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My Insurance Price

The five permitted rating factors

What can affect your price

HealthCare.gov lists five factors that can affect a Marketplace premium. Knowing them helps you match two quotes on the same basis; it does not turn a state average into a personal fairness verdict.

  1. Age

    Older adults can be charged more within federal limits. Under federal Marketplace rules, premiums for older adults can be up to three times those for younger adults. States can limit this factor further.

  2. Where you live

    Your ZIP sets your rating area. The same plan can cost very differently a county or a state line away. Your price is tied to your home address, not where you work.

  3. Tobacco use

    A permitted surcharge that states can restrict. Federal Marketplace rules allow insurers to charge tobacco users up to 50% more, while states can limit how the factor is used.

  4. Your metal tier

    The factor you fully control. Bronze, Silver, Gold, Platinum — the tier you choose moves your premium up or down. It's the one price lever entirely in your hands.

  5. Household size

    Covering dependents changes the total premium. HealthCare.gov lists individual versus family enrollment as a permitted premium factor because a plan covering a spouse or dependents can cost more.

What insurers can't use

Not your health status. Not your sex. Not your medical history or a pre-existing condition. Verify the current rating details and any state limits on the official Marketplace quote.

Sources: HealthCare.gov, "How insurance companies set health premiums" and 45 CFR 147.102. State rules may be stricter; verify against the current official quote. · Last reviewed: August 11, 2026