The monthly premium is the number people compare, and it is often the wrong one. The figure that matters is your total yearly cost: premiums plus what you pay when you use care. A cheap plan can cost far more than an expensive one in a year when something goes wrong.
Compare two health plans by total cost
Enter what you expect to spend on care this year, then try a bad year too. Works in any currency.
The four numbers on every plan
- Premium: what you pay each month whether or not you see a doctor.
- Deductible: what you pay for covered care before the plan starts sharing costs.
- Coinsurance or copay: your share after the deductible, either a percentage or a flat fee.
- Out-of-pocket maximum: the most you pay for covered, in-network care in a plan year. After that, the plan pays 100% of covered costs.
When a high deductible makes sense
A high-deductible plan tends to suit people who are generally healthy and hold enough cash to cover the deductible without borrowing. In the US, eligible high-deductible plans can be paired with a Health Savings Account, which offers tax advantages for medical costs. If a surprise bill would land on a credit card, the premium saving can vanish in interest.
Checks that catch people out
- Networks. Out-of-network care may not count towards your limit, or may not be covered at all. Search for your doctors and nearest hospital before you enrol.
- Drug lists. Look up your medicines on the plan formulary. A different tier can change the cost a lot.
- Family limits. Family plans have individual and family deductibles that interact differently from plan to plan.
- Employer money. A contribution into an HSA or a similar account is effectively a discount. Subtract it when you compare.
Outside the US
Canada and the UK fund core care publicly, so private cover usually concerns extras such as dental, prescriptions or faster elective treatment. In India, compare the sum insured, room-rent caps, co-pay clauses and waiting periods for existing conditions before you look at the premium.