Health Insurance Plan Comparator

Health insurance plans differ primarily in how they balance monthly premiums against out-of-pocket costs when you need care. High Deductible Health Plans (HDHPs) have lower monthly premiums but require you to pay a high deductible (minimum $1,650 for individuals in 2025) before insurance begins covering most services. HDHPs qualify you for a Health Savings Account (HSA), which provides triple tax advantages — contributions are tax-deductible, growth is tax-free, and qualified withdrawals for medical expenses are tax-free. For healthy, infrequent care users, HDHPs with HSAs are often the most cost-effective option.

Traditional plans like PPOs (Preferred Provider Organizations) and HMOs (Health Maintenance Organizations) have higher premiums but lower deductibles, copays, and out-of-pocket maximums. PPOs offer the flexibility to see any provider — in or out of network — without a referral. HMOs require using in-network providers and getting referrals from a primary care physician, but typically have lower premiums than PPOs at comparable coverage levels. For people who use healthcare frequently or have ongoing conditions, these plans often minimize total annual costs despite higher premiums.

The out-of-pocket maximum (OOPM) is your most important protection against catastrophic costs — once you hit your OOPM, insurance covers 100% of covered in-network costs for the rest of the year. In 2025, the ACA OOPM cap for individual plans is $9,450. Even the most expensive-seeming plan has a ceiling on how much you can owe. This calculator models three scenarios — a healthy year, an average year based on your inputs, and a worst-case year at the OOPM — to show the full range of financial outcomes under each plan.

1. Enter the key details for each plan: monthly premium, annual deductible, coinsurance rate, out-of-pocket maximum, copays for doctor and specialist visits, and ER copays.
2. Check the HSA Eligible box for any plan that qualifies (generally HDHPs with high enough deductibles).
3. Click "+ Add Plan" to compare up to three plans simultaneously.
4. Enter your expected annual healthcare usage: doctor visits, specialist visits, ER visits, monthly prescription costs, lab tests, and planned procedures.
5. Review the comparison table showing total annual cost for a healthy year, your average year based on your inputs, and a worst-case year at the out-of-pocket maximum.
6. The lowest-cost plan for each scenario is highlighted to help you identify the best choice for your risk tolerance.

• Factor in HSA tax savings for HDHP plans: If you are healthy and choose an HDHP, maximize your HSA contributions ($4,300 for individuals, $8,550 for families in 2025). The tax savings on contributions (effectively 22–37% for most earners) can more than offset the higher deductible, making HDHPs even more attractive than the raw premium comparison suggests.
• Model your actual expected usage honestly: The plan that looks cheapest at the "healthy year" scenario may not be best for you if you take regular medications, have a chronic condition, or anticipate planned procedures. Enter your real expected usage for the most accurate comparison.
• Consider the worst-case scenario if you have health risk: For people managing serious conditions or with family health history concerns, the plan with the lowest out-of-pocket maximum may provide the most financial security even if its average-year cost is not the lowest.
• Check your preferred providers are in-network: Network differences between plans can be as impactful as premium differences. If you have a preferred specialist or hospital, confirm they are in-network for any plan you are considering before enrolling.
• Use an FSA if an HSA is not available: If your plan is not HSA-eligible, a Flexible Spending Account (FSA) offered through your employer provides pre-tax contributions for predictable medical expenses — though FSAs have a "use it or lose it" rule unlike HSAs.
• Re-evaluate at every open enrollment: Your healthcare needs, the plans available, and the premium costs change annually. The plan that was optimal last year may not be optimal this year — re-run this comparison at each open enrollment period.