Finance Tools
Insurance vs Self-Pay Cost Calculator
Compare the estimated cost of using insurance vs paying self-pay (cash price) for a medical service, considering deductible, copay/coinsurance, and remaining out-of-pocket max.
How to use this insurance vs self-pay cost calculator
- Enter the self-pay (cash) price for the service.
- Enter the insurance allowed amount for the service.
- Enter remaining deductible, copay or coinsurance rate, and out-of-pocket max (optional).
- Calculate estimated insurance cost vs self-pay and compare.
Example
If self-pay price is $300, insurance allowed amount is $600, remaining deductible is $200, coinsurance is 20%, and remaining out-of-pocket max is $2,000:
- Insurance: pay deductible first ($200), then 20% of remaining ($400 × 0.20 = $80) → $280
- Self-pay: pay cash price ($300)
- Insurance is cheaper in this example ($280 vs $300)
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- Health Insurance Copay vs Coinsurance Calculator
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- Insurance Deductible Cost Calculator
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