Compare the total expected annual cost of two health insurance plans, combining premiums with expected out-of-pocket costs.
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A rough estimate of your medical needs for the year.
Estimated Total Annual Cost
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Plan A Total Annual Cost—
Plan B Total Annual Cost—
Formula
Total Annual Cost = (Monthly Premium × 12) + the lesser of your expected medical costs or the plan out-of-pocket maximum.
Example
Plan A costs $4,200 a year in premiums plus up to $4,000 in expected care, for about $8,200 total. Plan B costs $6,600 in premiums plus a capped $3,000 in care, for about $9,600 total, making Plan A the lower-cost choice here.
Not tax or financial advice. This calculator provides general estimates based on published 2026 figures. Always confirm important figures with the IRS, SSA, your state tax agency, a licensed lender, or a qualified professional.
Frequently Asked Questions
Does a lower premium always mean lower total cost?
Not necessarily. A lower premium plan often has a higher deductible and out-of-pocket maximum, which can cost more overall if you expect to need significant care during the year.
Does this account for coinsurance and copays in detail?
This simplified comparison assumes your total out-of-pocket spending is capped at the plan out-of-pocket maximum, which is how ACA-compliant plans are structured.