Use your browser’s Print menu to print or save this resource as a PDF. Keep completed worksheets privately. Do not put policy numbers, Medicare numbers, medical records or Social Security numbers in our general quote form.
Look beyond a health plan’s monthly premium
Compare the amount you expect to pay over a full year: twelve monthly premiums plus estimated out-of-pocket spending for care. Your estimate should include deductible payments, copays and coinsurance together, without counting the same expense twice.
Illustration: $300 a month × 12 + $1,800 estimated annual cost sharing = $5,400. These are example amounts, not a plan quote.
This simple estimate does not predict your care needs or subsidy eligibility. Premiums and some expenses do not count toward a plan’s out-of-pocket limit. Check covered services, network, prescriptions and exclusions separately; actual costs can differ.
HealthCare.gov: comparing total yearly costs · Compare available plans through HealthSherpa
