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Health insurance plan comparison

Which health plan costs less for the care spending you enter?

Your numbers

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Plan A costs less

$590

Plan A total$7,660
Plan B total$8,250
Plan A: your medical share$3,460
Plan B: your medical share$1,350
Plan A worst case for the year$11,700
Plan B worst case for the year$11,900

Tip. Model a quiet year and a rough year. If one plan wins both, the choice is easy. If not, you are choosing how much risk to carry.

Assumptions

  • You pay the deductible first, then the coinsurance share of everything above it, until the out-of-pocket maximum stops the bleeding.
  • Premiums sit outside the out-of-pocket maximum, which is how real plans work.
  • Total cost = annual premium + your share of the medical spending.
  • Assumes all care is in network and all of it counts toward the deductible. Copays, drug tiers, and separate specialty deductibles are not modelled.
  • One spending level. Run a healthy year and an expensive year: the cheaper plan often flips between them.
  • Estimate only. Real policies add exclusions, sub-limits, waiting periods, and network rules that this page does not model.

Sources

  • HHS 2026 out-of-pocket limits

Explore the numbers

Examples and charts

Start with a scenario, then read the response curve to see which input actually moves the answer.

Example 1

Quiet care year

Little more than routine visits, where the cheaper premium usually wins.

How much Plan A saves against Plan B

$2,700

Example 2

Average spending

Moderate use, which is where the two plans land closest together.

How much Plan A saves against Plan B

$590

Example 3

Serious medical year

A surgery or a chronic condition, where the out-of-pocket maximums decide the answer.

How much Plan A saves against Plan B

-$560

Sweeps expected medical spend from half to one and a half times your value, holding everything else fixed.

Response curve

How expected medical spend moves the result

How much Plan A saves against Plan B

$590

$400$600$800$1.0k$1.2k$1.4k$1.6k$3.0k$4.0k$5.0k$6.0k
Chart axis: Expected medical spendNow $4.5k → $590

What this calculates

Compares two health plans on premium plus your share of the medical spending, capped by each plan's out-of-pocket maximum. The right way to use it is twice: once for a quiet year and once for an expensive one, because the winner often flips.

How to use it

  1. Start with plan a annual premium and work down the form, or load an example to begin from a realistic case.
  2. Read the headline result alongside the supporting rows, which show the intermediate figures behind it.
  3. Check the assumptions. They decide what the number includes and, more importantly, what it leaves out.
  4. Sweep expected medical spend on the response curve to see how much it actually moves the answer.
  5. Run a cautious case as well as an optimistic one before using the estimate in a decision.

Common mistakes

  • Comparing premiums alone without the deductible and out-of-pocket maximum.
  • Forgetting that premiums come out of every paycheck whether you use care or not.
  • Choosing the low-deductible plan for peace of mind when the premium gap alone exceeds the deductible difference.

Formula

Your share pays the deductible then coinsurance until the out-of-pocket maximum; total = premium + your share

Inputs

  • Plan A annual premium
  • Plan A deductible
  • Plan A coinsurance (%)
  • Plan A out-of-pocket max
  • Plan B annual premium
  • Plan B deductible
  • Plan B coinsurance (%)
  • Plan B out-of-pocket max
  • Expected medical spend

FAQ

Does this include networks and drug tiers?

No. It assumes everything you enter is in network and counts toward the deductible as modelled. Out-of-network care often has a separate, much higher deductible and maximum, and some plans do not cover it at all.

What about copays?

This model uses deductible and coinsurance only. If your plan charges flat copays for visits or prescriptions, add your expected annual copays into the spending figure as an approximation.

How does an HSA change the comparison?

A high-deductible plan paired with an HSA lets you pay medical costs with pre-tax money, and any employer HSA contribution is effectively a premium reduction. Subtract the employer contribution from that plan's premium to approximate it.

What is the worst case each plan can cost me?

The premium plus the out-of-pocket maximum, which the result panel shows for both. That is the number that matters most if there is any chance of a serious year.

How much does health insurance cost per month?

Marketplace premiums for an individual often run about $300 to $900 a month before subsidies, depending on metal tier, age, and location. Employer coverage is usually cheaper because the employer pays part of the premium.

What is the difference between a deductible and an out-of-pocket maximum?

The deductible is what you pay before the plan shares costs. The out-of-pocket maximum is the cap on what you pay in a year for covered in-network care, and premiums do not count toward either.

Do out-of-network costs count toward my out-of-pocket maximum?

Usually not. Most plans have separate deductibles and maximums for out-of-network care, and some do not cover it at all. Check network status before care, not after.

Are these numbers financial advice?

No. They are educational estimates based on the inputs and assumptions on this page. Confirm important decisions with a qualified professional and your own documents.

Read the full guideHow to compare health insurance plans

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