Health Insurance Plan Cost Comparator
Which of two health plans has the lower modeled annual cost at your expected medical use? Compare your premiums and share of covered in-network charges, with employer HSA funding shown separately.
This calculator compares two individual health plans using premiums, one deductible, coinsurance and an out-of-pocket maximum. Plans with substantial copays, separate prescription deductibles or more complex coverage may need a different comparison.
What this comparison includes and excludes
This simplified model covers one individual for a full plan year, with one deductible followed by one patient coinsurance rate and one medical out-of-pocket maximum. Use it only for services that follow that structure. Copay-heavy plans, care covered before the deductible, separate prescription deductibles, embedded family deductibles, out-of-network and uncovered services need a different comparison.
Your modeled annual comparison
- Expected covered in-network allowed charges
Compares net modeled annual economic costs, including any employer HSA benefit. Lower modeled cost does not guarantee the best coverage for you.
Net modeled economic cost
Net modeled economic cost
A lower modeled cost is not a universal best plan. Rankings may change with medical use. Check provider networks and prescription coverage separately.
Annual cost breakdown
Annual premiums are what you pay for coverage. Patient medical costs are your modeled share of covered in-network care. Together they make up your annual cash cost before any employer HSA benefit.
Employer HSA funding is shown separately as account funding. It does not reduce your premium or the insurer’s billed medical charges. Net modeled annual economic cost subtracts that benefit from annual cash cost.
| Component |
|---|
No-use and covered in-network maximum exposure
Premiums are outside the medical cap. Maximum cash exposure includes premiums plus the medical out-of-pocket maximum; it excludes uncovered and out-of-network charges. Employer funding remains a separate benefit and does not reduce this cash-exposure figure.
| Component | Plan A | Plan B |
|---|
Low, expected and high scenarios
| Scenario | Allowed charges | Plan A | Plan B |
|---|
Methodology and assumptions
How the model works
Annual premium = your premium amount × 12 for monthly, × 1 for annual, or × your entered deduction count for payroll. Patient medical cost = the smaller of the out-of-pocket maximum and [the smaller of charges and deductible + charges above the deductible × patient coinsurance]. Gross annual cash cost = annual premiums + patient medical cost. Net modeled economic cost = gross cash cost − employer HSA funding.
Employer HSA funding is an account benefit, not a premium discount or a guarantee that cash will be available when bills arrive. Your own HSA deposits are not subtracted. Negative net economic cost means remaining modeled account benefit, not negative medical bills. Full precision is retained internally; currency is displayed in cents.
Limitations and sources
What this model leaves out
This is a simplified cost comparison, not an HSA eligibility determination or insurance recommendation. It excludes copays, services covered before the deductible, separate drug deductibles, family coverage, out-of-network care, uncovered services, employee HSA deposits and tax savings, HRA rules, subsidies, insurer lookup and uploads. Read each plan’s benefit documents and check its network and prescription coverage.
Sources: HealthCare.gov: coinsurance, deductibles, and out-of-pocket maximums.