Health Insurance Affordability Calculator

See what a health plan would really cost you in a year — premiums plus care — before you commit to it.

📖 How it works & FAQ

Monthly premium ($)

Annual deductible ($)

Out-of-pocket max ($)

Expected visits per year

Avg billed cost per visit ($)

Coinsurance after deductible (%)

What this calculator actually compares

The sticker price of a health plan is the monthly premium, but that is only half the bill. Your true annual cost is 12 months of premium plus what you pay out of pocket for care. This tool models that second half for you: care costs count fully against you until you meet the deductible, then your coinsurance percentage applies, and everything is capped at the plan's out-of-pocket maximum. Run the same numbers for two or three plans and the cheapest premium is often not the cheapest plan.

Why three usage scenarios

Nobody knows exactly how much care they will need, so the calculator shows a range. Low usage is half your expected visits, medium is exactly what you entered, and high usage is triple it — a rough proxy for a year with an injury, a new diagnosis, or a procedure. The worst-case card shows the most a plan can cost you in-network: full premium plus the entire out-of-pocket max. A low-premium, high-deductible plan can look great in the low column and painful in the worst case; that spread is the real affordability picture.

How to use it

Enter the plan's monthly premium, annual deductible, and out-of-pocket maximum from its summary of benefits.
Estimate your typical visits per year and the average billed cost per visit (an office visit often bills $150-$400; specialists and urgent care run higher).
Set the coinsurance percentage the plan charges after the deductible — 20% is a common default.
Read the four cards, then swap in a competing plan's numbers and compare totals scenario by scenario.

These figures are simplified estimates only, not financial, insurance, tax, or legal advice — always confirm details in the plan documents.

FAQ

Does this include copays or prescriptions?: Not separately. Fold typical copays and prescription spending into your average cost per visit, or add them mentally as a flat extra to each total.
What if my employer or a subsidy pays part of the premium?: Enter only the share you personally pay each month. The comparison should reflect your wallet, not the full unsubsidized rate.
Why does high usage sometimes cost less than I expected?: Once the deductible is met you only pay the coinsurance slice, and the out-of-pocket max hard-caps the damage — that cap is doing its job.
Is my data sent anywhere?: No. Everything runs in your browser; nothing is uploaded, stored, or shared.