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Health Insurance Plan Comparison Calculator
Which plan is really cheaper? Enter the premium, deductible, coinsurance, out-of-pocket maximum and any employer HSA contribution for two or three plans, and see the total yearly cost of each at low, medium and high medical use, plus the spending level where one plan overtakes the other.
Last updated:
Plan A
$/ mo
$
%
$
$/ yr
Plan B
$/ mo
$
%
$
$/ yr
Plan C (optional)
$/ mo
$
%
$
$/ yr
Usage scenarios (yearly medical costs before insurance)
$
A checkup and a couple of prescriptions.
$
Several visits, tests or a minor procedure.
$
Surgery, a hospital stay or a baby.
Enter your values to see the result.
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How to use the Health Insurance Plan Comparison Calculator
Enter Plan A and Plan B from your benefits guide: monthly premium you pay, deductible, coinsurance and out-of-pocket maximum.
Add any employer HSA or HRA money that comes with a plan.
Tick "Compare a third plan" if you have another option.
Adjust the low, medium and high usage amounts and choose the one you expect.
Press Compare plans and read the cheapest plan, worst cases and break-even points.
How the comparison works
For each plan and each usage level the calculator adds up what you would actually pay in a year:
Premiums = monthly premium × 12
Out of pocket = medical costs up to the deductible, then coinsurance % × the rest, capped at the out-of-pocket maximum
Total = premiums + out of pocket − employer HSA/HRA contribution
Example with the default numbers at $5,000 of care: the PPO costs $2,640 in premiums + $1,000 deductible + 20% × $4,000 = $800 coinsurance, a total of $4,440. The HDHP costs $1,080 + $3,300 + 20% × $1,700 = $340, minus $750 of employer HSA money, a total of $3,970. The HDHP is $470 cheaper here, but at $30,000 of care the PPO wins ($7,140 vs $7,330).
Quick guide to plan terms
Term
What it means
Where to find it
Premium
What you pay each month just to have the plan
Benefits enrollment page or paystub deduction
Deductible
What you pay for covered care before the plan starts sharing costs
Summary of Benefits and Coverage (SBC)
Coinsurance
Your percentage of costs after the deductible
SBC, usually "20%" or "30%" for in-network
Out-of-pocket max
The most you pay in a year for covered in-network care (premiums not included)
SBC, first page
Employer HSA/HRA
Money your employer deposits for you; it offsets your costs
Benefits guide
Tips for open enrollment
Check that your doctors and prescriptions are in network: out-of-network costs are not capped the same way.
Family plans may have an individual deductible inside the family deductible; use the family figures for a household-wide estimate.
If you pick an HSA-eligible plan, your own pre-tax HSA contributions save tax on top of the costs shown here.
Buying on the Marketplace? Estimate your premium tax credit first with the ACA subsidy calculator.
Frequently asked questions
How do you calculate the total cost of a health plan?
Total yearly cost = 12 × your monthly premium + what you pay out of pocket for care − any money your employer puts into an HSA or HRA. Out of pocket is everything up to the deductible, then your coinsurance share of the rest, capped at the out-of-pocket maximum.
Is a high-deductible plan cheaper than a PPO?
It depends on how much care you use. HDHPs usually have lower premiums and often come with employer HSA money, so they tend to win in low and medium use years. In a high-cost year the plan with the lower out-of-pocket maximum plus premiums usually wins. The break-even figure shows where the switch happens.
What medical costs should I enter for each scenario?
Use the full price of care before insurance (the allowed amount), not what you would pay. A light year might be a few hundred dollars, a moderate year a few thousand, and a year with surgery or a hospital stay tens of thousands. Last year's explanation of benefits statements are a good guide.
Does this include copays?
This calculator uses a deductible plus coinsurance model, which covers most costs on many plans. Fixed copays for office visits or prescriptions are not modeled separately; if a plan relies heavily on copays, add their yearly total to your scenario or treat it as a slightly lower coinsurance.
Should I count my own HSA contributions?
Your own HSA contributions are your money, not a cost, but they save tax. Only the employer contribution is entered here because it directly offsets costs. To see the tax savings of your own contributions, use the HSA calculator.
What is the worst case for a plan?
The worst case is a year in which you hit the out-of-pocket maximum: 12 months of premiums plus the full OOP max, minus any employer HSA money. It is the most you would pay for covered in-network care in one plan year.
Are all the tools on FreeToolCabin tested for quality and accuracy?
Yes! Every tool on our site undergoes automated Q/A testing in real browser environments to ensure high precision, correct output, and zero errors. If you happen to spot a bug or have a suggestion, please contact us at [email protected] and our team will review it right away.