Paul Zane Pilzer

This Guide shows the monthly cost, in each state, of representative individual/family health insurance policies for a healthy single person (male, age 35), a healthy family of four (parents, age 35, and children, ages 5 and 8), and a person (male, age 35) with a preexisting medical condition who does not medically qualify for private health insurance in 2006. See each state for policy details.

Scroll below to see a summary table of policy costs in all states. While the policies for each state were chosen to be as similar as possible, they are not directly comparable—benefits vary between states and between carriers.

Please refer to The New Health Insurance Solution for explanations of terms not shown below:

Key to State-By-State Guide
PP   Per person.
Average cost of individual policy sold in 2004   This figure is based on 82,000 policies sold to single individuals online by ehealthinsurance.com in 44 states during a six-month period in 2004 (see Chapter 2).
Guaranteed issue   A legal requirement in some states that health insurance carriers accept all applicants regardless of health status, age, and so on. New York, New Jersey, Massachusetts, Maine, and Vermont are guaranteed-issue states.
Community rated    A legal requirement in some states that all applicants (both high- and low-risk) are charged the same health insurance premium for the same coverage regardless of health status, age, and so on. New York, New Jersey, Massachusetts, Maine, and Vermont are community-rated states.
HIPAA-eligible (federally eligible) individual    Person whose health insurance has been terminated and who has elected and exhausted COBRA. Federal law requires that each state offer its HIPAA-eligible residents individual health insurance without exclusions for preexisting conditions (see Chapter 3).
State-guaranteed coverage    All states have a state risk pool or its equivalent to provide state-subsidized coverage to individuals who cannot medically qualify for private health insurance—in 10 states you must be HIPAA-eligible to get this state-guaranteed coverage (see Chapter 7).

Applicants Who Cannot Afford Health Insurance
All states have programs (e.g., Medicaid) for residents receiving public assistance or who cannot afford health insurance—these programs vary greatly and are not included in this appendix. See Chapter 7 and contact your department of health insurance to learn about programs for low-income residents in your state.

Cost of Individual/Family Health Insurance Policy for a Single Applicant—National Average (2006) (Male, age 35)

See individual state pages for details on each policy.
*A few states have either not yet modified their regulations to allow HSAs or carriers are not yet offering individual/family HSA-qualified policies.

Cost of Individual/Family Health Insurance Policy —National Average (2006) (Two Parents, Age 35; Children, Ages 5 & 8)

See individual state pages for details on each policy.
*A few states have either not yet modified their regulations to allow HSAs, or carriers are not yet offering individual/family HSA-qualified policies.

New Health Insurance Solutions for individuals, families, self-employeds, and businesses.

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