United States · Health insurance
Health plan comparison calculator.
Enter two plans and how much care you expect to use. See each plan’s total yearly cost in a light year, a typical year and a bad year, and the spending level where the cheaper plan flips.
Total yearly cost = 12 × monthly premium + what you pay for care. For care you pay everything up to the deductible, then your coinsurance share, never more than the out-of-pocket maximum. A cheaper premium usually means a higher bill in a bad year.
Your two plans
Your estimate
How the comparison works
HealthCare.gov defines the deductible as the amount you pay for covered services before your plan starts to pay, coinsurance as your percentage of the cost of a covered service after the deductible, and the out-of-pocket maximum as the most you pay in a year for covered in-network care, not counting premiums. This page applies those three terms to the care you expect.
Formula: your care cost = all of the spending if it is under the deductible; otherwise deductible + coinsurance × (spending − deductible); capped at the out-of-pocket maximum. Employer HSA or HRA money offsets only what you actually spend on care. Total = 12 × premium + care cost − that offset.
Worked example
Plan A has a $300 premium, $5,000 deductible, 20% coinsurance and $9,000 maximum. Plan B has a $550 premium, $1,000 deductible, 10% and $5,000. With $4,000 of care, A costs $3,600 + $4,000 = $7,600 and B costs $6,600 + $1,300 = $7,900. In a $60,000 year, A costs $12,600 and B $11,600. A is cheaper below about $4,350 of care; B above it. The form is preloaded with this example.
What this page does not do
- Copays, separate drug deductibles, preventive care that is covered before the deductible, out-of-network care and family deductible rules are not modelled. Allowed amounts are the amounts your plan has negotiated, not the billed charge.
- It does not include the tax savings from paying premiums or HSA contributions before tax, or limits on HSA contributions.
- The out-of-pocket maximum for ACA Marketplace plans in 2026 is no more than $10,600 for an individual and $21,200 for a family, according to HealthCare.gov; a plan can set a lower one. Enter the figure from your plan document.
Sources: HealthCare.gov, Deductible and Out-of-pocket maximum/limit, read October 4, 2026.
Frequently asked questions
Is a low-premium plan always cheaper?
Only in years you use little care. With a high deductible the total can exceed a higher-premium plan in a heavy-use year.
Do premiums count toward the deductible or out-of-pocket maximum?
No. HealthCare.gov says premiums are not part of the out-of-pocket limit, so this page adds them separately.
What if my plan uses copays?
Copays are not modelled here. Estimate an equivalent amount of coinsurance, or compare using the plan's own cost-estimate tool.
How do I estimate my spending?
Use last year's explanation-of-benefits statements for allowed amounts, and add any planned care. Try a light, typical and bad year to see the range.
Estimate only
This page is educational and is not insurance, medical or tax advice. Plans have rules this page does not model; check the plan's summary of benefits and coverage before choosing. Calculations run in your browser; nothing is sent anywhere.