Calculators
Health Insurance Cost Calculator
Calculate what you would pay for a year of medical costs under a plan's deductible, coinsurance and out-of-pocket maximum, plus premiums.
- Runs in your browser
- Nothing uploaded
The tool
Enter your numbers below. Results update as you type, and nothing leaves your browser.
Everything you enter stays on your own machine. Nothing is sent to us or to anyone else, which you can confirm in your browser network tab.
What people use it for
- Budgeting healthcare costs
- Understanding a plan before enrolment
- Planning for surgery or a birth
- HSA planning
About this tool
What the Health Insurance Cost Calculator does
With most health plans you pay costs up to the deductible, then a coinsurance percentage of further costs, until you reach the out-of-pocket maximum. Adding premiums gives your total annual cost for a given level of medical spending.
It also works as a health insurance deductible calculator.
Formula
- Out-of-pocket = costs up to the deductible + coinsurance × costs above it, capped at the out-of-pocket maximum
- Total = out-of-pocket + premiums − employer HSA contribution
Worked example
Using the starting values in the calculator above:
| Input | Value |
|---|---|
| Expected medical costs for the year | $6,000 |
| Deductible | $3,000 |
| Coinsurance after the deductible | 20% |
| Out-of-pocket maximum | $7,000 |
| Monthly premium (your share) | $400 |
| Employer HSA contribution | $0.00 |
| Result | Value |
|---|---|
| Your total annual cost | $8,400 |
| Out-of-pocket for care | $3,600 |
| Annual premiums | $4,800 |
| Paid by the plan | $2,400 |
How to read the result
Copays for office visits and prescriptions may apply before the deductible on some plans; check the summary of benefits.
In a high-cost year, the out-of-pocket maximum plus premiums is your worst case.
Estimates for planning only. Actual premiums and benefits depend on the insurer, policy terms and underwriting.
Related calculators
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- Auto Insurance Coverage Calculator: Get suggested auto liability limits based on what you could lose in a lawsuit, and check whether collision and comprehensive cover still pays.
- Long-term Care Cost Calculator: Project future long-term care costs with inflation and compare them with a policy’s daily benefit, benefit period and elimination period.
- Group Health Insurance Cost Calculator: Calculate employer and employee costs for a group health plan by coverage tier, with cost per employee.
Browse every calculator in Insurance Calculators, or talk to us about websites and lead generation for insurance agencies.
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Questions
Questions about this tool
The things clients actually want to know — costs, timelines, ownership and what happens after launch.
The amount you pay for covered care before the plan starts sharing costs.
Your percentage share of costs after the deductible.
The most you pay for covered care in a year, after which the plan pays 100%.
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