What Civilian Health Care Costs


A few things have come together to make me think that perhaps we military folks, myself included, might have some unrealistic ideas about the cost of civilian health care.  First, there has been some enthusiastic commenting about the rise in the premiums for Tricare Young Adult.  Then, I had a conversation with a civilian friend about how much her family spends on health care each year.  Lastly, a recent review of the Army’s Soldier For Life-Transition Assistance Program revealed that soldiers, particularly junior enlisted, often have unrealistic expectations about what type of salary they can expect to earn when they leave the military, leading me to wonder whether troops also underestimate the costs of civilian health care coverage.

And so, I thought it might be a good idea to look at what health insurance is costing a variety of civilians out there.

I’ve gathered information about health care costs from a variety of real-life sources.  I don’t have all the information for every example, because I want to respect the privacy of the individuals who were so kind as to share this information with me.  I’ve also rounded the amounts, to disguise any specific plans, and simplified the details.  This isn’t designed to be a penny-to-penny analysis, just to give us military folks any idea what medical insurance costs out there in the civilian world.

Please keep in mind that these premiums are NOT what the insurance actually costs.  In most cases, the employer is picking up hundreds of dollars in premiums each month.

A Young Family

One employee who shared her details with me would pay $187 every two weeks ($4862 per year) for her family’s health insurance.  Their $3,000 deductible means that they also pay for the first $3,000 in actual care each year.  In addition, this plan has a separate pharmacy deductible of $300 per family, and pharmacy co-pays of up to $60 per month per medication.

The company also offers vision coverage at a cost of about $9 every two-week ($234 per year) for a family, and dental coverage at about $34 every two weeks ($884) for a family.

This family opts to use the husband’s Tricare, saving at least $8,000 per year versus using the wife’s employer-sponsored plan.  My estimate is that this family would spend about $10,000 a year on total health costs (premiums plus deductibles plus co-pays) using this plan.

A Single Person

One of the people who shared her information with me has some super-fabulous benefits.  Her company pays the entire cost of her health insurance premium, and she pays just a small deductible each year.  (A few hundred dollars.)  She’s an educated, skilled professional in a corporate setting – jobs like this tend to have benefits that are significantly better than the national average.

Two Jobs, Two Kids

One of my examples has the choice between two plans:  his and hers.  They’re both excellent, but still not enough to keep their health care costs down to what I might consider a reasonable level.

Her Plan: has a premium of $200 every two weeks ($5200 per year).  She also happens to have access to the fact that her employer contributes almost $600 every two weeks to her premiums (about $15,000 per year.  Not a typo.)  They pay a $700 deductible every year for in-network care, plus co-pays of $20 for primary care, $30 for specialty care, $50 for urgent care and $150 for emergency room care.  They also pay up to $55 each month per prescription.

His Plan:  has a premium of $250 every two weeks ($6,500 per year).  The deductible for this plan is $1,250 per year, with 10% co-pays for in-network care, and up to $50 per 30 day prescription.  This is the plan that they have been using, and they estimate that they spend approximately $4,500 a year on co-pays for a total yearly out-of-pocket cost of around $11,000.

Great Benefits From A European Company

Yet another kind person who shared their information prefaced their sharing by saying that their benefits were great because it was an (un-named European country) company.  Once I saw their details, I agree.  Her family pays just $250 per month ($3,000 per year), with an in-network deductible of just $200 per year.  She estimates that in addition to premiums, her family paid about $750 in out-of-pocket costs last year, for a total cost of less than $4,000 for the year.

One Parent, One Child

Different health care plans structure their packages differently.  One of my examples offers insurance that is less expensive than the family rate, just for a single parent with one child.  This plan costs $116 every two weeks ($3,016 per year) and features a $700 per year deductible.  It has co-pays of $20, urgent care co-pays of $50, and ER co-pays of $150.

Another Single Sample

Unlike my fortunate friend above, the typical single doesn’t get free health coverage from their employer.  Another example is more typical:  $55 per two-week pay period ($1430 per year) plus a $500 in-network deductible and up to $50 for each 30 day supply of prescription medications.

Single Person #3

My third single example pays just $27 every two weeks in premiums ($702 per year), but has a $1,600 deductible, a 10% co-pay on care, and up to $50 co-pay on prescriptions.  Probably a decent plan if you never, ever go to the doctor or pay for care, but not the best choice for someone who does expects to use the benefits.

I hope these real-life examples help you to understand what to expect in the way of health care expenses when you leave the military.  I started this post with the intent of surprising some people by how much civilian health insurance costs, and then even I was surprised.  Quite possibly the most surprising part is that all my examples felt that their health insurance was very competitive and that they had friends who paid significantly more.  That shouldn’t be a complete surprise:  Average total (employer and employee) premiums for employer-sponsored family health coverage reached $17,545 this year, according to the Kaiser Family Foundation/Health Research & Education Trust 2015 Employer Health Benefits Survey.  That’s just premiums, not deductibles, co-pays and co-insurance costs.  So even my friends who are spending more than $10,000 a year aren’t even beginning to pay the full cost of their care/coverage.

Tricare isn’t perfect, but it is gosh-darn good insurance at a price that cannot be beat.  I am even more aware of that than I was when I started this post.  Thank you, Tricare!


Photo courtesy of http://401kcalculator.org under the Creative Commons license.

About the Author

Kate Horrell
Kate Horrell is a military financial coach, mom of four teens, and Navy spouse. She has a background in taxes and mortgage banking, and a trove of experience helping other military families with their money. Follow her on twitter @realKateHorrell.