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Health Insurance Comparison Calculator
Free health insurance comparison calculator. Compare HDHP, PPO, and HMO plans by total annual cost including premiums, deductibles, copays, coinsurance, and HSA benefits.
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Best Plan at Your Usage Level
HDHP
$7,350.00/year total
Saves $1,050.00/year vs most expensive option
HDHP Total⧉
$7,350.00
Premiums: $4,200.00 + OOP: $3,400.00 − HSA: $250.00
PPO Total⧉
$8,400.00
Premiums: $6,600.00 + OOP: $1,800.00
Total Cost by Usage Level
| Scenario | HDHP | PPO | Winner |
|---|---|---|---|
| Low ($1,000) | $4,950.00 | $7,600.00 | HDHP |
| Medium ($5,000) | $7,350.00 | $8,400.00 | HDHP |
| High ($15,000) | $9,350.00 | $10,400.00 | HDHP |
| Max (OOP Max) | $10,950.00 | $11,600.00 | HDHP |
Simplified model. Does not account for copay structures, network differences, prescription formularies, or specific coinsurance tiers. Use as a starting comparison during open enrollment.
Planning notes, formulas, and examples
About the Health Insurance Comparison Calculator
Choosing a health insurance plan is one of the most confusing annual financial decisions. A lower premium doesn't always mean a cheaper plan — higher deductibles and out-of-pocket costs can easily offset premium savings. And HSA tax advantages can make an HDHP the cheapest option even when it looks more expensive on paper.
This calculator compares up to 3 health plans side by side, calculating the true total annual cost at different levels of healthcare usage: low (preventive only), medium (a few doctor visits and prescriptions), and high (surgery, hospitalization, or chronic condition).
Use it during open enrollment to make a data-driven choice instead of guessing. Health insurance plans differ widely in premiums, deductibles, copays, coinsurance rates, and out-of-pocket maximums. The cheapest monthly premium often costs more in total for anyone who uses moderate or significant healthcare. This calculator reveals your projected total annual cost under each plan option you are considering.
When This Page Helps
The wrong plan choice can cost you $2,000-$5,000+ per year. This calculator factors in premiums, deductibles, copays, coinsurance, out-of-pocket maximums, and HSA tax benefits to find the true cheapest option for YOUR level of healthcare usage. Comparing total cost across scenarios helps you pick the plan that matches your actual usage, not just the lowest sticker price.
How to Use the Inputs
- Enter details for each plan: monthly premium, deductible, copay, coinsurance %, and out-of-pocket maximum.
- If applicable, enter HSA or employer contributions.
- Set your expected healthcare spending level (low, medium, high).
- Compare total annual costs across all plans.
- Select the plan with the lowest total cost for your expected usage.
Formula used
Total Annual Cost = (Monthly Premium × 12) + Out-of-Pocket Costs − HSA Tax Savings
Out-of-Pocket = min(Deductible + Coinsurance on remaining costs, Annual Out-of-Pocket Max)
HSA Tax Savings = HSA Contribution × Marginal Tax RateExample Calculation
Result: HDHP total: $6,400 | PPO total: $8,000 | HDHP saves $1,600/year
In the page's simplified side-by-side model, the HDHP totals $4,200 in premiums plus $2,200 of out-of-pocket cost at $5,000 of medical spending, for $6,400 total. The PPO totals $6,600 in premiums plus $1,400 out of pocket, for $8,000 total. The HDHP is $1,600 cheaper in this scenario even before adding any employer HSA contribution or tax benefit.
Tips & Best Practices
- If you're generally healthy and rarely see doctors, an HDHP with HSA is almost always the cheapest option.
- If you have a chronic condition or planned surgery, run the numbers with high expected costs — a PPO may save money.
- HSA contributions are triple tax-advantaged: tax-deductible going in, tax-free growth, tax-free withdrawals for medical expenses.
- Don't forget employer HSA contributions. Some employers contribute $500-$2,000/year to your HSA.
- The out-of-pocket maximum is your worst case. If total costs exceed the max, every plan covers 100% beyond that point.
- Consider family vs. individual deductibles if covering dependents. Family deductibles are typically 2× individual.
The Total Cost Mindset
During open enrollment, most people compare premiums and stop there. But premiums are only part of the equation. A $200/month premium savings with an HDHP versus a PPO equals $2,400/year. But if the HDHP has a $3,000 higher deductible, you need to spend at least $3,000 in healthcare to break even. For low-usage years, the HDHP wins. For high-usage years, run the full calculation.
The HSA Advantage
At a 30% marginal tax rate, maxing out an individual HSA ($4,150) saves $1,245 in taxes. That's $1,245 of free money that effectively reduces your HDHP's total cost. Over 20 years of maxing HSA contributions with investment growth, you could accumulate $200K-$400K in tax-free medical funds.
Open Enrollment Strategy
Gather three pieces of data: (1) your past year's total medical spending, (2) any planned procedures for next year, and (3) each plan's full cost breakdown. Plug them into this calculator. The answer is usually clear within minutes.
Sources & Methodology
Last updated:
Methodology
This page compares up to three plans by adding annual premiums to modeled out-of-pocket cost at the selected medical-spending level, then subtracting the estimated tax value of any employer HSA contribution. For each plan it applies deductible first, then coinsurance on the remaining allowed spending, and caps the result at the entered out-of-pocket maximum.
This is a simplified total-cost worksheet, not a Summary of Benefits and Coverage replacement. It does not model copays, tiered drug formularies, separate family deductibles, network quality, utilization management, or uncovered services, so the result should be used as an apples-to-apples planning aid rather than as the final plan-selection document.
Sources
- Summary of Benefits and Coverage (HealthCare.gov) — HealthCare.gov explains the SBC framework used to compare plans on an apples-to-apples basis.
- Coinsurance (HealthCare.gov) — HealthCare.gov glossary reference for deductible, coinsurance, and out-of-pocket-max interactions.
- Revenue Procedure 2025-19 (Internal Revenue Service) — IRS publication giving the 2026 HSA contribution and HDHP inflation-adjusted limits used in the page’s HSA discussion.
Frequently Asked Questions
HDHP (High Deductible Health Plan): lowest premiums, highest deductible, HSA-eligible. PPO (Preferred Provider Organization): moderate premiums, moderate deductible, broader network, no referrals needed. HMO (Health Maintenance Organization): varies on cost, requires in-network care and referrals for specialists.
A Health Savings Account (HSA) is only available with HSA-eligible HDHPs. It offers triple tax benefits: contributions are tax-deductible, growth is tax-free, and withdrawals for medical expenses are tax-free. For 2026, the IRS contribution limits are $4,400 for self-only coverage and $8,750 for family coverage. It remains one of the most tax-efficient accounts available for eligible medical spending.
Low usage (healthy adult, preventive only): $500-$1,500/year. Medium (a few doctor visits, prescriptions, minor procedure): $3,000-$7,000. High (surgery, hospitalization, chronic condition): $10,000-$25,000+. Review your past year's Explanation of Benefits (EOB) statements for actual costs.
After you meet your deductible, coinsurance is the percentage of costs you pay. For example, 80/20 coinsurance means the plan pays 80% and you pay 20% until you hit the out-of-pocket maximum. Different from copays, which are flat dollar amounts per visit.
If you have high, predictable medical costs (chronic conditions, planned surgeries), can't afford to cover the deductible out of pocket, or won't contribute to the HSA (losing the tax benefit). For families with frequent doctor visits, a PPO sometimes wins on total cost.
If you can afford it, absolutely. Unlike FSAs, HSA funds never expire and can be invested for long-term growth. Many people use HSAs as stealth retirement accounts: pay medical expenses out of pocket now, let the HSA grow tax-free, and withdraw decades later. It's optimal to maximize HSA contributions every year.
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