Health Insurance Calculator
Annual premium + out-of-pocket projection by plan type (HMO, PPO, HDHP).
Estimated annual healthcare cost
$7,900
Worst-case ceiling is premium + OOP max. Your claim cost = deductible + 20% coinsurance until OOP max.
Choosing a health plan by its monthly premium alone is how people overpay. The cheapest premium often comes with the highest deductible, so a low-premium plan can cost you far more in a year you actually use care. This calculator estimates your total annual cost — premiums plus expected out-of-pocket — by plan type.
It compares HMO, PPO, and high-deductible (HDHP) structures so you can see which wins for your expected usage, whether you’re mostly healthy or managing ongoing care.
How this calculator works
The calculator adds your annual premium to your expected out-of-pocket spending for the year. It applies the plan’s deductible, then coinsurance, capped at the out-of-pocket maximum — so a heavy-usage year is limited to premium + the OOP max. Comparing plans this way reveals the breakeven: low-premium/high-deductible plans win in healthy years, richer plans win in high-care years.
What affects the number
- Monthly premium × 12 (the cost you pay even if you use nothing)
- Deductible — what you pay before the plan starts sharing costs
- Coinsurance/copays after the deductible
- Out-of-pocket maximum — your worst-case yearly ceiling
- Your expected usage — routine care vs. surgeries, prescriptions, or chronic conditions
- HSA eligibility (HDHPs) and any employer HSA contribution
Frequently asked questions
Should I pick the plan with the lowest premium?
Only if you expect to use little care. A low premium usually means a high deductible, so in a year with surgery, a baby, or ongoing treatment you can pay thousands more. Compare total cost (premium + out-of-pocket), not premium alone.
What’s the difference between HMO, PPO, and HDHP?
HMOs are cheaper but require referrals and in-network care. PPOs cost more but offer flexibility and out-of-network options. HDHPs have low premiums and high deductibles, and pair with a tax-advantaged HSA — best for healthy savers.
Is a high-deductible health plan worth it?
For healthy people who rarely use care, yes — the low premium plus HSA tax savings usually win. If you have a chronic condition or expect major care, a richer plan with a lower deductible often costs less overall.
What is an out-of-pocket maximum?
It’s the most you’ll pay in a year for covered in-network care (excluding premiums). Once you hit it, the plan pays 100%. It’s the number that caps your worst-case year, so weigh it heavily.
This calculator provides general estimates for educational purposes only and is not insurance advice or a quote. Your actual rates and coverage needs depend on your specific situation and insurer.