Health Insurance Plan Comparison Calculator (deductible · premium · out-of-pocket max)
Compare health insurance plans by evaluating premiums, deductibles, and out-of-pocket maximums. Educational guidance, worked examples, methodology, sources, and contact details included.
- Page updated:
- Jul 14, 2026
- Tool version:
- v1.0.1
Overview
Compare two health insurance plans by adding up the yearly premiums and the out-of-pocket costs (deductible plus coinsurance, capped at the out-of-pocket maximum) at the level of care you expect.
Results are orientative; your actual costs depend on the care you actually use during the year.
Core inputs
Results
Plan A - total annual cost
$5,800.00
Plan B - total annual cost
$6,350.00
Plan A - out-of-pocket (excl. premiums)
$2,200.00
Plan B - out-of-pocket (excl. premiums)
$950.00
Difference (A - B)
-$550.00
Recommendation
Plan A is cheaper overall at this expected usage.
How to read the result
- What it means
- The displayed value is an estimate based on your inputs. It represents the calculated scenario under current assumptions, not a guaranteed amount.
- Calculation limits
- The model uses simplified formulas and cannot account for all variables in your specific case (local regulations, personal conditions, temporal changes).
- Next step
- Use the result as a starting point. Adjust parameters to compare scenarios and validate with a professional when needed.
Glossary+−
- Premium
The regular payment (monthly or yearly) you make to maintain health insurance coverage.
- Deductible
The amount you pay for covered services before your plan begins to share costs.
- Coinsurance
The percentage of allowed charges you pay after meeting the deductible (e.g., 20%).
- Copay (Copayment)
A fixed dollar amount you pay for a covered health care service, typically at the time of service.
- Out-of-pocket maximum (OOP max)
The most you will pay during a policy period for covered services. After you reach this amount, the insurer pays 100% of covered services.
- Allowed charge / Allowed amount
The maximum amount a plan will consider for a covered service. Your cost-sharing is based on this amount.
Key takeaways
This tool compares two health plans on total annual cost at a chosen level of expected care. Run a few usage scenarios before deciding.
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Worked examples
$5,000 of expected care
Plan A: $300/mo, $1,500 deductible, 20% coinsurance, $6,000 OOP max. Plan B: $450/mo, $500 deductible, 10% coinsurance, $4,000 OOP max.
Interpretation
Plan A totals about $5,800 (premiums $3,600 + OOP $2,200); Plan B about $6,350. At this usage Plan A is roughly $550 cheaper.
Frequently asked questions
Which plan is better?
It depends on how much care you expect. Try a low-usage and a high-usage scenario: low-premium plans usually win when you use little care, richer plans win when costs are high.
What is coinsurance?
The share of costs you pay after meeting the deductible, e.g. 20%. It applies until you reach the out-of-pocket maximum.
Are premiums included in the out-of-pocket max?
No. The out-of-pocket maximum caps deductible and coinsurance only; premiums are always paid on top.
Sources & references
- Centers for Medicare & Medicaid Services (CMS): https://www.cms.gov
- HealthCare.gov – Health insurance terms and definitions: https://www.healthcare.gov/glossary
- Kaiser Family Foundation (KFF) – Explainers on cost-sharing: https://www.kff.org
Quality & oversight
- Author
- Ugo Candido, MBA
- Maintained by
- Ugo Candido, MBA
- Page updated
- Jul 14, 2026
- Tool version
- v1.0.1