% of poverty line
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Your Household
+ partner age 35 · 2 kids · ColoradoPrimary Insured
Spouse / Partner
Children (Dependents)
Dependents stay on your plan until 26. ACA caps premiums at 3 children.
Location & Plan
A 5-digit ZIP prices at its local area where the data allows. City, metro, and state picks use a statewide average; local prices can differ, sometimes by a lot.
Advanced Assumptions
$
2026 Estimate
Unsubsidized · Non-TobaccoAnnual Household Cost
Monthly premium
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Annual premium
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At age 50
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At age 60
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| Member | Age | Monthly | Annual |
|---|---|---|---|
| Total premium | — | — | |
| Total household | — | — | |
The Healthcare Hump
Unsubsidized · Real (today's) dollars · +1.5% annual premium trend above CPIExcess above today's baseline
Projected annual premium, unsubsidized
Today's annual premium (baseline)
How to read this: The shaded area is the extra cost above today's premium your portfolio needs to cover before Medicare at 65. Drops happen when dependents age off your plan at 26.
The Buffer Calculation
Additional FIRE portfolio neededPresent-Value Buffer (above your 4% Rule number)
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at a 2% real return assumption
Educational estimate only - not financial advice. Verify rates at healthcare.gov.
2.0%
1.5%
Undiscounted Buffer
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Raw sum of excess costs in real (today's) dollars, no discounting
Years to Medicare
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Years of unsubsidized ACA exposure
Peak Annual Cost
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Highest year before Medicare
Peak Year
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Your age at peak premium
How this works: The present value of every dollar your projected premiums exceed today's, discounted at your chosen real return. Add it to your 4% Rule FIRE number. The younger you retire and the leaner your target, the more this matters. Read the full analysis →
Why this instead of healthcare.gov's window shopper
What this does that a quote tool can'tHealthcare.gov and most premium calculators answer one question: what does a plan cost me this year. That is the wrong question for early retirement. The number that breaks a FIRE plan is the cumulative cost of buying your own insurance every year from the day you retire until Medicare picks you up at 65, while premiums climb with your age. This tool projects that entire path, year by year, then converts it into the single figure your plan actually needs: the extra portfolio buffer to fund the gap above your 4% Rule number. It defaults to unsubsidized costs on purpose, because building a 20-year retirement plan on a premium tax credit that a single year of income can erase is a risk worth seeing in full before you decide to take it.
No proprietary black box. Every figure traces to a named public dataset: 2026 CMS Health Insurance Exchange Public Use Files for premiums, KFF's 2026 benchmark analysis for the state-based-exchange states, AHRQ MEPS for out-of-pocket estimates, IRS Rev. Proc. 2025-25 for premium tax credit percentages, and the 2025 HHS poverty guidelines. Nothing you type is sent anywhere or stored; every calculation runs locally in your browser.
Frequently asked questions
What is the healthcare hump?
ACA premiums rise steeply with age. Federal rules allow a 64-year-old to be charged three times what a 21-year-old pays. For early retirees, that creates a growing annual cost between retirement and Medicare at 65 that the standard 4% Rule does not capture. This tool sizes that gap and the extra portfolio buffer needed to fund it.
What plan year does the estimator use?
The 2026 ACA plan year. Premiums come from the CMS 2026 Health Insurance Exchange Public Use Files for the 30 federal-exchange states, with state-level 2026 benchmark estimates for the 21 state-based-exchange states. Out-of-pocket estimates come from the AHRQ Medical Expenditure Panel Survey.
Does it include premium tax credits (subsidies)?
By default, no. It shows worst-case unsubsidized costs, because relying on subsidies is a risky long-horizon planning assumption. You can toggle on a premium tax credit scenario that applies the post-2025 rules, including the 400% of federal poverty level eligibility cliff that returned when the enhanced credits expired at the end of 2025.
Is the estimator free, and where does my data go?
It is free and runs entirely in your browser. All inputs are calculated locally and are not sent anywhere.
Can I use it to choose or buy a health plan?
No. It is a planning estimate, not insurance advice and not an enrollment tool. Actual plan costs vary by specific plan, network, and county, so always verify current rates at healthcare.gov or your state exchange before making coverage decisions.
Methodology & Sources
Show your workData Sources
- Rate PUF (2026): Individual plan premiums by age, state, and rating area. CMS CCIIO, updated April 2026.
- Plan Attributes PUF (2026): Metal level classification (Silver, Bronze, Expanded Bronze). CMS CCIIO.
- SBE State Estimates: State-level average benchmark premiums for the 21 state-based exchange states not in the federal PUF, from KFF's 2026 Marketplace Average Benchmark Premiums analysis (enrollment-weighted SLCSP for a 40-year-old).
- OOP Costs: MEPS-informed planning estimates of annual out-of-pocket spending by age band, adjusted upward from AHRQ MEPS 2023 population means to reflect individual-market cost sharing (higher deductibles than the employer plans that dominate MEPS). Includes deductibles, copays, coinsurance, and prescription drugs; excludes premiums. These are planning figures, not published MEPS means.
- QHP Landscape (2026): County to rating-area assignments for the 30 federal-exchange states. CMS, data.healthcare.gov, Individual Market Medical.
- ZIP crosswalk: HUD-USPS ZIP-COUNTY crosswalk, first quarter 2026 (03/2026), dominant county by residential address share. huduser.gov.
- Coverage: 30 FFE/SBE-FP states with exact rating-area data; 21 SBE states with state-level estimates.
Calculation Methodology
- SLCSP: Second-lowest-cost silver plan premium at each rating area, the federal benchmark rate used for subsidy calculations.
- Bronze: Lowest-cost bronze or expanded bronze plan per rating area.
- Age projection: Uses actual plan rates at ages 21, 30, 40, 50, 60, and 64 from the Rate PUF, with linear interpolation for intermediate ages.
- Children: Child (under-21) rate from SLCSP; ACA caps family premium at 3 children's rates maximum. Dependents remain on plan to age 26.
- Tobacco: Surcharge derived from the IndividualTobaccoRate field in the Rate PUF. Not all states allow tobacco rating.
- State averages: Rating-area rates weighted by silver plan count as an enrollment proxy. Validated within ~1–3% (median) of KFF's published enrollment-weighted state benchmarks.
- Location resolution: Five-digit ZIPs in the 30 federal-exchange states resolve to their ACA rating area through the HUD-USPS ZIP-COUNTY crosswalk (March 2026): each ZIP prices at the rating area holding most of its residential addresses. 610 of the 21,543 mapped ZIPs have more than 20 percent of addresses in a second area; those price at the dominant area. City, metro, and state selections, and all state-based-exchange states, use the statewide figure described above. The note beneath the estimate states which basis is in use.
- Bronze ratio: Bronze prices anchor to each area's lowest-bronze-to-benchmark ratio, and the projection holds that ratio fixed across all years. In practice the ratio drifts modestly year to year as insurers reprice metal tiers, so far-horizon bronze figures inherit that assumption.
- Age rules: NY and VT are community rated (no age variation, so the projection is flat). MA uses a 2:1 compressed age curve. Utah files its own state age curve (a plateau through the late 20s and early 30s, reaching the federal 3.0 cap by age 60); the tool applies Utah's filed per-age curve directly. All other states follow the federal 3:1 age band.
- OOP estimate: MEPS-informed OOP figures by age, adjusted upward for individual-market cost sharing and interpolated across 12 age-band midpoints. Individual OOP varies widely by health status - healthy adults may spend near $0 while those with chronic conditions can hit the ACA max-OOP ($10,600/individual in 2026). The figure is a planning midpoint, not a prediction or a published survey mean.
- Premium growth: User-adjustable real growth above CPI (default 1.5%/yr). Applied as (1+g)^t to premiums only, not OOP. The 2026 plan year saw benchmark premiums rise ~26% nationally, driven by enhanced subsidy expiration and GLP-1 drug costs.
- MOOP stress test: Replaces the N highest-OOP years with the ACA max out-of-pocket limit ($10,600 individual / $21,200 family for 2026, per 45 CFR 156.130), inflated by the premium growth rate. A planning hedge for high-cost medical years, not a probability model.
- Bronze OOP factor: OOP estimates multiplied by 1.30x for bronze plans. Bronze carries higher deductibles and cost-sharing; the 30% uplift is a planning approximation.
- Premium tax credits: Optional toggle using current-law PTC rules (post-2025, with 400% FPL cliff). Applicable percentages from Rev. Proc. 2025-25. FPL from the 2025 HHS poverty guidelines ($32,150 for a family of four), which govern premium tax credits for the 2026 coverage year; the 2026 guidelines published in January 2026 ($33,000 for a family of four) apply to 2027 coverage. Household size for the FPL test is approximated by plan household each year (kids drop out at 26). MAGI and FPL held constant in real terms across the projection. Credits are not the default - relying on income management to stay under the cliff is a strategy with real execution risk.
- Buffer: PV of (projected annual cost − today's baseline) from current age to 65, discounted at your chosen real return rate.
What this tool does not model: Medicare costs after 65 or cost-sharing reductions beyond the OOP estimates. Premium tax credits are off by default but can be toggled on for comparison (see the article for why relying on subsidies is a risky planning assumption). Premium growth above CPI is user-adjustable, defaulting to +1.5%/yr based on the ~26% national benchmark increase for the 2026 plan year. The 30 FFE states in the CMS Public Use File do not include CA, CO, CT, MA, MD, MN, NJ, NY, PA, WA, and others that operate their own state exchanges.
Rating areas are the geographic pricing unit for ACA premiums. Each state divides into 1–67 rating areas. If you don't know yours, the state average gives a reasonable planning estimate. Differences within a state are typically 10–35%.
Data notes: A few states carry less intra-state detail than the rest. Arkansas currently shows a single statewide figure across all rating areas; Oregon and Montana have whole-dollar (rounded) rates in several areas; Mississippi's bronze plans price unusually close to silver; and one Michigan rating area's lowest bronze prices slightly above its silver benchmark (several others sit just below it). All 349 rating-area rate sets, including these, were verified value-for-value against the final CMS 2026 Rate PUF on 2026-07-29, so these patterns reflect the filed rates themselves. The same audit found and corrected one real defect: Utah's mid-curve ages had been built from federal age factors instead of Utah's own filed curve, understating Utah premiums for ages 22 to 59 (fixed in v1.3.0).
This tool is for educational and planning purposes only. It is not financial, legal, or insurance advice. Premiums shown are unsubsidized. Actual plan costs vary by specific plan, provider network, and enrollment date. Always verify current rates at healthcare.gov or your state exchange before making coverage decisions. BiggerPockets Money is not a licensed insurance agent or financial advisor.