Which States Have the Most Expensive Health Insurance?
Employer-sponsored health insurance is the most common form of insurance for individuals in the U.S., but the price of these health insurance plans vary based on location. We analyzed data from the Medical Expenditure Panel Survey to find out where the most expensive health insurance markets are located and provide you with the most up-to-date information available.
States with the Most Expensive Health Insurance Premiums
This study is based on average total yearly premiums and employee contributions for private-sector establishments. In 2019, the average yearly premium was $6,972 for an individual (3.8% more than in 2018) and $20,486 for a family (4.7% more than in 2018). Even within the most expensive health insurance markets, prices continue to rise across the country for everyone from small business owners to large corporations.
Nick Schrader, an insurance agent at Texas General Insurance weighs in on the differential costs of health insurance premiums nationwide, “(the variation in price) is primarily because of the number of insurance companies available in the area, the accessibility to health care providers, and institutions around, and government mandates on how much insurance companies can charge people depending on the state and federal laws of the area.” We take a closer look at the most expensive health insurance markets below.
1. Anchorage, AK
Although Anchorage is the most popular city in Alaska, the population is below 300,000 people. A small risk pool, the group of members enrolled in a single plan, leaves consumers vulnerable to high premiums; the cost of an individual premium for an individual is the highest in the United States at $9,530 per year. This is 37% higher than the national average making Anchorage the most expensive health insurance market in the U.S.
2. New Haven, CT
The New York Times reported insurance companies that serve New Haven, CT earned more during the pandemic compared to the previous year, yet the price of health insurance continues to rise. Many young, healthy people are electing out of health insurance altogether because it is so expensive. This year, the average yearly premium amounted to $8,755 and one of the highest family premiums at $23,329.
3. Wilmington, DE
Areas with smaller populations have fewer doctors and hospitals which can make health insurance expensive for consumers. Fewer providers leave health insurance companies with less leverage to negotiate the price of care. Wilmington, DE has the third-highest average cost at $8,527 per year.
4. New York, NY
As expected, one of the most expensive cities in the country also has one of the most expensive health insurance markets. At number four on our list, New York, NY employer-sponsored insurance premiums cost $8,199 on average.
5. Cleveland, OH
According to the Commonwealth Fund report, residents of 42 states spend more than 10% of their income on health insurance. Ohio has the third-highest number of high deductible enrollees in the nation because the premiums are outrageous. In Cleveland, the yearly health insurance premium is $7,947.
6. Orlando, FL
The home of Universal Studios: Orlando, Fl is next on our list with a total annual premium of $7,825. On average, the population in Florida is older which translates to higher premiums. People who are older often have more health conditions to account for, so health insurance companies raise the price of premiums.

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7. Newark, NJ
Not too far from New York City in distance or price of insurance plans, Newark ranks the 7th most expensive health insurance market for employer-sponsored health insurance. Here the total cost is $7,491 with an employee contribution of $1,668.
8. Riverside, CA
Along the Santa Ana River, Riverside, California has one of the fastest-growing health insurance markets and also one of the most expensive at $7,477 per individual per year.
9. Bridgeport, CT
Another quickly growing market in Connecticut resides in Bridgeport, CT. The average yearly premium for an individual plan is $7,444. In Connecticut, people who make over 400 percent of the Federal Poverty Line do not receive subsidies, but traditional health insurance is still out of reach leading to a cause for concern over the health of residents as prices continue to rise.
10. Baltimore, MD
At only one dollar above the average cost of health insurance in Burlington, Vermont, the average cost of health insurance in Baltimore, Maryland is $7,418. This year, health insurance companies are still requesting to increase the price of plans even though it is already one of the most expensive health insurance markets in the U.S.
Most Expensive Health Insurance Plans on the Marketplace
Those who do not receive insurance through their employer can obtain affordable health insurance through the Marketplace established by the Affordable Care Act (ACA). Based on the level of health insurance coverage you choose on the Marketplace, the premium varies. Catastrophic plans have the lowest monthly fee and highest deductible, while platinum plans have the most expensive health insurance premium and lowest deductible.
Average Monthly Health Insurance Premium by Metal Tier
Metal Tier | 2021 Monthly Premium |
---|---|
Catastrophic | $313 |
Bronze | $387 |
Expanded Bronze | $418 |
Silver | $539 |
Gold | $594 |
Platinum | $709 |
Furthermore, the premium depends on the amount of flexibility your plan offers. Restrictive plans, like HMOs, have lower costs associated because you can only see specific doctors under certain conditions.
Schrader adds, “An indemnity health plan is the most expensive type of health insurance. It allows the insured to choose their health facility and the specialist they wish to see. Furthermore, an indemnity health plan will enable you to see experts without a referral, which is why it is more expensive.” These plans are quite uncommon, but the average premiums of the more common types of health insurance plans are listed below.
Average Monthly Premium By Plan Type
Type | 2021 Monthly Premium |
---|---|
HMO | $427 |
POS | $462 |
PPO | $517 |
EPO | $469 |
Still, premium costs are impacted by the location of the enrollee. Many of the cities mentioned in the first half of this article are located in states where there are high Marketplace prices due to population demographics and health service access.

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Average Marketplace Premiums by Metal Tier, 2018-2021
Most Expensive Health Insurance Markets Frequently Asked Questions (FAQs)
Where are the most expensive health insurance markets?
The most expensive health insurance markets exist in places with less healthcare access and high-priced services. The most expensive health insurance markets in the U.S. are:
- Anchorage, AK
- Wilmington, DE
- New York, NY
- New York, NY
- Cleveland, OH
- Orlando, FL
- Newark, NJ
- Riverside, CA
- Bridgeport, CT
- Baltimore, MD
Why is health insurance more expensive in some places?
The cost of health insurance is dependent on the demographics of the population and the availability of health care services. In places with younger, healthier, working populations, insurance rates tend to be lower. Additionally, where there is a surplus of medical facilities like hospitals and specialists, the cost of care is less expensive because there is more competition between providers.
What are the most expensive health insurance plans?
The most expensive health insurance plans are those that offer the greatest flexibility. Plans that cover services from out-of-network providers and without a referral are the most expensive because they are most attractive to the consumer. They are also the most expensive because the insurance company has less negotiating power with the provider.
Bottom Line
As the costs of health insurance continue to rise, many people are seeking alternative options to expensive health insurance plans. Despite the location, metal tier, and plan type, health insurance premiums are out of reach for many, especially those who are not offered coverage through their employer.
Instead of enrolling in a traditional plan, Mira provides access to same-day lab tests, low-copay urgent care, and up to 80% off prescription drug prices at a fraction of the cost. For only $45 per month, freelancers, restaurant workers, and those who are experiencing unemployment can finally get the care they need at an affordable price.
Alexis Bryan MPH, is a recent graduate of Columbia’s Mailman School of Public Health. She is passionate about increasing access to care to improve health outcomes. Outside of work, she loves to travel, read, and pay too much attention to her plants.