Confused by coinsurance? Not sure whether an HMO or PPO is right for you? You’re not alone.
Understanding health insurance is a headache — but it doesn’t have to be. At CostHowMuch, we built this interactive Insurance Toolkit to make it simple.
🏥 What’s Inside This Insurance Breakdown Tool
This page gives you a complete walkthrough of how insurance plans really function — visually, interactively, and in plain English. No forms to fill out. No insurance jargon required.
- ✅ PPO vs HMO vs HDHP vs EPO: Understand the differences between plans and who each one is best for.
- 💸 Deductible & Out-of-Pocket Cost Estimator: See what a procedure will actually cost you depending on your plan.
- 🧾 Copay vs Coinsurance Explained: Learn which one applies and how it impacts your wallet.
- 📊 Side-by-Side Plan Comparison Table: Instantly compare insurance options based on cost, coverage, and flexibility.
- ❓ Is It Covered? Category Explorer: Check what types of care are typically covered — and what’s usually not.
🧠 Use the Tool Below to Understand Your Plan
Explore each section of our toolkit to get a crystal-clear picture of how your health insurance works — before the bill shows up.
1. Plan Type Visualizer
2. Deductible & Out-of-Pocket Estimator
3. Copay vs Coinsurance Explainer
Copay
Flat fee (e.g., $25 per visit)
Coinsurance
Percentage of cost (e.g., 20% of $400 = $80)
4. Plan Comparison Table
Plan Type | Premium | Deductible | OOP Max | Doctor Choice | Referral Needed? |
|---|---|---|---|---|---|
PPO | High | High | High | Any Provider | No |
HMO | Low | Low | Low | In-Network Only | Yes |
HDHP | Very Low | Very High | High | Some Flexibility | No |
EPO | Medium | Medium | Medium | In-Network Only | No |
5. “Is It Covered?” Explorer
🔍 Common Insurance Questions (And Plain-English Answers)
What’s the difference between a deductible and a copay?
Your deductible is the amount you pay out-of-pocket before your insurance starts covering things. A copay is a flat fee you pay for a visit or service — usually $20-$50 — regardless of your deductible.
What’s coinsurance?
Coinsurance means you share a percentage of the bill with your insurance company. If your coinsurance is 20%, and the procedure costs $1,000, you pay $200 after the deductible is met.
What plan is best for someone who rarely sees a doctor?
An HDHP (High Deductible Health Plan) might work best — especially if you want to take advantage of an HSA (Health Savings Account). It keeps monthly premiums low, though you pay more if something serious happens.
Is therapy covered by insurance?
In most cases, yes — especially under ACA-compliant plans. But coverage may require pre-authorization, a network therapist, or session caps. Check the “Mental Health” section in the toolkit above for specifics.
How can I know what’s covered without calling anyone?
That’s what this toolkit is for. Use the dropdown under “Is It Covered?” above to get quick answers by category.
📌 Why This Matters
Most Americans don’t know how their plan actually works until they get hit with an unexpected medical bill. This toolkit helps you understand insurance before it burns through your savings.
🔗 Share This Page
Found this helpful? Share it with your coworkers during open enrollment, HR reps, or anyone navigating a confusing medical bill. The more we all understand the system, the harder it is for it to take advantage of us.