15 states ranked · CMS Plan Year 2026 filed rates
Licensed Independent Agent · NPN #22052447 · 21 States
Across 15 states and 1,314 counties, the cheapest Silver plan for a 40-year-old ranges from $558/month in Indiana to $875/month in Nebraska. For Massage Therapists specifically, the state that ranks best on median Silver premium is Indiana; the worst is Nebraska.
When you use coverage regularly, the annual total is driven by what each visit costs and whether the clinician you already see is contracted. A plan $40 cheaper that drops your specialist is not cheaper. These rankings pair median premium with how many carriers actually file in the state.
Occupational context: Chronic hand, wrist, and shoulder overuse injury. Note that this affects which plan design fits — it does not affect eligibility or price. Under the ACA, carriers may not rate by occupation or health history, so a massage therapist and an office worker of the same age in the same county see the same filed premium.
Ordered by median Silver premium. Premiums are full price before subsidies.
| # | State | Median Silver @40 | Highest OOP max | Carriers | Counties |
|---|---|---|---|---|---|
| 1 | Indiana | $558 | $0 | 5 | 92 |
| 2 | Ohio | $625 | $0 | 11 | 88 |
| 3 | South Carolina | $636 | $0 | 6 | 46 |
| 4 | Alabama | $680 | $0 | 4 | 67 |
| 5 | Wisconsin | $687 | $0 | 12 | 72 |
| 6 | Michigan | $708 | $0 | 7 | 83 |
| 7 | South Dakota | $725 | $0 | 3 | 66 |
| 8 | Oklahoma | $731 | $0 | 7 | 77 |
| 9 | Kansas | $765 | $0 | 6 | 105 |
| 10 | Florida | $789 | $0 | 15 | 67 |
| 11 | Utah | $805 | $0 | 6 | 29 |
| 12 | Texas | $807 | $0 | 15 | 254 |
| 13 | North Carolina | $828 | $0 | 6 | 100 |
| 14 | Arkansas | $828 | $0 | 4 | 75 |
| 15 | Nebraska | $875 | $0 | 5 | 93 |
Most Massage Therapists buying their own coverage are also deducting it. Categories that typically apply to this trade: Table, oils, room rental, licensing, liability insurance. Self-employed health insurance premiums are generally deductible above the line under IRC §162(l) when you are not eligible for an employer plan through a spouse. That is a tax question, not an insurance one — confirm it with your CPA.
The subsidy math matters more than the premium: premium tax credits phase with household income, so two Massage Therapists in the same county with different net income can pay very different amounts for the identical plan.
Indiana, at a median Silver premium of $558 per month for a 40-year-old before subsidies. Nebraska is the most expensive at $875.
No. ACA plans are community rated. Price varies only by age, ZIP code, tobacco use, and household size. Occupation cannot be used to rate, decline, or exclude you.
Patient-facing and standing work means steady, predictable utilization — regular visits, prescriptions, physical therapy. Copay structure and network breadth drive real annual cost more than the headline premium, so the tables here rank states on median premium and carrier count together.
Coverage by County publishes a page for every county in each state, with the carriers filing there and their filed premiums, plus profession-specific guides for Massage Therapists in each state.
The table above uses CMS plan-level records, which exist only for states on healthcare.gov. Six states run their own exchanges and are absent from that file. The benchmark premium — the second-lowest-cost Silver plan for a 40-year-old, weighted by county enrollment — is published on the same basis for every state, so it is the one number that compares all 21.
| # | State | Benchmark @40 | YoY | Exchange |
|---|---|---|---|---|
| 1 | Maryland | $414 | +13% | SBE |
| 2 | Virginia | $455 | +22% | SBE |
| 3 | Indiana | $474 | — | healthcare.gov |
| 4 | Nevada | $497 | +20% | SBE |
| 5 | Ohio | $513 | — | healthcare.gov |
| 6 | Michigan | $523 | — | healthcare.gov |
| 7 | Colorado | $557 | +20% | SBE |
| 8 | South Carolina | $564 | — | healthcare.gov |
| 9 | Oklahoma | $604 | — | healthcare.gov |
| 10 | Wisconsin | $611 | — | healthcare.gov |
| 11 | Georgia | $615 | +25% | SBE |
| 12 | North Carolina | $638 | — | healthcare.gov |
| 13 | Utah | $640 | — | healthcare.gov |
| 14 | Alabama | $645 | — | healthcare.gov |
| 15 | Illinois | $646 | +36% | SBE |
| 16 | South Dakota | $655 | — | healthcare.gov |
| 17 | Texas | $661 | — | healthcare.gov |
| 18 | Kansas | $670 | — | healthcare.gov |
| 19 | Florida | $683 | — | healthcare.gov |
| 20 | Nebraska | $710 | — | healthcare.gov |
| 21 | Arkansas | $774 | — | healthcare.gov |
KFF, “Marketplace Average Benchmark Premiums,” 2026. Benchmark is the second-lowest-cost Silver plan for a 40-year-old, weighted by plan selections. State-run exchange states are marked SBE and use state rate-filing data rather than the CMS Landscape file.