2027 Open Enrollment Health Insurance Calculator, HDHP vs PPO True Cost (Excel + Google Sheets)

The cheapest premium is almost never the cheapest plan.

A plan that costs 90 a month less can cost you 3,000 more the year something goes wrong. Nobody works that out in their head during open enrollment, so most people pick on premium and hope. This spreadsheet works out the whole number instead - premiums plus what you actually pay at the doctor - for up to five plans at once.

And it gives you three answers, because you cannot know which year you are about to have:

- a LIGHT year: check-ups and a couple of prescriptions
- an EXPECTED year: what you honestly think will happen
- a BAD year: surgery, a hospital stay, a diagnosis

The right plan is often different in each one. Seeing all three side by side is the entire point.

* WHAT IT WORKS OUT

For every plan and every scenario:
- premiums for the year
- copays on your visits and prescriptions, if the plan charges them
- the deductible, then coinsurance on whatever is left
- all of it capped at that plan's out-of-pocket maximum
- minus any HSA money your employer puts in - that is real money
- minus the tax saving on your own HSA or FSA contribution

TRUE COST = premiums + out-of-pocket - employer HSA - tax saving

It also shows the number people forget to check: the most each plan could ever cost you if the year goes badly. That is the difference you would actually have to find in cash, and it is usually what decides a close call.

* WHAT IS ON EACH TAB

START HERE - how the file works, what to have in front of you, and exactly how the maths is done, so you can check it.
Setup - self-only or family, your marginal tax rate, and the 2027 HSA and HDHP limits from IRS Revenue Procedure 2026-24.
Your Plans - up to five plans side by side. Premium, deductible, coinsurance, out-of-pocket maximum, copays, employer HSA money, HSA eligibility. Plus a check that flags a plan whose deductible sits above its own out-of-pocket maximum.
Expected Care - eleven kinds of care with a count and a typical charge, in all three scenarios. Sensible starting numbers are already filled in; change them.
True Cost - the answer. One number per plan per scenario, with the cheapest highlighted and the gap to the next plan shown.
Break-Even - every plan's total cost at eighteen levels of medical spend, so you can see exactly where the ranking flips.
Dashboard - best plan in each kind of year, the cost of guessing wrong, and the worst case for every plan.
Decision and Deadlines - your enrolment window counted down in days, what you chose and why, and six things to confirm before you commit.

* HOW IT WORKS

Open it in Excel, or upload it to Google Drive and open with Google Sheets. Copy the numbers off each plan's Summary of Benefits and Coverage - every US plan has to give you one. Say how much care you expect. Read the answer.

No account to make, no subscription, no add-on to install, nothing linked to your insurer. Nothing you type leaves your computer.

* WHAT YOU GET

One .xlsx file with all eight tabs, instantly downloadable after purchase. Works in Microsoft Excel 2007 or newer, and in Google Sheets.

* PLEASE READ

This is a personal decision-making tool, not insurance advice, tax advice, legal advice or medical advice, and not a substitute for a licensed broker or benefits adviser. Every figure it produces is arithmetic on numbers you type in yourself. The model assumes you stay in network, and treats copays as counting toward the out-of-pocket maximum but not the deductible, which is how most - not all - copay plans work. Your plan's Summary of Benefits and Coverage always overrides anything shown here. Confirm before you enrol.

Because this is an instant digital download, it cannot be returned. If something does not work, message me and I will fix it.

P.S. - Also grab our FREE Mini Budget Tracker spreadsheet: https://neattrailco.com

- NeatTrailCo · Simple templates for a tidier, calmer life ✨