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Compare the annual cost of two health plans

Test a simple annual scenario for two plans and see how premiums and the costs of receiving care interact.

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How to read this tool

Educational model for one person and a full plan year: one uniform coinsurance category plus separate annual copays. It does not replace actual plan terms or claim processing.

Fictional example

Fictional plans A and B each use $8,000 in allowed charges, plus separate annual copays of $240 and $120. Annual cost is $7,340 for A and $7,520 for B, including $300 outside the cap per plan. These are not market prices or available offers.

Calculations and filters run in this page. This tool does not send your entries or save them automatically. Your browser may restore fields. Changing page or language can lose your entries. Downloads stay on your device; keep them private. Do not enter names, account numbers or other identifiers.

Your inputs

Amounts in U.S. dollars (USD). Percentages use 0–100 unless a field states otherwise. Replace every example value with figures that match your situation.

Your inputs
Plan A

Use the actual premium after any confirmed subsidy; no tax credit is calculated.Allowed range: 0 – 1000000

The full deductible at the start of a plan year, for the same individual scope as the cap.Allowed range: 0 – 1000000

Percentage you pay on this category of allowed covered charges after the applicable deductible.Allowed range: 0 – 100

Copy the plan-specific annual individual cap. Premiums and excluded services are outside it.Allowed range: 0 – 1000000

Allowed charges for the modeled coinsurance category. Exclude all charges for services paid through the separate copays.Allowed range: 0 – 1000000

Your separate estimate of noncovered or out-of-network patient costs; exclude premiums already entered. This is held fixed in sensitivity.Allowed range: 0 – 1000000

Your annual copay total for services exempt from the modeled deductible and counting toward the same covered cap. Exclude those services from allowed charges. Held fixed in sensitivity.Allowed range: 0 – 1000000

Only for the allowed-charge category. Separate copays bypass this deductible. Does not combine multiple deductibles or drug rules.

Plan B

Use the actual premium after any confirmed subsidy; no tax credit is calculated.Allowed range: 0 – 1000000

The full deductible at the start of a plan year, for the same individual scope as the cap.Allowed range: 0 – 1000000

Percentage you pay on this category of allowed covered charges after the applicable deductible.Allowed range: 0 – 100

Copy the plan-specific annual individual cap. Premiums and excluded services are outside it.Allowed range: 0 – 1000000

Allowed charges for the modeled coinsurance category. Exclude all charges for services paid through the separate copays.Allowed range: 0 – 1000000

Your separate estimate of noncovered or out-of-network patient costs; exclude premiums already entered. This is held fixed in sensitivity.Allowed range: 0 – 1000000

Your annual copay total for services exempt from the modeled deductible and counting toward the same covered cap. Exclude those services from allowed charges. Held fixed in sensitivity.Allowed range: 0 – 1000000

Only for the allowed-charge category. Separate copays bypass this deductible. Does not combine multiple deductibles or drug rules.

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Enter your own figures, then calculate. The filled-in values are a fictional example.

Compare annual spending using the right inputs

Use each plan’s actual monthly premium, deductible, coinsurance and out-of-pocket limit for the same person and plan year. Enter allowed charges separately for each plan because negotiated prices can differ. A provider’s full bill is not automatically the allowed amount.

The starting values are fictional. Replace them with a consistent scenario based on plan documents or an estimate using the relevant network. This calculator does not retrieve plans, confirm provider participation or estimate premium tax credits.

What the model calculates

When the deductible applies, the allowed-charge category uses it first and coinsurance applies to the remainder. Otherwise, coinsurance starts at the first dollar. Separate annual copays are added and your combined covered share stops at the entered cap. Premiums and outside costs are then added beyond the cap.

The premiums-plus-cap metric excludes the separate outside-cost entry. It is a limited comparison of premiums and the covered cap, not a guarantee of your highest possible annual spending. Uncovered services, out-of-network bills and other exclusions can add costs.

Use sensitivity without implying a precise insurance quote

The table compares half, all and twice each plan’s allowed-charge category. Premiums, annual copays and outside costs stay fixed. Exclude all services paid with those copays from allowed charges to prevent double counting. If their use changes, revise the copay total in another scenario.

You supply the annual copay total: the model does not calculate a precise mix of visits, preventive care, pharmacy rules, family accumulators or prior spending. Aggregate coinsurance is rounded once rather than processing each claim. Read the Summary of Benefits and Coverage and official plan documents before choosing.

Official sources

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