles, copays and coinsurance). Category 1 and combined ranges: Some quotes in this range include a separate hospital and accident gap policy. Category 4 ranges: Includes the plan's $24.95 monthly association fee; a one-time $99 fee applies with the first month.
What does PPO health insurance cost?
For a quick budget, use the combined group-style row. Plans in these two categories we see often run roughly $500–$950/month for a healthy single adult, roughly $1,000–$1,800/month for a couple, roughly $950–$1,700/month for one adult plus children and roughly $1,600–$2,300/month for a family, depending on age, state, network and underwriting. The plans with an integrated gap benefit sit higher in that range; the total-cost section below shows what the extra premium may and may not buy.
These plans are not sold through the ACA Health Insurance Marketplace (HealthCare.gov or your state's exchange) and are not individual-market ACA plans. You can't use a premium tax credit or cost-sharing reduction to pay for them. As HealthCare.gov puts it, “the only way to get the premium tax credit is through the Marketplace.”
Important: Plans sold outside the ACA Marketplace may be subject to underwriting, age limits, state availability and each plan's own eligibility rules. Not all plans are available in all states. Rates are not guaranteed and can change. Benefits, limits and exclusions are set by the official plan document or policy, which controls if it differs from this page. This page is a general summary, not a contract or an offer of coverage.
Straight talk: A plan sold outside the Marketplace can cost less than a full-price ACA plan if you're healthy, earn too much for a tax credit, or want a specific network. But if you qualify for a tax credit or Medicaid, have a pre-existing condition, are pregnant or planning to be, or take expensive medications, an ACA plan is usually the safer buy, and the only way to get the premium tax credit is through the Marketplace. We'll price both side by side before you decide. Call (844) 788-3733.
How We Built This Price Report
Every private-plan premium on this page comes from one source: FreedInsure's broker plan catalog of monthly premiums, fall 2026. Benefit details come from the plans' own Summaries of Benefits and Coverage (SBCs) and brochures. When a brochure and its SBC disagree, we use the SBC and the less favorable figure.
- Categories, not products. We sorted plans into four categories by benefit design. We don't name products, plan labels or brands, and we never tie a price to a single plan.
- Rounded ranges. For each category and household rate tier, we show the range of monthly premiums we commonly see, rounded to the nearest $25 (nearest $10 for fixed-indemnity plans). No cents.
- What moves a price. Prices vary by age, state, household size, network, plan design and each plan's eligibility and underwriting rules. Some plans price by age band; others use one flat rate.
- Checked before publishing. Ranges are re-checked against the catalog before publishing and before each update, and the “as of fall 2026” stamp stays until the catalog changes.
- What's left out. ACA Marketplace premiums (we use IRS tax-credit figures instead), short-term medical and health-sharing ministries aren't in these ranges.
🏢 Category 1: Group PPO Plans
Group health plans offered through a sponsoring employer or organization, with individual and family rate tiers. Their SBCs state they provide minimum essential coverage and meet the minimum value standard. In-network deductibles run about $5,000–$6,000 for one person.
🔗 Category 2: Group Plans With a Gap Benefit
Group EPO/PPO plans with a high stated deductible ($6,000–$9,000 for one person) and an “integrated gap benefit” that may pay down eligible in-network costs, subject to the plan's terms and limits.
📋 Category 3: Limited-Benefit Copay Plans
Pay a defined list of services, with copays or coinsurance and hard caps on visits, days and hospital stays. Their materials don't state that they meet ACA standards or count as minimum essential coverage.
💵 Category 4: Fixed-Indemnity Plans
Pay set dollar amounts per service or day, whatever the bill, and are sold with an association membership. A supplement, not major medical coverage, and not minimum essential coverage.
Why the network changes the price
The network is part of the price. The Category 1 and 2 plans in our catalog use the Cigna PPO network. Category 3 plans use the Cigna, First Health or PHCS network, and fixed-indemnity plans have no network. The same benefit design can be sold on different rented networks at different monthly prices, so choosing the network is part of choosing the price.
Some private plans rent access to the Cigna PPO network. Your plan administrator, not Cigna, may process your claims. Cigna, First Health and PHCS are provider networks, not insurance companies, and they don't pay claims. A plan that uses the Cigna, First Health or PHCS network sets its own benefits and pays claims through its own administrator. Before you get care, confirm your doctor or facility is in network using the directory and phone number on your plan ID card. More on how the First Health network and the PHCS network work.
Private Health Insurance Cost by Age
Some plans price by age band; others use one flat rate. In our catalog, the fixed-indemnity category has the clearest age bands, so it's the category we can show by age. For the other categories, use the ranges above and get a quote for your own age, state and household.
THIS IS A SUPPLEMENT TO HEALTH INSURANCE AND IS NOT A SUBSTITUTE FOR MAJOR MEDICAL COVERAGE. LACK OF MAJOR MEDICAL COVERAGE (OR OTHER MINIMUM ESSENTIAL COVERAGE) MAY RESULT IN AN ADDITIONAL PAYMENT WITH YOUR TAXES.
| Fixed-Indemnity Plans, Single Adult | Monthly Premium, Fall 2026 |
|---|---|
| Under 50 | Roughly $140–$370 |
| Ages 50–70 | Roughly $330–$500 |
Plans in this category we see often run roughly $140–$370/month for a healthy single adult under 50 and roughly $330–$500/month for ages 50–70, depending on age, state and underwriting. Those are the catalog's pricing bands, not eligibility rules; any age limits are set by each plan. Over a year, that's about $1,680–$6,000 in premiums, plus the one-time $99 fee.
Pricing note: Price ranges are examples of monthly quotes we commonly see as of fall 2026, not offers or guarantees. Your rate depends on age, state, household size, network, plan design and each plan's eligibility and underwriting rules. Premiums are separate from what you pay when you get care (deductibles, copays and coinsurance). Includes the plan's $24.95 monthly association fee; a one-time $99 fee applies with the first month.
What a fixed-indemnity premium buys
Fixed-indemnity plans pay a set dollar amount for each covered service or day, no matter what the provider charges. You pay the rest, and there's no out-of-pocket maximum. They are not major medical coverage and are not minimum essential coverage. The plans we reviewed limit coverage for pre-existing conditions (listed as “12/12”), cover complications of pregnancy but don't list routine maternity care, and cap prescription, outpatient, surgical and lifetime benefits. Prices include a $24.95 monthly association fee, plus a one-time $99 fee with the first month.
The plans we reviewed paid $125–$225 per office visit and $1,000–$2,000 for a hospital confinement, with caps such as a $4,000 yearly outpatient cap and $500–$1,000 a year for prescriptions. The “12/12” notation commonly means a 12-month look-back and a 12-month exclusion; the policy defines it.
Some plans are sold with a membership in an association, and the monthly price includes the association fee. That is not the same as an association health plan (AHP), which is an employer group health plan under federal law. And because the loss-of-coverage Special Enrollment Period is triggered by losing minimum essential coverage, a fixed-indemnity plan ending doesn't, by itself, open one. That's why we present these plans first as a supplement to major medical coverage, not a replacement.
Premium Is Not Total Cost: What Each Plan Type Leaves You to Pay
The premium keeps the plan in force; the deductible, copays, coinsurance and anything over a plan's caps are what you pay when you use it. Those care costs vary more across these categories than the premiums do. Below, each category's premium sits next to its deductible and out-of-pocket context from the plans' own SBCs. Fixed-indemnity plans are covered in the age section above.
Category 1: group PPO plans with standard cost sharing
Plans in this category we see often run roughly $500–$775/month for a healthy single adult, depending on age, state, network and underwriting, which is about $6,000–$9,300 a year before any care. In the plan documents we reviewed, in-network deductibles ran about $5,000–$6,000 for one person ($10,000–$12,000 for a family), with out-of-pocket limits of about $7,000–$8,700 ($14,000–$17,400 for a family).
Some designs let you see a primary care doctor or specialist for a flat copay before the deductible (for example $40 and $80), with generic drugs at $0. Other designs put almost everything, including prescriptions, under the deductible; in-network preventive care is the exception. ER visits, imaging, surgery, hospital stays and childbirth are typically 30% after the deductible. The plans' own coverage examples show a member paying $6,370–$6,960 of a $12,700 normal delivery, $2,113–$5,440 of $5,600 in managed diabetes care and $2,530–$2,800 of a $2,800 simple fracture.
The out-of-pocket limit doesn't cap everything: premiums, balance billing, pre-certification penalties and non-covered care fall outside it. PPO plans with out-of-network benefits charge more out of network: in the plans we reviewed, that meant 50% coinsurance after a separate, higher deductible ($9,000–$10,000 for one person). Out-of-network providers may bill you for the difference between their charge and what the plan pays. That amount doesn't count toward your out-of-pocket limit. Out-of-network preventive care and prescriptions are not covered.
Monthly rates for some plans include a separate hospital and accident gap plan. Gap benefits are subject to that policy's own terms, limits and exclusions. The medical plan's deductible and cost sharing are shown before any gap benefit.
Category 2: group EPO/PPO plans with an integrated gap benefit
Plans in this category we see often run roughly $700–$950/month for a healthy single adult, depending on age, state, network and underwriting, or about $8,400–$11,400 a year. In the documents we reviewed, the stated in-network deductible and out-of-pocket limit were the same figure: $6,000–$9,000 for one person ($12,000–$18,000 for a family). The gap benefit “may reduce eligible in-network member exposure” to a lower amount, subject to the plan's terms and limits. Copays, penalties, balance billing and non-covered services may not be eligible for the gap benefit.
Before the deductible, office visits run $25–$40 for primary care and $50–$60 for a specialist, and generic drugs are $0. Diagnostic tests, imaging, surgery, hospital stays and childbirth are 30% after the deductible. The plans' own coverage examples, before the gap benefit, show a member paying about $6,050 for a normal delivery, $5,600 for managed diabetes care and $2,800 for a simple fracture. The EPO plans we reviewed cover in-network care only; out-of-network care isn't covered except for emergencies.
How the “integrated gap benefit” works: The plan's stated in-network deductible and out-of-pocket limit are higher than the reduced amount you may see advertised. The plan's integrated gap benefit may offset eligible in-network deductible and coinsurance amounts, subject to the terms and limits of the plan. Copayments, non-covered services, penalties, balance billing and other excluded charges may not be eligible. Ask us for the plan's Summary of Benefits and Coverage and the gap benefit's terms before you enroll.
Group plan notice (Categories 1 and 2): This is a group health plan offered through a sponsoring employer or organization, not an individual ACA plan. Its Summary of Benefits and Coverage states that it provides minimum essential coverage and meets the minimum value standard. If you are eligible for certain types of minimum essential coverage, you may not be eligible for the premium tax credit. Eligibility is set by the plan document.
Category 3: limited-benefit copay plans
Plans in this category we see often run roughly $375–$600/month for a healthy single adult, depending on age, state, network and underwriting, or about $4,500–$7,200 a year. The lower premium buys a set list of services with copays and hard caps. In the plans we reviewed: 3 lab/X-ray/imaging services a year, 2 ICU plus 2 non-ICU hospital stays of up to 5 days each, and 10 home-health visits.
In the copay design, the deductible is $500 or $1,500 for one person, and every copay applies after the deductible: $50 for an office visit, $250 for the ER facility plus $250 for the physician, and $1,000 per hospital stay. Preventive care and generic drugs may be covered before the deductible. Brand-name and specialty drugs may be available only through patient-assistance programs, and some plans exclude organ transplants and dialysis entirely. One design has a $0 deductible but 40% coinsurance, caps such as 5 inpatient days and 2 ER visits a year, and prescriptions through a discount card only. A discount card is not insurance.
Limited-benefit plan notice (Category 3): This is a limited-benefit plan. It pays for a defined list of services, with copays, visit and day limits, and caps on hospital stays, and it excludes some major treatments. Its plan materials don't state that it meets ACA coverage standards or that it counts as minimum essential coverage. Costs above the plan's limits are yours to pay. Benefits are subject to the governing plan document. Copays apply after the deductible unless the plan says otherwise. In the copay design, coverage is in-network only, even though the network is called a PPO. Out-of-network care isn't covered except under the plan's emergency-care protections. In the coinsurance design, prescription savings come from a discount card. A discount card is not an insured prescription benefit.
Pre-certification (Categories 1–3): Some services, such as imaging, surgery and hospital stays, need pre-certification before you get them. If you skip it, the plan may charge a penalty ($500 in the plans we reviewed), and in most of those plans the penalty doesn't count toward your out-of-pocket limit.
How Do Private Plan Prices Compare With ACA Costs for 2027?
Start with income, not a price list. For 2027 coverage, premium tax credits apply at 100%–400% of the federal poverty level (FPL): about $15,960–$63,840 for one person or $33,000–$132,000 for a family of four, as of fall 2026 under current law. Those dollar figures come from the 2026 poverty guidelines, which Marketplace credits for 2027 use.
The credit caps what you're expected to pay for your area's benchmark Silver plan at a share of income. The IRS set the 2027 scale at 2.15% of income below 133% FPL, rising to 10.22% from 300% to 400% FPL (Rev. Proc. 2026-26). Here's that math at four sample incomes for one person (our arithmetic, rounded):
Single, $31,920 (200% FPL)
Expected contribution 6.78% of income: about $2,164 a year, or roughly $180/month for the benchmark Silver plan. With a cost-sharing reduction silver plan, the 2027 out-of-pocket maximum at this income is $4,000.
Single, $39,900 (250% FPL)
Expected contribution 8.66%: about $3,455 a year, or roughly $288/month. With a cost-sharing reduction silver plan, the 2027 out-of-pocket maximum at this income is $9,600.
Single, $47,880 (300% FPL)
Expected contribution 10.22%: about $4,893 a year, or roughly $408/month. The standard 2027 ACA out-of-pocket ceiling of $12,000 applies.
Single, $63,840 (400% FPL)
Expected contribution 10.22%: about $6,524 a year, or roughly $544/month. Above this income there's no tax credit under current law, so you'd pay the ACA plan's full price.
A family of four at 300% FPL ($99,000) would be expected to pay 10.22%, about $10,118 a year or roughly $843/month, toward the benchmark Silver plan. Run your own household through our 2027 ACA subsidy calculator or check the 2027 ACA income limits.
Reading the two side by side
For a healthy single adult, group-style PPO/EPO plans in our catalog ran roughly $500–$950/month. At 200%–300% FPL, the expected contribution above ($180–$408/month) sits below the bottom of that range; at 400% FPL ($544/month) the two overlap. Premiums alone don't settle it. The expected contribution is pegged to the benchmark Silver plan, so a cheaper plan can cost less and a richer one more. The ACA plan carries its own deductible, with an out-of-pocket maximum of up to $12,000 for one person ($24,000 for a family) in 2027, and it must cover pre-existing conditions. Enhanced credits expired December 31, 2025, so treat the 400% cap as current law, not final.
Above 400% FPL, there's no tax credit under current law, and that's where a plan sold outside the Marketplace can cost less than a full-price ACA plan if you're healthy and accept its trade-offs. Full-price ACA premiums vary by age, county and plan, so we don't print them here; see our health insurance cost guide or see if you qualify, and we'll quote both side by side. At about 138% FPL or below (about $22,025 for one person under the 2026 guidelines) in one of the 41 states, including DC, that have expanded Medicaid, Medicaid is usually the answer; we'll tell you and point you to the state application.
Quick decision table
| Your Situation | Usually Better | Why |
|---|---|---|
| Income 100%–400% FPL | ACA Marketplace | The tax credit is available only through the Marketplace (HealthCare.gov) |
| Income at or below about 138% FPL, expansion state | Medicaid | About $22,025 for one person under the 2026 guidelines |
| Pre-existing condition or ongoing treatment | ACA | Marketplace plans must cover pre-existing conditions; private plan documents limit them or are silent |
| Pregnant or planning a pregnancy | ACA | Covered from the day your plan starts (HealthCare.gov); fixed-indemnity plans list only complications of pregnancy |
| Healthy, over 400% FPL, wants Cigna PPO network access | Compare both; a group-style PPO may cost less | Category 1 and 2 ranges vs. a full-price ACA quote |
| Healthy, over 400% FPL, low budget, generics only | Compare both; a limited-benefit plan may fit if the caps are acceptable | Category 3 caps on tests, hospital stays and visits |
| Already has major medical, wants cash benefits | Fixed indemnity as a supplement | Pays set amounts; not major medical or minimum essential coverage |
| Missed Open Enrollment, no SEP | Talk to us | Bridge options vs. waiting for Open Enrollment (Nov 1, 2026 – Jan 15, 2027); a private plan's approval and start date depend on that plan's own rules |
Open Enrollment for 2027 coverage runs November 1, 2026 – January 15, 2027 on HealthCare.gov as of fall 2026; enroll by December 15 for a January 1 start. State exchanges can set different dates. To start on the ACA side, compare ACA Marketplace plans, then let us price the alternatives.
Sources
- FreedInsure broker plan catalog, fall 2026 — monthly premiums by plan and household rate tier, plus the plans' Summaries of Benefits and Coverage and brochures (internal data; product names withheld).
- IRS Rev. Proc. 2026-26 — 2027 premium tax credit expected-contribution percentages (2.15% to 10.22%).
- CMS 2027 benefit-year parameters (January 29, 2026) — $12,000 / $24,000 out-of-pocket maximum and cost-sharing reduction limits.
- HHS ASPE poverty guidelines — 2026 guidelines of $15,960 for one person and $33,000 for a family of four.
- IRS Instructions for Form 8962 — Marketplace credits use the prior year's poverty guidelines.
- HealthCare.gov: pre-existing conditions — Marketplace plans must cover treatment for pre-existing medical conditions, and pregnancy and childbirth are covered from the day the plan starts.
- HealthCare.gov: dates and deadlines — Open Enrollment for 2027 coverage.
- KFF: Status of State Medicaid Expansion Decisions — 41 states, including DC, as of August 21, 2026.
- 45 CFR 155.420 — the loss-of-coverage Special Enrollment Period is tied to losing minimum essential coverage.
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Important: Plans sold outside the ACA Marketplace may be subject to underwriting, age limits, state availability and each plan's own eligibility rules. Not all plans are available in all states. Rates are not guaranteed and can change. Benefits, limits and exclusions are set by the official plan document or policy, which controls if it differs from this page. This page is a general summary, not a contract or an offer of coverage.
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