Health Insurance Cost Calculator
Compare two plans by their true total annual cost, not just the premium
This calculator estimates your true total annual cost for two health insurance plans — premiums plus expected out-of-pocket spending — so you can see which plan actually costs less at your expected level of care.
Compare Two Plans
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Plan A
Plan B
Plan A Total Cost
$0
Plan B Total Cost
$0
Cheaper Plan
—
Savings
$0
Cost Breakdown
Plan A — Annual Premium
Plan A — Out-of-Pocket$0
Plan B — Annual Premium
Plan B — Out-of-Pocket$0
Break-even Usage Level—
📖 How to Actually Compare Health Insurance Plans
The monthly premium is the number insurers put front and center, but it's only one piece of what a health plan actually costs you over a year. A lower premium often comes with a higher deductible and coinsurance — meaning you pay more out of pocket if you actually need care. The only fair comparison is total annual cost: premium plus what you'd realistically spend on care.
The Total Cost Formula
Total Annual Cost = (Monthly Premium × 12) + Out-of-Pocket Spending
Out-of-pocket spending itself follows a predictable structure on most plans: you pay 100% of costs until you hit your deductible, then a coinsurance percentage of costs until you hit your out-of-pocket maximum, then $0 beyond that. The out-of-pocket max is your ceiling — no matter how expensive a medical event gets, that plan feature caps what you personally pay in a year.
Key Terms
| Term | What It Means |
|---|---|
| Premium | What you pay every month just to have the plan, regardless of whether you use care |
| Deductible | What you pay out of pocket before the plan starts sharing costs |
| Coinsurance | The percentage of costs you pay after the deductible, until you hit your out-of-pocket max |
| Out-of-pocket maximum | The most you'll pay in a year (premiums aside) — the plan covers 100% of costs beyond this |
Worked Example: Low Premium vs High Premium Plan
Two plans, both facing $4,000 in expected annual medical expenses:
| Plan A (Higher Premium) | Plan B (Lower Premium) | |
|---|---|---|
| Monthly premium | $350 ($4,200/yr) | $180 ($2,160/yr) |
| Deductible | $1,500 | $5,000 |
| Coinsurance | 20% | 30% |
| Out-of-pocket on $4,000 of care | $2,000 | $4,000 |
| Total annual cost | $6,200 | $6,160 |
Despite the much lower premium, Plan B ends up costing almost the same as Plan A at this usage level — because its higher deductible offsets the premium savings once you actually use care. This is exactly the kind of gap a premium-only comparison misses.
Low-Deductible vs High-Deductible: Which Fits You?
| Your Situation | Tends to Favor |
|---|---|
| Frequent doctor visits, ongoing prescriptions, chronic condition | Lower deductible, higher premium plan |
| Rarely use care, healthy, want to minimize fixed monthly cost | Higher deductible, lower premium plan (often HSA-eligible) |
| Uncertain — somewhere in between | Compare total cost at a few different usage scenarios, not just one |
💡 High-deductible plans are frequently paired with a Health Savings Account (HSA), which lets you set aside pre-tax money for medical expenses. If you're comparing an HSA-eligible plan, factor in the tax savings and any employer HSA contribution — they can meaningfully change the real cost comparison.
❓ Frequently Asked Questions
Should I choose the plan with the lowest premium?
Not necessarily. A lower premium often comes with a higher deductible and coinsurance, meaning you pay more out of pocket if you need care. The only way to know which plan is actually cheaper for you is to compare total annual cost — premium plus expected out-of-pocket spending — at your realistic level of healthcare use.
What is the difference between a deductible and an out-of-pocket maximum?
The deductible is what you pay before your plan starts sharing costs at all. The out-of-pocket maximum is the most you'll pay in a year total (not counting premiums) — once you hit it, the plan covers 100% of further costs. The deductible is always lower than or equal to the out-of-pocket max.
What is coinsurance?
Coinsurance is the percentage of costs you're responsible for after meeting your deductible, until you hit your out-of-pocket maximum. For example, with 20% coinsurance, you pay 20% of covered costs and your insurance pays the remaining 80%, until your out-of-pocket max is reached.
Is a high-deductible health plan a good idea?
It depends on how much healthcare you expect to use. If you're generally healthy with few medical expenses, a high-deductible plan's lower premium can mean real savings, especially if it's paired with a tax-advantaged HSA. If you have ongoing medical needs, a lower-deductible plan with a higher premium often costs less in total once you actually use care.
What is a break-even usage level between two plans?
It's the amount of annual medical spending at which two plans cost exactly the same in total. Below that usage level, the plan with the lower premium tends to be cheaper; above it, the plan with the lower deductible tends to be cheaper. Knowing this number helps you decide based on how much care you actually expect to need.