Flagship tool · ACA / Marketplace first
Insurance Cost & Coverage Planner
Estimate what health coverage could really cost you — premiums, deductibles, and expected out-of-pocket — based on your household and situation.
No quote requests. No lead selling. Your inputs are used only to generate estimates.
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Situation
Situation & location
We use your ZIP to set state (and county when we know it). No data is stored.
How our estimates work
Premiums: We start from educational marketplace average baselines, adjust by state, apply a simplified ACA age curve, optional tobacco loading, and metal-tier relative factors (Bronze / Silver / Gold style paths).
Subsidies: If you enter income, we compare it to HHS federal poverty guidelines (2025) and apply an enhanced premium tax credit contribution table for context. Cost-sharing reductions are noted for Silver when FPL suggests eligibility.
Out-of-pocket: Utilization, prescriptions, and major-care flags change expected care costs — never the ACA premium eligibility story for pre-existing conditions.
Provenance: State-adjusted marketplace average premium baselines derived from publicly reported KFF / CMS marketplace average premium patterns (educational reconstruction — not live plan quotes). Last reviewed 2026-07. Phase 3B-2 will layer live CMS Marketplace API landscape stats when available.
Premium
What you pay each month to keep coverage active — before or after tax credits.
Deductible
What you typically pay for care before the plan shares more costs (varies by design).
Out-of-pocket
What you may pay for care in a year, up toward the plan’s maximum out-of-pocket limit.
Why the cheapest premium is often not the cheapest plan
Total annual cost = premiums you pay + care you pay. A rock-bottom monthly premium can hide a deductible that turns an ordinary year of care into a budget shock. Silver plans can win on total cost when subsidies or cost-sharing reductions apply. Gold paths can win when use is high. This planner exists to surface that tradeoff — not to push a carrier.
Related CMS-powered tools
FAQ
- Does this tool give me real plan prices?
- When the CMS Marketplace API is available, metal-path ranges are anchored to the local plan landscape for your ZIP and household (lowest Bronze / Silver / Gold style premiums and deductible bands). Those are still educational ranges — not quotes or an official award. If the API is unavailable, we fall back to state-adjusted educational baselines. Official prices and eligibility only come from HealthCare.gov or your state marketplace.
- Do pre-existing conditions increase my premium here?
- No. Under the ACA, marketplace plans cannot charge more for pre-existing conditions. We never use conditions to raise premium estimates. Health needs only inform expected out-of-pocket and plan-fit guidance.
- Why is the cheapest premium often not the cheapest plan?
- A low monthly premium (often Bronze) can pair with a high deductible. If you need care, total annual cost (premium + what you pay at the doctor) can exceed a higher-premium Silver or Gold path — especially with subsidies or CSR on Silver.
- What about auto, home, or life insurance?
- This planner focuses on ACA / marketplace health coverage, where public subsidy rules and metal-tier structure support transparent total-cost education. Other lines may return later as separate reference tools.
- Do you sell my information or take lead fees?
- No. Inputs stay in your browser for this estimate. We do not gate results behind phone or email forms, and we do not sell leads from this tool.
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Independent directory. Not affiliated with any insurance carrier, agency, or agent. All information is for research purposes only. Always verify licensing directly with your state's Department of Insurance, NAIC, or official sources before engaging any provider.