Health Plan: Deductible vs Premium
Total annual cost = premiums × 12 + expected medical × cost-share until OOPM.
Result
Total annual cost
$8,400
$4,800 premium + $3,600 OOP medical.
- Annual premium$4,800
- Deductible$3,000
- Coinsurance20%
- OOP max$8,000
- Expected medical$6,000
- Out-of-pocket spend$3,600
- Total annual cost$8,400
Step-by-step
- Annual premium = $4,800.
- Pay deductible ($3000), then 20% of overage. Capped at OOP max $8,000.
- Total = premium + OOP = $8,400.
How to use this calculator
- Enter premium + plan limits + expected medical use.
- Compare totals across plan options.
About this calculator
Health plans trade off premium vs. cost-share. Low-deductible plans charge higher premiums but lower per-visit. High-deductible (HDHP) charges low premium, you cover first $3,000+ of care, but caps your worst-case at OOP max. The break-even depends on actual usage — light users prefer HDHP; heavy users (chronic conditions, planned surgery) prefer low-deductible.
Frequently asked
No — OOP max is your medical cost cap. Premiums are separate. Total annual cost = premium + OOP medical (capped at OOP max).
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