To compare health insurance plans, line up each plan’s Summary of Benefits and Coverage (SBC) and estimate your total yearly cost: twelve months of premium after any tax credit, plus the deductible, copays and coinsurance you expect to use, capped by the out-of-pocket maximum. Then check the network, the drug list and the plan’s quality rating.
Updated October 2026 for the 2027 plan year
Key facts (2027 plan year)
- Every insurer and job-based plan must give you a Summary of Benefits and Coverage in the same standard format, so plans from different companies can be compared line by line (HealthCare.gov).
- HealthCare.gov advises you to compare estimated total yearly costs, not just the premium, because deductibles, copays and coinsurance can add more than the premium itself (HealthCare.gov).
- On average, a Bronze plan pays 60% of covered costs, Silver 70%, Gold 80% and Platinum 90%; Silver with extra savings pays 73% to 96% (HealthCare.gov).
- For 2027, no ACA plan’s in-network out-of-pocket maximum can exceed $12,000 for one person or $24,000 for a family (CMS 2027 payment parameters).
- Marketplace plans carry 1 to 5 star quality ratings for member experience, medical care and plan administration (HealthCare.gov).
- Open Enrollment for 2027 coverage on HealthCare.gov runs November 1, 2026 to January 15, 2027; enroll by December 15, 2026 for coverage starting January 1 (HealthCare.gov).
- How do you compare health insurance plans side by side?
- What is a Summary of Benefits and Coverage?
- How do you estimate a plan’s total yearly cost?
- How do you compare networks and plan types?
- How do you compare prescription drug coverage?
- Do quality star ratings matter?
- Health insurance comparison worksheet
- Which plan wins for low, medium and high use?
- What mistakes do people make when comparing plans?
- Frequently asked questions
How do you compare health insurance plans side by side?
You compare health insurance plans side by side by holding every plan to the same seven checks: monthly premium after tax credit, deductible, copays and coinsurance, out-of-pocket maximum, network, drug list and quality rating. Use the same household, ZIP code and income for every plan.
Follow these steps in order:
- Estimate your 2027 household income. Your savings depend on it. Our 2027 subsidy guide shows the income bands.
- List your care for the year. Doctors, prescriptions with doses, and planned care.
- Pull three to five plans in your county, across two or more metal levels.
- Open the SBC for each plan and copy the same lines into one worksheet.
- Estimate the total yearly cost for low, medium and high use.
- Check networks and drug lists for each finalist.
- Use quality ratings as a tiebreaker, then enroll before your deadline.
Still choosing a metal level or plan type? Start with how to choose a health plan. For the whole process, from dates to enrollment, see how to shop for health insurance.
What is a Summary of Benefits and Coverage, and why does it matter?
A Summary of Benefits and Coverage (SBC) is a short, plain-language document every health plan must provide in one standard format. That shared layout makes it the fairest tool for a health insurance comparison across insurers.
HealthCare.gov shows the SBC on each plan’s page, and you can ask any insurer for a copy at any time (HealthCare.gov).
The SBC lines to copy into your comparison
- Overall deductible, and whether it is per person or per family.
- Services covered before the deductible, such as primary care or generic drugs.
- Out-of-pocket limit, the most you pay for in-network covered care in a year.
- Copays and coinsurance for visits, urgent care, the ER and hospital stays.
- Prescription drug costs by tier.
- Network rules: referrals and out-of-network coverage.
- Coverage examples, which show what the plan would pay in common situations such as childbirth and diabetes care.
The coverage examples use the same sample medical events for every plan, so you can see how much of a bill each plan leaves to you. Terms are explained in our health insurance terms glossary.
How do you estimate a plan’s total yearly cost?
A plan’s total yearly cost is twelve months of premium after your tax credit, plus what you expect to pay out of pocket for care. Your worst case is twelve months of premium plus the out-of-pocket maximum. Compare both numbers for every plan.
HealthCare.gov recommends estimating costs at low, medium and high levels of use (HealthCare.gov).
Best case: you barely use care
Twelve months of premium, plus copays for any covered-before-deductible visits. In-network preventive care is covered at no cost on ACA plans.
Expected case: your normal year
Premiums, plus your usual visits and prescriptions at each plan’s copay or coinsurance. Care subject to the deductible counts at full plan price until it is met.
Worst case: a big medical event
Premiums plus the full out-of-pocket maximum. For 2027 that cap can’t exceed $12,000 for one person or $24,000 for a family on any ACA plan, and many plans set it lower. Our guide to deductibles vs. out-of-pocket maximums explains how the two limits interact.
| Cost element | When you pay it | How to compare |
|---|---|---|
| Premium (after tax credit) | Every month, even with no care | Multiply by 12 for every plan |
| Deductible | Before the plan shares most costs | Check which services skip the deductible |
| Copays | Flat fee per visit or drug | Price the visits you actually expect |
| Coinsurance | Percentage of the bill after the deductible | Lower percentage matters most for big bills |
| Out-of-pocket maximum | Caps your in-network costs for the year | Add to 12 months of premium for your worst case |
Your tax credit works on any metal level, so always compare prices after the credit. If your income is at or below 250% of the federal poverty level, read cost-sharing reductions before you compare: a Silver plan with extra savings can beat both Bronze and Gold on total cost.
Honesty.AI checks your subsidy, then lines up every plan in your ZIP code on total cost. Chat, voice or text, 24/7.
How do you compare networks and plan types?
Compare networks by checking whether your doctors, hospitals and pharmacy are in each plan’s network, then by plan type. HMO and EPO plans generally cover only in-network care except emergencies; PPO plans pay part of out-of-network care.
HealthCare.gov describes the four main types this way (HealthCare.gov plan types):
| Plan type | Out-of-network coverage | Referral for specialists | Best fit |
|---|---|---|---|
| HMO | Usually none, except emergencies | Usually required | People happy with one local network |
| EPO | None, except emergencies | Often not required | People who want specialist access inside one network |
| PPO | Yes, at higher cost | Not required | People who see out-of-network doctors |
| POS | Yes, at higher cost | Required | People who want a primary doctor plus some flexibility |
Network size matters more than the label. Search each plan’s provider directory, then call the office and ask, “Are you in network with this exact plan for 2027?” Our full guide to in-network vs. out-of-network care covers surprise bills and what to do if a doctor leaves, and HMO vs. PPO vs. EPO vs. POS goes deeper on plan types.
How do you compare prescription drug coverage?
Compare drug coverage by looking up each medicine, at your dose, on every plan’s formulary, which HealthCare.gov defines as the list of prescription drugs a plan covers (HealthCare.gov glossary). Note the tier, whether the drug skips the deductible, and any prior authorization or step-therapy rule.
Drug lists vary by plan, even inside one insurer. For someone on an expensive brand-name drug, this line can decide the whole comparison.
- Tier: lower tiers usually cost less.
- Before or after the deductible: the SBC shows whether drug copays apply right away.
- Prior authorization or step therapy: approval first, or another drug first.
If you take a drug every month, HealthCare.gov’s plan comparison tool lets you search for your drugs, doctors and facilities in each plan (HealthCare.gov).
Do health plan quality star ratings matter?
Quality star ratings matter as a tiebreaker. Marketplace plans are rated from 1 to 5 stars on member experience, medical care and plan administration, using the same method for every plan.
The Centers for Medicare & Medicaid Services (CMS) runs the Marketplace Quality Rating System, (CMS). HealthCare.gov notes two limits: the ratings use the previous year’s data, and new or small plans may have no rating, which doesn’t mean they are low quality (HealthCare.gov).
Use the stars after cost, network and drugs. For other ways to judge an insurer, such as complaint records, see how to judge the best health insurance companies.
Health insurance comparison worksheet
A health insurance comparison worksheet puts the same SBC lines from every plan in one table. Fill in each row before you decide.
| Line to fill in | Where to find it | Plan A | Plan B | Plan C |
|---|---|---|---|---|
| Metal level and plan type | Plan name and SBC page 1 | |||
| Monthly premium after tax credit, times 12 | Your quote or HealthCare.gov | |||
| Deductible (person / family) | SBC, first question | |||
| Care covered before the deductible | SBC, second question | |||
| Out-of-pocket maximum (person / family) | SBC, out-of-pocket limit | |||
| Primary care and specialist cost | SBC, common medical events | |||
| Each prescription’s tier and cost | Plan formulary | |||
| Your doctors and hospital in network? | Provider directory + call the office | |||
| Referral needed? Out-of-network covered? | SBC network questions | |||
| Quality stars | HealthCare.gov plan details | |||
| Best-case and worst-case yearly total | Your math from the rows above |
Using a health savings account? Note which plans are HSA-eligible; see what is an HSA.
Which plan wins for low, medium and high use?
The plan that wins depends on how much care you use. Low users usually come out ahead with a lower premium, high users with a lower deductible and out-of-pocket maximum, and people at lower incomes with a Silver plan that carries cost-sharing reductions. Three examples, without prices because yours depend on ZIP code, age and income:
Scenario 1: low use, a healthy single adult
A 29-year-old renter expects one checkup and no regular prescriptions. The premium is most of the yearly cost, so a Bronze plan, or a Catastrophic plan if eligible, often wins. Still compare out-of-pocket maximums: one emergency can reach the cap. If income is at or below 250% of the federal poverty level, check a Silver plan with extra savings too. Young adults have more options, covered in health insurance for young adults.
Scenario 2: medium use, a family with kids
Two parents and two children expect several sick visits and one monthly prescription. The details under the deductible decide it. A Silver or Gold plan that covers primary care and generic drugs before the deductible can cost less over the year than a Bronze plan whose deductible must be met first. Check the per-person and family deductibles and the pediatrician’s network. Our family health insurance guide covers household rules and the family out-of-pocket maximum.
Scenario 3: high use, a planned surgery or chronic condition
An adult with a knee surgery scheduled, or someone managing diabetes with specialist visits and brand-name drugs, will likely hit the out-of-pocket maximum, so the worst case is the expected case. A Gold or Platinum plan with a higher premium can produce the lowest total. The surgeon, hospital and specialists must all be in network.
What mistakes do people make when comparing plans?
The most common mistakes are comparing premiums only, auto-renewing without shopping, skipping the network check, and mixing prices before and after the tax credit.
- Auto-renewing. A KFF analysis of 276 insurers found a median proposed premium increase of 15% for 2027. Your 2026 plan may no longer be the best value. See why premiums went up for 2027.
- Comparing ACA plans with non-ACA plans as if they were the same. Short-term plans can exclude pre-existing conditions and can’t use tax credits. Read our short-term health insurance guide first.
- Guessing income. From tax year 2026, excess advance credits must be repaid in full (IRS).
- Missing the deadline. Enroll by December 15, 2026 for January 1 coverage. Full dates are in our Open Enrollment 2027 guide.
How Honesty helps you compare health insurance plans
Honesty®, a licensed AI insurance agent from Honesty® Insurance Services, LLC (NPN 21094885), helps you compare health insurance plans on total yearly cost for your household. It checks Medicaid, CHIP, tax credit and cost-sharing reduction eligibility first, then compares ACA, alternative and ancillary plans side by side.
- Your doctors and drugs, checked against each plan’s network and drug list.
- Unbiased among carriers. It compares plans by your family’s needs and never steers you to an insurer.
- Enrolls in minutes. When you find the right plan, Honesty can enroll you through the Marketplace so your savings apply.
- Privacy first. We never sell or share your data, and there are no spam calls.
- 24/7 by chat, voice or text, licensed in 49 states and DC.
Honesty is not affiliated with HealthCare.gov or CMS. See how Honesty.AI works, our health insurance quotes guide and what a health insurance broker does.
Compare every plan in your ZIP code, honestly
Honesty.AI checks your 2027 savings, compares ACA, alternative and ancillary plans by your family’s needs, and enrolls you in minutes, 24/7. We never sell or share your data.
Frequently asked questions
What is the best way to compare health insurance plans?
Compare each plan’s Summary of Benefits and Coverage line by line, then estimate total yearly cost: twelve months of premium after tax credit plus expected out-of-pocket costs, capped by the out-of-pocket maximum. Check networks, drug lists and quality stars last.
Is the plan with the lowest premium the cheapest?
Not always. A low premium often comes with a high deductible. If you use a lot of care, a plan with a higher premium and a lower deductible or out-of-pocket maximum can cost less over the year.
Where can I compare health insurance plans for 2027?
On HealthCare.gov or your state exchange, through a licensed agent or broker such as Honesty, or directly with insurers. Only plans bought through the Marketplace can use the premium tax credit and cost-sharing reductions.
What should I look for on a Summary of Benefits and Coverage?
The deductible, which services are covered before the deductible, the out-of-pocket limit, copays and coinsurance, prescription drug tiers, referral and out-of-network rules, and the coverage examples for childbirth and diabetes care.
Should I compare Bronze and Silver plans if my income is low?
Yes. If your income is at or below 250% of the federal poverty level, Silver plans come with cost-sharing reductions that lower deductibles and copays. A Silver plan can then cost less per year than a Bronze plan.
Do health insurance comparison sites sell my information?
Many lead-generation sites share your details with several agents, which leads to calls and texts. Read the consent text before entering a phone number. Honesty never sells or shares your data.
Keep learning: Bronze vs. Silver vs. Gold vs. Platinum, the cheapest health insurance routes, what health insurance costs in 2027, the health insurance marketplace and Special Enrollment Periods.
