Insurance vs Self-Pay Comparison

The calculator computes the true annual cost for each scenario:

A negative break-even means self-pay is always cheaper regardless of visit frequency. When insurance wins, the break-even shows the minimum annual visits where insurance becomes the better deal.

• High medication volume: If you take multiple branded or specialty medications, insurance formulary pricing often beats cash prices significantly.
• Catastrophic coverage value: Insurance's greatest value is protection against hospitalisation, complications, and specialist referrals - which are difficult to predict and can run to tens of thousands.
• Employer contributions: If your employer covers part of the premium, the effective cost to you is lower - always factor employer contributions into your comparison.
• Direct Primary Care (DPC): A growing alternative - flat monthly membership fee for unlimited GP visits. Often EUR50-100/month with dramatically reduced prescription costs. Pairs well with a catastrophic-only insurance plan.
• Preventive coverage: Most insurance covers diabetes-related preventive care at no cost - annual eye exams, foot exams, and certain labs - value that self-pay doesn't capture.