Enter plan details and your expected care usage. See costs split by premiums and out-of-pocket. Download a clear report and compare plans confidently now.
Meta description (25 words): Compare plans with premiums, deductibles, copays, and coinsurance. Estimate annual costs using visits, prescriptions, and expenses. Choose the best option that fits your budget today.
| Item | Plan A | Plan B | Plan C |
|---|---|---|---|
| Monthly premium | $220 | $170 | $120 |
| Deductible | $1,000 | $2,500 | $4,000 |
| Coinsurance | 20% | 30% | 40% |
| Out-of-pocket max | $4,500 | $6,000 | $8,000 |
| Primary / Specialist copay | $30 / $60 | $25 / $50 | $20 / $40 |
| Generic Rx copay | $10 | $15 | $20 |
| Usage (year) | Primary 4, Specialist 2, Urgent 1, ER 0, Generic Rx 12 | ||
| Allowed expenses (year) | $2,500 | ||
A plan’s true price is not just the premium. This calculator estimates annual premiums, then adds expected out‑of‑pocket spending and subtracts any credits. For example, $180 per month equals $2,160 per year, before deductibles or copays. If a plan offers $500 in annual credits, your total falls by $500. That framing keeps comparisons consistent.
Allowed expenses represent services that usually trigger deductible and coinsurance. If your deductible is $2,000 and allowed expenses are $2,500, then $2,000 is paid first and the remaining $500 is shared by coinsurance. At 30% coinsurance, that portion is $150. Raising allowed expenses to $10,000 would add $2,400 in coinsurance after the deductible, showing the slope clearly.
Visits and prescriptions often behave like fixed prices, especially before you meet a deductible. Four primary visits at $30 each add $120. Two specialist visits at $60 add $120 more. Twelve generic prescriptions at $10 add another $120. One urgent visit at $75 and one ER copay of $300 can change rankings fast. Copay designs vary, so enter your plan’s schedule.
High-cost years can erase premium savings quickly. If allowed expenses rise to $20,000, deductible plus coinsurance plus copays may exceed the out‑of‑pocket cap. The calculator applies the cap, which can turn a “cheap premium” plan into the costliest option if its maximum is much higher. A $6,000 cap versus an $8,000 cap is a $2,000 risk difference, before premiums.
Use identical utilization inputs across Plan A, Plan B, and Plan C. Then review each component: premiums, deductible paid, coinsurance paid, and total capped out‑of‑pocket. In many mid‑spend scenarios, a moderate premium with a lower cap wins. In low‑spend years, a lower premium often leads. Try two runs—low expenses and high expenses—to see where each plan breaks even for your household.
It depends on plan design. Many office-visit copays apply before the deductible, while labs and imaging may be subject to it. Confirm your benefits, then enter matching copays and allowed expenses.
Use expected negotiated charges for services beyond simple copays: diagnostics, procedures, therapy, outpatient, or hospital care. If unsure, run three scenarios—low, medium, and high—to understand sensitivity.
Prescriptions are modeled as tiered copays using yearly counts for generic, preferred brand, and non-preferred brand. If your plan uses drug coinsurance, approximate that spend inside allowed expenses and reduce copay counts.
Higher premiums sometimes buy a lower deductible, lower coinsurance, and a lower out-of-pocket maximum. When expected spending rises, those protections can save more than the premium difference, reducing total annual cost.
Yes. Enter fixed annual amounts that reduce your net cost, such as employer HSA/HRA funding, wellness incentives, or subsidies. Avoid counting the same benefit twice if it already reduces your premium.
No. Results are estimates and do not capture network restrictions, prior authorizations, embedded deductibles, or separate drug deductibles. Use the output to shortlist plans, then verify details with plan documents.
Important Note: All the Calculators listed in this site are for educational purpose only and we do not guarentee the accuracy of results. Please do consult with other sources as well.