Health Insurance Cost Estimator

Compare health plans by total yearly cost — premiums plus out-of-pocket spending — not by premium alone.

How to use this estimator

1. Enter your monthly premium, annual deductible, and annual out-of-pocket maximum from the plan summary.
2. Enter how many doctor visits you expect in a typical year.
3. Press Calculate Yearly Cost to see two totals: a low-use year and a high-use year.
4. Repeat for each plan you are comparing, using the same visit estimate for all of them.
5. Pick the plan with the lowest total cost for the use level you realistically expect — not just the lowest premium.

What affects health insurance costs

The monthly premium is only the entry price. A low-premium plan often has a high deductible, so you pay more before the plan starts sharing costs. Your deductible, copays, and coinsurance (your percentage share of a bill) decide how fast costs add up, and the out-of-pocket maximum caps your yearly spending on covered care. Age, location, tobacco use, and plan type (such as HMO versus PPO) also affect premiums, as does whether your regular doctors and hospitals are in the plan's network — out-of-network care can cost far more or not be covered at all.

How to compare health policies

Add premiums and expected out-of-pocket spending together; never judge a plan by premium alone. Check that your doctors, hospitals, and regular medicines are covered, and compare the deductible, copay for primary care and specialists, and the out-of-pocket maximum side by side. If you expect a surgery, a pregnancy, or ongoing treatment in the coming year, the plan with the higher premium but lower out-of-pocket maximum often wins. Read the summary of benefits for each plan before enrolling.

Key terms

Premium is what you pay each month to keep the plan, whether or not you use care. Deductible is what you pay yourself for covered care each year before the plan starts paying its share. Copay is a fixed fee per visit or prescription, such as $35 for a doctor visit. Coinsurance is your percentage share of a bill, such as 20%. Out-of-pocket maximum is the most you pay in a year for covered services — after you reach it, the plan pays 100% of covered costs for the rest of the year (premiums usually do not count toward it).

Frequently Asked Questions

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