Health Insurance Out-of-Pocket Cost Calculator
Estimate your annual health insurance out-of-pocket costs based on deductible, copays, coinsurance, and out-of-pocket maximum.
Calculation Inputs
Calculation Results
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Enter inputs on the left and click Calculate to view results.
Formula & Methodology
OOP = min(Deductible + Coinsurance × (Bills − Ded), OOP Max)
Total health spending = premium + out-of-pocket costs. High-deductible plans work if healthy; low-deductible if heavy utilizer.
Frequently Asked Questions
What is an out-of-pocket maximum?
The most you'll pay for covered services in a year. After reaching the OOP max, insurance pays 100%. In 2024, the max for marketplace plans is $9,450 individual.