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Health Insurance Calculator

Compare HMO, PPO, and HDHP health insurance plans side by side. Estimate monthly premiums, annual deductibles, out-of-pocket maximums, and HSA savings. Find the most cost-effective plan based on your age, family size, and expected medical usage.

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Compare Health Insurance Plans

Find affordable coverage that fits your budget and needs.

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How to Use Health Insurance Calculator

  1. 1Select your age range and family size.
  2. 2Enter your expected annual medical expenses.
  3. 3Compare estimated costs across HMO, PPO, and HDHP plans.
  4. 4Review HSA savings potential for HDHP plans.

Frequently Asked Questions

Enter your age, family size, income, and expected medical usage. The calculator estimates monthly premiums, deductibles, and out-of-pocket costs for HMO, PPO, and HDHP plans, helping you compare total annual costs.

HMO plans have lower premiums but require referrals and in-network care. PPO plans offer more flexibility with higher premiums. HDHP plans have the lowest premiums but highest deductibles, and qualify for tax-advantaged HSA accounts.

Yes, for HDHP plans the calculator shows HSA contribution limits and potential tax savings, which can significantly reduce the effective cost of high-deductible plans.

Estimates are based on national average premiums adjusted for age and family size. Actual premiums vary by location, insurer, and plan specifics. Use this as a starting point for comparing plan types.

Yes, the Health Insurance Calculator is 100% free to use with no limitations. There is no registration required, no daily usage caps, and no hidden fees. You can use it as many times as you need.

Yes, after running your calculation you can copy the results to your clipboard or take a screenshot. The Health Insurance Calculator displays a detailed breakdown so you can easily record or share your numbers. No account is required to use or save results.

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About Health Insurance Calculator

Compare HMO, PPO, and HDHP health insurance plans side by side. Estimate monthly premiums, annual deductibles, out-of-pocket maximums, and HSA savings. Find the most cost-effective plan based on your age, family size, and expected medical usage.

NexTool's Health Insurance Calculator is completely free to use with no sign-up required. Your data is processed directly in your browser and never sent to our servers, ensuring complete privacy and instant results.

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Compare Options

Comparison · 2 options reviewedHSA vs. FSA: Which Health Savings Account Should You Choose?Compare Health Savings Accounts and Flexible Spending Accounts on tax benefits, rollover rules, contribution limits, and investment options. Find the right health account for your situation.Best Of · 5 options reviewedBest Health Insurance Plans of 2026Choosing the right health insurance plan can save you thousands of dollars in 2026. This comparison breaks down the top marketplace and employer health insurance plans across HMO, PPO, EPO, and HDHP categories. We evaluated each option on monthly premium costs, deductible amounts, copay structures, prescription drug coverage, mental health benefits, and provider network size. Whether you are shopping during open enrollment, qualifying for a special enrollment period, or evaluating employer-sponsored options, this guide helps you match your healthcare needs and budget to the right plan tier—Bronze, Silver, Gold, or Platinum. We also cover how subsidies and tax credits can dramatically reduce your monthly costs and explain when a high-deductible plan with an HSA makes more financial sense than a traditional copay plan.

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1875

Premiums increase significantly with age, especially after 50.

$0$250,000

Lower incomes may qualify for ACA marketplace subsidies.

This affects your estimated out-of-pocket medical expenses.

Tobacco Use

Insurers can charge up to 50% more for tobacco users under ACA rules.

Best Value for Your Profile

HDHP — $5,315/year

Effective monthly cost: $443.00 (premiums + expected medical costs - HSA tax savings)

HMO

Health Maintenance Organization

Monthly Premium

$333.00

$3,996/year

Deductible$1,500
Out-of-Pocket Max$6,500
Primary Care Copay$25
Specialist Copay$50
Coinsurance20%

Est. Medical Costs$2,100
Total Annual Cost$6,096

PPO

Preferred Provider Organization

Monthly Premium

$444.00

$5,328/year

Deductible$2,000
Out-of-Pocket Max$8,000
Primary Care Copay$30
Specialist Copay$60
Coinsurance25%

Est. Medical Costs$2,615
Total Annual Cost$7,943
Recommended

HDHP

High Deductible Health Plan

Monthly Premium

$246.00

$2,952/year

Deductible$3,000
Out-of-Pocket Max$7,050
Primary Care CopayAfter deductible
Specialist CopayAfter deductible
Coinsurance30%

HSA Eligible

Max contribution: $4,150/year. Triple tax advantage: tax-deductible contributions, tax-free growth, tax-free qualified withdrawals.


Est. Medical Costs$3,150
Total Annual Cost$5,315

Side-by-Side Comparison

FeatureHMOPPOHDHP
Monthly Premium$333.00$444.00$246.00
Annual Premium$3,996$5,328$2,952
Deductible$1,500$2,000$3,000
Out-of-Pocket Max$6,500$8,000$7,050
Coinsurance20%25%30%
Est. Medical Costs$2,100$2,615$3,150
Total Annual Cost$6,096$7,943$5,315

Annual Cost Breakdown

HMO$6,096
Premiums
Medical
PPO$7,943
Premiums
Medical
HDHP$5,315
Premiums
Medical
PremiumsEst. Medical Out-of-Pocket

Plan Type Comparison Guide

HMO

Pros

  • - Lowest premiums among managed plans
  • - Low copays for in-network care
  • - Predictable costs per visit
  • - No claim forms for in-network

Cons

  • - Requires PCP referrals for specialists
  • - No out-of-network coverage (except ER)
  • - Limited provider choice

PPO

Pros

  • - No referrals needed for specialists
  • - Out-of-network coverage available
  • - Largest provider network
  • - Most flexibility in choosing doctors

Cons

  • - Highest monthly premiums
  • - Higher deductibles than HMO
  • - Out-of-network costs are much higher

HDHP

Pros

  • - Lowest monthly premiums
  • - HSA eligible (triple tax benefit)
  • - HSA funds roll over year to year
  • - Good for healthy individuals

Cons

  • - Highest deductible to meet first
  • - Higher coinsurance rate
  • - Pay full cost until deductible met
  • - Risky if unexpected medical needs arise

Disclaimer: These estimates are based on 2024 national averages and ACA guidelines. Actual premiums vary significantly by state, county, insurer, and specific plan. Subsidy estimates use simplified Federal Poverty Level calculations. Always compare actual plan options on healthcare.gov or your state marketplace. This tool is for educational purposes only and does not constitute insurance advice.