Health Insurance Plan Comparison Calculator

Health insurance cost is more than just your monthly premium. The true annual cost of a health plan depends on your premium, deductible, copays, coinsurance, out-of-pocket maximum, and how much healthcare you actually use. Comparing plans requires looking at the full picture.

Formulas: Annual Premium Cost = Monthly Premium × 12 Total Annual Cost (healthy year) = Annual Premium + Routine Visits + Prescriptions Total Annual Cost (sick year) = Annual Premium + Min(Actual Medical Bills, Out-of-Pocket Max) Break-even Point = (Premium Difference between plans) ÷ (Cost-per-use Difference)

Key insurance terms:

• Premium: what you pay monthly regardless of use
• Deductible: amount you pay out-of-pocket before insurance starts paying (resets annually)
• Copay: fixed fee per visit after the deductible is met, typically 20 to 50 for a routine doctor visit
• Coinsurance: percentage you pay after deductible (e.g., you pay 20%, insurer pays 80%)
• Out-of-pocket maximum: the most you’ll pay in a year; insurance covers 100% after this

Plan comparison example. The figures below are illustrative US plans, and the arithmetic works the same in any currency because nothing here is converted, only added up.

Annual premium cost: Plan A: 180 × 12 = 2,160 | Plan B: 420 × 12 = 5,040 Premium savings with Plan A: 2,880 a year

Scenario: 8,000 in medical bills Plan A: 2,160 premium + 3,000 deductible + 20% of the remaining 5,000 = 2,160 + 3,000 + 1,000 = 6,160 Plan B: 5,040 premium + 500 deductible + 20% of the remaining 7,500 = 5,040 + 500 + 1,500 = 7,040 Plan A saves 880 even in a high-medical-use year.

Neither plan reaches its out-of-pocket maximum here: Plan A pays 4,000 against a 6,500 cap and Plan B pays 2,000 against a 4,000 cap. The caps only start doing work above roughly 20,500 of bills on Plan A, and it is worth pushing the number up in the calculator to find where your own plans cross over.

That crossover is the whole comparison, and it is worth being precise about which way it runs. The high-deductible plan wins the quiet years, because the premium saving is money you keep whatever happens. The low-deductible plan wins the catastrophic ones, because its out-of-pocket cap is lower. Somewhere between those two extremes the lines cross, and the calculator finds that point rather than making you hunt for it by trial and error.

HSA advantage: With Plan A (a High-Deductible Health Plan, or HDHP) you can contribute to a Health Savings Account (HSA). Contributions are pre-tax, growth is tax-free, and withdrawals for medical expenses are tax-free. Unused funds roll over indefinitely, which makes the account a quiet retirement vehicle as well as a medical one. The annual contribution limits are indexed and go up most years, with separate single and family figures plus a catch-up allowance from 55, so check the current numbers with your plan administrator rather than trusting a figure printed on any website.