Health Insurance
Estimate & compare health insurance costs including premiums, deductibles & out-of-pocket expenses. Find the most cost-effective plan for your needs.
Plan A
Plan B
About Health Insurance
Free Online Tool
Health Insurance Comparison
Enter the monthly premium and total coverage amount for two health insurance plans — get a cost-per-dollar-of-coverage comparison, protection efficiency score, and a clear recommendation on which plan delivers better financial protection.
How to Use This Tool (30 Seconds)
- 1Enter Monthly Premium for Both Plans: Input the monthly premium you pay for Plan A and Plan B. Use the employee-paid portion only — exclude any employer contribution. This is the amount deducted from your paycheck or charged to your bank account each month.
- 2Enter Total Coverage Amount: Input the maximum total benefit payout for each plan — the coverage ceiling stated in the plan documents. For health insurance, this is typically the annual out-of-pocket maximum subtracted from the policy's lifetime or annual benefit limit. Higher coverage limits indicate greater financial protection against catastrophic events.
- 3View the Coverage Efficiency Score: The tool calculates cost per $1,000 of coverage, annual premium cost, and a protection ratio — how many dollars of coverage you receive per dollar of premium — for both plans side by side.
- 4Read the Recommendation: The summary identifies which plan provides more coverage per premium dollar, flags any plan with a poor protection ratio, and explains under which health usage scenario each plan becomes the better financial choice.
The Coverage Efficiency Formulas
The tool derives four metrics from your two inputs per plan. The most important is the protection ratio — how much coverage you receive per dollar of premium paid:
// Annual premium cost
annualPremium = monthlyPremium × 12
// Cost per $1,000 of coverage
costPer1000 = (annualPremium ÷ totalCoverage) × 1,000
// Protection ratio — coverage per premium dollar
protectionRatio = totalCoverage ÷ annualPremium
Excellent: > 50× | Good: 20–50× | Poor: < 20×
// Coverage advantage between plans
coverageGap = coverageA − coverageB
premiumGap = premiumA − premiumB (monthly)
// Example: Plan A vs Plan B
A: $250/mo premium, $500,000 coverage
annualPremium = $3,000 | costPer1000 = $6.00 | ratio = 167×
B: $180/mo premium, $150,000 coverage
annualPremium = $2,160 | costPer1000 = $14.40 | ratio = 69×
Plan A: $840 more per year but 2.4× the protection ratio
The protection ratio reframes the premium question from which plan is cheaper to which plan provides more coverage per dollar spent. A plan costing $840 more annually but covering $350,000 more in potential medical expenses is not expensive — it is efficient. The cost per $1,000 of coverage normalizes both plans to the same coverage baseline, making the true cost of protection directly comparable regardless of premium or coverage size.
Health Plan Type Reference — Coverage vs Premium Structure
| Plan Type | Avg Monthly Premium | Typical Coverage | Best For |
|---|---|---|---|
| Bronze (ACA) | $250–$400 | $5M lifetime limit | Young, healthy, low usage |
| Silver (ACA) | $350–$550 | $5M lifetime limit | Moderate usage, cost-sharing subsidies |
| Gold (ACA) | $500–$750 | $5M lifetime limit | Frequent medical users, chronic conditions |
| Platinum (ACA) | $700–$1,000+ | $5M lifetime limit | High usage, predictable costs preferred |
| HDHP + HSA | $150–$350 | $5M lifetime limit | Healthy adults, tax-advantaged savings |
| Short-Term Plan | $50–$200 | $100k–$2M limit | Transitional coverage, gap periods only |
Premium estimates based on 2024 Healthcare.gov marketplace data for a 40-year-old single adult before subsidies. Actual premiums vary significantly by age, location, tobacco use, and plan provider. The ACA eliminated lifetime benefit limits for essential health benefits in 2014.
⚡ Pro Tip
The premium and coverage comparison answers the wrong question for most people. The financially correct question is: what is my maximum annual out-of-pocket exposure under each plan? Add your annual premium to each plan's out-of-pocket maximum — the most you can pay in a bad medical year — and compare those totals. A lower-premium plan with a $7,000 out-of-pocket maximum costs $10,400 worst-case at $280/month premium. A higher-premium plan at $420/month with a $3,000 out-of-pocket maximum costs $8,040 worst-case. The more expensive premium plan is $2,360 cheaper in a major medical event — a calculation invisible in a premium-only comparison.
Disclaimer: This tool is for informational purposes only and does not constitute insurance or medical advice. Coverage comparisons are based on user-entered figures and do not account for deductibles, copayments, coinsurance, network restrictions, or specific benefit exclusions. Consult a licensed insurance broker or benefits advisor before selecting a health insurance plan.
Frequently Asked Questions
Q: What should I enter as the total coverage amount?
Enter the plan's annual benefit limit or out-of-pocket maximum as the coverage figure — whichever is more relevant to your risk assessment. For ACA-compliant plans, use the annual out-of-pocket maximum as a practical coverage ceiling. For supplemental or short-term plans, use the stated lifetime or annual benefit limit from the plan documents.
Q: Should I enter the full premium or just my employee contribution?
Enter only your employee-paid portion — the amount deducted from your paycheck or billed to you. The employer contribution is compensation you receive regardless of which plan you choose, so it should not factor into your personal cost comparison. If comparing a marketplace plan against an employer plan, use your total out-of-pocket premium cost for each.
Q: What is a good protection ratio for health insurance?
A protection ratio above 50× — receiving $50 or more in coverage per dollar of premium — is considered efficient for comprehensive health plans. Most ACA Gold and Platinum plans with $5M coverage limits and $500–$750 monthly premiums achieve ratios of 550–800×. Short-term plans with low coverage ceilings ($100k–$200k) often score below 20× despite lower premiums, indicating poor coverage efficiency.
Q: How does a high-deductible health plan (HDHP) compare on this metric?
HDHPs typically have low premiums and high coverage limits, producing excellent protection ratios. However, the ratio does not capture the deductible — the amount you pay before coverage activates. An HDHP with a $1,500 premium and $5M coverage scores a ratio of 3,333× but requires you to cover the first $1,600 (2024 IRS minimum) of medical expenses before any reimbursement. Pair with the HSA tax advantage for the full picture.
Q: Is a lower monthly premium always better if I am healthy?
Only if you account for the worst-case scenario. Healthy individuals tend to underweight catastrophic risk when comparing premiums. A single emergency hospitalization averages $30,000–$50,000 in the US — a plan saving $200/month in premiums but exposing you to $7,000 more in out-of-pocket maximum saves $2,400 annually but costs $4,600 more in a single bad year. The premium saving is real; the coverage gap risk is larger.
Q: Can I compare a health plan against dental or vision insurance with this tool?
Yes — the cost-per-$1,000-coverage formula and protection ratio apply to any insurance product with a monthly premium and a coverage limit. Dental plans, vision plans, disability insurance, and life insurance all produce valid comparisons using these two inputs. The benchmark thresholds differ by insurance type but the relative comparison between two plans remains valid.
Q: What is the most important factor this tool does not capture?
Network coverage — whether your doctors, hospitals, and specialists are in-plan. A plan with a superior protection ratio that excludes your primary care physician or preferred hospital may cost significantly more in practice due to out-of-network charges. Always verify network inclusion for your key providers before making a final plan selection based on premium and coverage figures alone.