Health insurance cost calculator
Enter plan cost-sharing numbers and expected billed spending to see an educational annual total. Actual plan terms vary.
Results will appear here after you calculate.
Assumptions
- Spending is treated as a single allowed amount applied to deductible then coinsurance, then copays, then capped by the out-of-pocket maximum.
- Networks, prior authorization, drug tiers and family vs individual deductibles are not modeled.
- Premiums are added to medical cost sharing and generally do not count toward the out-of-pocket maximum.
- Preventive care that some plans cover before the deductible is not subtracted automatically.
Premium
The amount you pay to keep the plan, usually monthly. Employer contributions or marketplace subsidies can change what you personally pay; enter the amount you actually pay.
Deductible
Covered costs you generally pay before coinsurance begins, with important exceptions on many plans.
Copay
This form uses estimated annual copays as a dollar total so the model stays simple. Real copays are often per visit or per prescription.
Coinsurance
Your percentage of allowed charges after deductible rules apply, until you reach the out-of-pocket maximum.
Out-of-pocket maximum
A typical cap on in-network cost sharing for covered services. The “maximum potential annual cost” shown is premium plus this cap based on the numbers you entered.
Frequently asked questions
Does this enroll me in coverage?
No. It only adds the numbers you provide.
Why can medical cost be lower than my spending?
After the deductible, coinsurance shares the remaining allowed amount, and the out-of-pocket maximum can cap what you pay for covered care.
This website provides general educational information and estimates. It is not an insurance company, insurance agent, broker, financial adviser, attorney, or other licensed professional. Calculator results are illustrative and should not be considered insurance quotes or professional advice.