How healthy is your coverage?
Updated for plan year 2026
Answer a handful of questions and get a 0–100 coverage health score — with the full breakdown of how every answer moved the number, and links to the tools that fix what is weighing it down. It is a transparent self-assessment and a starting point, not a verdict on your plan.
How the score works
The score is deliberately simple and transparent — there is no hidden weighting. Everyone starts at a baseline of 50. Having coverage adds 20 points; not having it subtracts 30. A plan that fits the care you expect adds 15; one that doesn’t subtracts 15. A sign you might be overpaying subtracts 15. Each known coverage gap subtracts 10, down to a floor of 30. Being able to absorb a worst-case out-of-pocket year adds 15, and actually using your free preventive care adds 5. The total is capped at 0–100, and the results page lists every contribution so you can see exactly where your number comes from. Because it’s built only from your answers, it can’t see your actual policy, network, or drug list — treat it as a conversation starter, not a review of your plan.
Frequently asked questions
How is the coverage health score calculated?
- It is a transparent additive model. Everyone starts at a baseline of 50. Each answer then adds or subtracts a fixed number of points: having coverage adds 20 (no coverage subtracts 30), a plan that fits your expected usage adds 15, a sign of overpaying subtracts 15, each known gap subtracts 10 up to a 30-point floor, being able to cover a worst-case out-of-pocket year adds 15, and using your free preventive care adds 5. The total is capped at 0–100. The result page shows every one of these contributions, so the number is never a black box.
Is a high score a guarantee my coverage is good?
- No. This is an educational self-assessment based only on the answers you give — not a review of your actual policy documents, network, or formulary. A high score means your answers point in a healthy direction; it is a starting point for a conversation with a licensed agent, not a verdict.
What should I do with a low score?
- Look at the factor breakdown to see what pulled the number down, then use the linked tools — the overpayment check, the coverage gap finder, the true-cost calculator, or the subsidy estimator — to address each weak spot. You can also have a licensed agent review your coverage directly.
The Insurance Guide is not an insurance company, agency, or licensed advisor, and this tool does not provide insurance, tax, or financial advice. The coverage health score is an educational self-assessment built only from the answers you enter — not a review of your policy and not a guarantee of coverage or price. Confirm anything that affects your coverage with the marketplace or a licensed agent.