Health Insurance Calculator: Compare Two Plan Budgets

Compare supplied health plans using premiums, one deductible, coinsurance, copays and an in-network out-of-pocket maximum for a single covered person.

Annual allowed charges subject to deductible ($)Use in-network negotiated amounts, not provider sticker prices; assumes the same charges under both plans

Other annual costs outside either plan maximum ($)Uncovered or out-of-network spending, assumed the same for both plans

Plan A: monthly premium you pay ($)After employer contributions or already-confirmed subsidies

Plan A: annual deductible ($)

Plan A: your coinsurance after deductible (%)

Plan A: in-network out-of-pocket maximum ($)

Plan A: separate annual copays ($)Only services outside the charge field; assume these copays count toward the same maximum

Plan B: monthly premium you pay ($)After employer contributions or already-confirmed subsidies

Plan B: annual deductible ($)

Plan B: your coinsurance after deductible (%)

Plan B: in-network out-of-pocket maximum ($)

Plan B: separate annual copays ($)Only services outside the charge field; assume these copays count toward the same maximum

Compare two health plan budgets using premiums and cost-sharing amounts from their documents. This scenario covers one person, one deductible and one in-network out-of-pocket maximum per plan. It estimates annual spending rather than recommending a plan or determining premium subsidies.

How to use this tool

Enter negotiated allowed charges for services subject to the deductible, using a common scenario for both plans.
Enter each monthly premium after any confirmed assistance.
Add deductible, your coinsurance percentage, out-of-pocket maximum and separate copays.
Add expenses outside the maximum, then compare annual totals and higher-use scenarios.

Formula

Covered cost = min(maximum, min(charges, deductible) + coinsurance × max(0, charges − deductible) + separate copays)

Annual total = 12 × premium + covered cost + excluded expenses

Copays must refer to services omitted from the charge input and count toward the same maximum. Premiums and excluded expenses never use that maximum. The model starts with no deductible already met and keeps all costs in one plan year. Family rules, separate prescription deductibles and service-specific exceptions need a more detailed comparison.

Example

With $10,000 allowed charges, Plan A costs $300 monthly with a $2,000 deductible and 20% coinsurance. Its cost is $3,600 premiums + $2,000 + 20% × $8,000 = $7,200. Plan B costs $450 monthly, with a $500 deductible and 20% coinsurance: $5,400 + $500 + $1,900 = $7,800. Neither reaches its respective $6,000 or $3,000 maximum.

Frequently asked questions

Should I enter the provider’s billed price?

Use the plan’s allowed in-network price. Different negotiated prices can change the comparison; the shared input assumes equal prices for this scenario.

Is the maximum a limit on everything I spend?

No. Premiums, uncovered services and out-of-network costs generally sit outside the in-network maximum. The displayed high-use budget is not a universal spending ceiling.

Does the cheaper result mean better insurance?

No. Networks, drug formularies, exclusions and service access matter. Confirm those features and actual cost-sharing rules before comparing prices.

Sources

This tool gives an estimate for general information only. It is not financial, tax, legal or medical advice — check with a qualified professional before you rely on the result.

Last updated: 2026-10-30