| Item | Plan A | Plan B | Plan C |
|---|---|---|---|
| Monthly premium | $320 | $410 | $265 |
| Deductible | $1,500 | $800 | $2,500 |
| OOP max | $6,000 | $4,500 | $7,000 |
| Coinsurance | 20% | 15% | 30% |
| Primary copay | $25 | $20 | $30 |
| Specialist copay | $45 | $40 | $55 |
| Rx copay | $12 | $10 | $15 |
| Assumptions | |||
| Primary visits | 2 | ||
| Specialist visits | 1 | ||
| Rx fills | 12 | ||
| Allowed services cost | $2,500 | ||
| Typical output | |||
| Estimated total annual (example) | Lower when premiums + OOP are balanced | Often steady for moderate usage | Can win for low usage |
Annual premium = monthly_premium × 12
Copays = (primary_visits × primary_copay) + (specialist_visits × specialist_copay) + (rx_fills × rx_copay)
Deductible applied = min(allowed_services_cost, deductible)
Coinsurance spend = max(0, allowed_services_cost − deductible_applied) × (coinsurance_pct ÷ 100)
Estimated out-of-pocket (OOP) is capped by the plan’s out-of-pocket maximum:
- If copays count toward the cap: OOP = min(oop_max, deductible_applied + coinsurance_spend + copays)
- If copays do not count: OOP = min(oop_max, deductible_applied + coinsurance_spend) + copays
- If OOP max is unknown (0): OOP = deductible_applied + coinsurance_spend + copays
Estimated total annual cost = annual_premium + estimated_OOP
- Find each plan’s monthly premium, deductible, OOP max, coinsurance, and copays.
- Estimate your annual usage: visits, prescriptions, and expected covered services cost.
- Enter values for up to three plans and press Compare Plans.
- Review the table. The highlighted plan has the lowest estimated total.
- Download the results as CSV for spreadsheets or PDF for sharing.