Finance Tools

Out-of-Pocket Medical Expense Calculator

Estimate your out-of-pocket medical expense by combining provider charges with your payment responsibility (copay/coinsurance) and any deductible you expect to pay.

Out-of-Pocket Medical Expense Calculator

Estimate your out-of-pocket cost using total provider charges, deductible you expect to pay, and your cost-sharing (copay or coinsurance). This is a planning estimate, not a policy statement.

Estimated out-of-pocket expense
$0.00
Breakdown
Total charges$0.00
Deductible you pay$0.00
Remaining after deductible$0.00
Coinsurance (20%)$0.00
Total out-of-pocket$0.00

Simplification note: Plans vary in how copays and coinsurance apply. Use this tool for quick estimates.

How it works

Out-of-pocket cost often includes what you pay toward deductible plus your cost-sharing: either a flat copay or a coinsurance percentage on the remaining amount.

FAQ

Copay vs coinsurance—what’s the difference?
Copay is a fixed amount. Coinsurance is a percentage of the allowed cost (often after deductible).
What if my deductible is already met?
Enter 0 for the deductible you expect to pay for this visit, then use copay or coinsurance only.

How to use this out-of-pocket medical expense calculator

  1. Enter the total provider charges (estimated bill amount).
  2. Enter any deductible amount you expect to pay for this visit.
  3. Choose whether you pay a copay or coinsurance.
  4. Enter the copay amount or coinsurance percentage.
  5. See your estimated out-of-pocket medical expense.

Example

If total charges are $1,000, you expect to pay $200 of deductible, and coinsurance is 20%:

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