How does the size of my family impact my insurance cost?

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If you purchase your own health coverage, this explains how the number of people covered by your insurance affects your monthly payment and other costs.

The size of your family doesn't necessarily determine what you spend on doctors and prescriptions. A healthy family of six could spend less than a married couple with chronic conditions. But when it comes to your health insurance costs, the number of people on a plan does affect what you pay. We'll show you how.

Premiums and people on your plan

When you add a spouse or child onto a plan, your monthly payment goes up. That's because you're charged for each person covered by your plan. When you have more than three children under the age of 21, you only pay for the three oldest. Here's how that works.

  • Darrell and Tamara have five children, ages 5, 8, 12, 14 and 16. Although their health plan covers all seven of them, they're only charged on their monthly premium for five people. They're not charged for their two youngest children.
  • Samar has two children, ages 7 and 10. So her health plan covers three people, and she's charged for three people on her monthly premium.
  • Terry and Joaquin have four children, ages 17, 20, 22 and 24. Their health plan covers six people. Because two of their children are over age 21, they're charged on their monthly premium for all six people.

Individual versus family plans

An individual plan has one member, or just one person covered by the plan. Family plans cover two or more members.

Your plan's deductible and out-of-pocket maximum are based on whether you have an individual or family plan.

The deductible and out-of-pocket maximum for a family plan is usually double of an individual plan. So if the deductible for a plan is $2,000 for a family, it's $1,000 for an individual. If the out-of-pocket maximum for an individual plan is $6,000, it will be $12,000 for a family, no matter how many people the plan covers.

Take a look at the individual and family health insurance plans to get more information.

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