Health insurance methodology

How we research health insurance

We are not an insurance agency and we do not sell insurance. We are a comparison and information site. Health insurance on this site means marketplace health insurance under the Affordable Care Act (the plans sold on HealthCare.gov and the state-based exchanges) plus Medicaid eligibility information. We do not give medical advice. Our pages explain cover and costs; they do not tell you what care you need or which plan is right for your health.

How we research

Our research follows the same steps for every health insurance page on the site.

1. Start with the official source, not a roundup. For premiums, that means KFF State Health Facts and the Centers for Medicare & Medicaid Services (CMS). For marketplace rules, it means HealthCare.gov and the state exchanges. Secondary sources (articles, roundups, aggregators) are never the source of a figure. If an official source cannot be found, the figure is not published.
2. Copy the figure exactly as the source prints it. No rounding, no estimating, no "correcting" a source's own rounding.
3. Name the statistic, the profile, the place, and the date, every time. A marketplace premium is meaningless without the metal tier, the age, whether it is before or after premium tax credits, the place, and the year. Every published average on the site travels with a line naming all of those, and a "Current as of" date directly with the figure.
4. Cross-check between sources. Our state marketplace figures are read from KFF State Health Facts and cross-checked against HealthCare.gov. Where the two disagree, the page says so and states which figure is used.
5. Have every page reviewed by an editor before publication. Our editors are Enu Zehra and Ms. Kakka. They check every figure against its named source. A page is not published until the figures check out.
6. Re-verify on a fixed schedule. Averages are reviewed at least every six months. A figure past its review date is flagged, not silently left as if it were current. Marketplace figures change every plan year, so our health pages are re-checked at each open enrollment.

The sources we use

KFF State Health Facts: Average Monthly Marketplace Premiums by Metal Tier. This is the source of every state and countrywide marketplace premium average on the site. United States, 2027: benchmark premium $703 per month; 2026 benchmark: $625 per month. Profile: a 40-year-old, before premium tax credits, enrollment-weighted county averages. The benchmark plan is the second-lowest-cost silver plan. The rise in the benchmark from 2026 to 2027 reflects expiring enhanced premium tax credits and filed rate increases. Geography: all 50 states plus the District of Columbia. Current as of November 2026.

Centers for Medicare & Medicaid Services. Health Insurance Exchanges 2026 Open Enrollment Report and 2026 Marketplace Open Enrollment Period State-Level Public Use File, 27 March 2026. Across all plan selections in the 2026 open enrollment period, the average monthly premium was $741 before tax credits and $178 after tax credits. For people who received advance premium tax credits, the average premium after credits was lower still. Geography: all 50 states plus the District of Columbia, covering both HealthCare.gov and the state-based exchanges. Note: the report's narrative text gives the 2026 before-credit average as $619, that is the 2025 value. The State-Level Public Use File prints $741 for 2026, which is the figure used here. Current as of November 2026.

HealthCare.gov. The federal marketplace site is the cross-check for our KFF figures and the source for marketplace rules: open enrollment dates, special enrollment periods, the definition of the benchmark plan, and the premium tax credit rules. Where a state runs its own exchange, the state exchange is the source for that state's rules.

State-based exchanges and state Medicaid agencies. For 2026, 21 states run a state-based exchange and 26 use the federally facilitated marketplace. Medicaid has expanded in 39 states and the District of Columbia, and has not expanded in 8 states: Alabama, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Wisconsin, and Wyoming. These counts are from KFF State Health Facts and are stated on our state pages with the date checked. Medicaid eligibility rules differ by state, and our eligibility pages state the rule for the state they describe, with the source.

What does a benchmark premium mean, and what does it not mean?

The benchmark premium is the second-lowest-cost silver plan for a 40-year-old, before premium tax credits, averaged across counties with enrollment weights. It is the figure the premium tax credit is calculated from, which is why it is the most useful single number for comparing places. It is not the price you will pay. Your premium depends on your age, your household size and income, the metal tier you choose, and the plan you pick. After premium tax credits, the average enrollee in the 2026 open enrollment period paid $178 per month, far below the $741 before-credit average. Both figures are published side by side on our pages, because the before-credit figure alone would mislead most readers.

A benchmark premium is also a snapshot in time. Premiums are set every plan year, and the 2027 figures differ from the 2026 figures. Every figure on the site carries its plan year and a "Current as of" date. When a new plan year's figures are published, we update and re-date them.

What we do not do

• We do not publish per-carrier health premiums as averages. No free source publishes them in a comparable form. Per-carrier health prices on this site are Quote-only: no price figure appears on the entry at all, not even a "from" figure.
• We do not invent ratings. No carrier or plan rating appears without its source, scale, and date stated on the same card. No "best plan" verdict is drawn from averages, because averages cannot support one.
• We do not publish savings claims. No savings figure appears unless the basis (who saved, versus what, over what period, from what data, dated) is stated beside it in the same view. If the basis cannot be stated, the figure does not appear.
• We do not give medical advice. Our pages explain how marketplace cover works, what the metal tiers mean, and what premiums and subsidies look like. They do not tell you what care you need, which plan is right for your health, or whether a treatment is covered. Those are questions for your doctor and for the plan documents.
• We do not take payment for placement. No carrier or plan pays to appear, to rank higher, or to be shown first. Sort order on results is by lowest price among published averages.
• We do not show carrier logos, "Buy now" buttons, or lead-generation funnels. We ask for your ZIP code and basic facts only. We never ask for contact details, and nothing you enter travels to a carrier.

How often we update

Published averages are reviewed at least every six months; the next review is due May 2027. Marketplace figures are re-checked at each open enrollment, when the new plan year's premiums are published. State exchange and Medicaid figures are re-checked whenever a state announces a change, and at each six-month review at the latest. When a figure is updated, the "Current as of" date and the "Last reviewed" date on the page change with it. When a source publishes a correction, we correct the figure and add a correction note under our corrections policy.

Limitations: read this before you decide

• No comparison covers every plan. Plans that do not publish usable figures, are sold only off-exchange, or are available only through an employer may not appear here at all. Check HealthCare.gov or your state exchange for the full list of plans in your area.
• A published average is not your price. See above. Your premium after tax credits depends on your income and household size; use the marketplace's own calculator or application for your exact figure.
• Averages go stale. Every average carries a "Current as of" date and a plan year. An average past its review date is flagged.
• Marketplace rules change every plan year: open enrollment dates, subsidy rules, and plan availability. Our pages state the plan year they describe; a page describing 2026 does not describe 2027.
• Medicaid eligibility is a state rule, not a national one. Our eligibility pages describe one state at a time, and the rule for your state is the one that applies to you.
• Sorting, filtering, and side-by-side comparison need JavaScript. Without JavaScript the full comparison is shown on the page, but it cannot be re-sorted, filtered, or compared side by side in the browser.

Sources

1. KFF State Health Facts, Average Monthly Marketplace Premiums by Metal Tier. https://www.kff.org/affordable-care-act/state-indicator/average-marketplace-premiums-by-metal-tier/
2. Centers for Medicare & Medicaid Services, Health Insurance Exchanges 2026 Open Enrollment Report and 2026 Marketplace Open Enrollment Period State-Level Public Use File, 27 March 2026. https://www.cms.gov/data-research/statistics-trends-reports/marketplace-products/2026-marketplace-open-enrollment-period-public-use-files
3. HealthCare.gov (marketplace rules, open enrollment dates, premium tax credit rules). https://www.healthcare.gov/
4. KFF State Health Facts, marketplace type and Medicaid expansion status by state, as cited on each state page.

Questions or corrections: hello@countrypilot.net (email only) or our corrections policy. Content reviewed by editors Enu Zehra and Ms. Kakka. Nothing on this site is medical advice.

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See also: How we calculate averages · Editorial policy · Corrections policy