Health Insurance Cost Calculator

How it is calculated

The tool estimates your out-of-pocket medical spending as the smaller of the care you expect to use and your deductible: out-of-pocket = min(expected claims, deductible). Then total cost = annual premium + out-of-pocket. All three inputs are yearly dollar amounts and cannot be negative. In other words, the model assumes you pay for care in full until you reach the deductible and that the plan pays everything above it. It does not add copays or coinsurance after the deductible, and it has no separate out-of-pocket maximum. Real plans differ, so treat the number as a floor for a plan with cost-sharing after the deductible. Run the tool once per plan with the same expected claims to compare them.

Common mistakes

• Comparing plans by premium alone. A cheaper premium with a larger deductible can cost more in a year with heavy care.
• Entering the monthly premium. The field is the annual premium, so multiply a monthly amount by 12.
• Using the total billed amount for expected claims when your plan has negotiated rates. Use what you expect to be charged under the plan.
• Forgetting the cost-sharing that many plans charge after the deductible. This tool does not add it, so a plan with coinsurance will cost more than shown.
• Using the same expected claims figure for plans that cover different providers or services. Estimate care you will actually use under each plan.