How HerePup estimates your health plan costs
Choosing a plan means guessing what your care will cost. HerePup gives you a better starting point: it builds a model from your own claims history, works out how each plan you can choose would cover that kind of care, and lets you adjust it for the year you expect.
You can use it whenever your coverage choice matters: at open enrollment, when you start a new job or compare offers, after a life event such as marriage or a new baby, or when you're planning and budgeting for the year ahead.
Watch the walkthrough (3½ minutes)
Shown with a made-up household and sample documents. Captions are available.
Step by step
Tell HerePup who's covered
Add each person in your household and whether they're an adult or a child. HerePup uses this to pick the right coverage level for every option: employee only, employee plus spouse, employee plus children, or family.
Add your plan options
Drag in each employer's benefit guide or plan summary. Typed and scanned PDFs both work. HerePup reads the premiums for each coverage level, deductibles, out-of-pocket maximums, coinsurance, office, specialist, urgent care and ER copays, prescription tiers and employer HSA contributions. You check and confirm every number. If you and a spouse or partner have different employers, add both.
Bring in your claims history
Drag in your explanations of benefits (EOBs), the claims spreadsheet from your insurer's member website, and your pharmacy claims. The last 12 months is the best starting point; with earlier years too, you can plan around your highest, lowest or average year. HerePup works out what kind of care each claim was, such as an office visit, a specialist, urgent care, the ER, a procedure or a prescription, and asks you to confirm anything it isn't sure about. Direct connections to insurers are in testing, and you can request yours.
Estimate what every option will cost
HerePup models each kind of care in your history under every plan and every way your household could enroll: which visits would be a flat copay and which would go to the deductible, when coinsurance and out-of-pocket maximums kick in, and the total: premiums plus your share of care, minus employer HSA money. When your files include what your insurer actually charged, HerePup checks its model against it.
Adjust for the year ahead
Expecting more care, or less? The What if slider models anywhere from no care to three times the care in your history and shows the point where a different plan becomes the better choice, so you can pick a plan that holds up for the year you expect.
See it month by month
A low-deductible plan spreads its cost evenly through premiums; a high-deductible plan costs less up front but can bring big bills in the months you need care. The month-by-month view shows when each plan's costs are likely to land, and how much to set aside for the expensive months.
Spend less on the same care
HerePup also looks across your claims for the same kind of care at different providers, such as two urgent care centers, the same test at two labs or the same drug at two pharmacies, and shows what the lower-cost one would save you, so you can choose it next time.
HDHP or PPO? Why your own claims matter
Plans trade premiums against what you pay when you get care. A high-deductible health plan (HDHP) usually has the lowest premiums and often comes with employer HSA money, but you pay the full price of most care until the deductible is met. A PPO or EPO with a low deductible costs more every paycheck, but many visits cost only a flat copay.
Which one costs less depends on how your household uses care: how many visits, what kind, how many prescriptions, and whether one person or everyone meets the deductible. Averages and plan comparison charts can't tell you that. A model built from your own claims can, and it shows whether a heavier or lighter year would change the answer.
For a quick side-by-side without uploading anything, try the HSA vs PPO calculator, or read how to choose a health plan.
What you'll need
- The benefit guide or plan summary from each employer offering you coverage
- Your recent claims from your insurer's member website, ideally the last 12 months (EOB PDFs or a claims spreadsheet)
- Pharmacy claims, if you fill prescriptions
- About 10 minutes. Nothing is uploaded, and there's no account to create
What HerePup doesn't do yet
HerePup compares costs, not provider networks, so check that your doctors are in each plan's network. Its estimates start from your history and the adjustment you choose, so they can't foresee new conditions or care you don't expect. It doesn't model specialty drug tiers yet, and its results are estimates, not a promise of what a plan will cost. See the FAQ for more.