This medical bill estimator calculates your out-of-pocket cost for a medical service based on your deductible, coinsurance rate, and out-of-pocket maximum. Results are estimates — actual costs depend on your plan's contracted rates.
Estimate Out-of-Pocket Cost
How to Use the Medical Bill Estimator
This medical bill estimator helps you understand what you might owe after insurance. Find your deductible, coinsurance percentage, and out-of-pocket maximum on your insurance card or Summary of Benefits and Coverage document.
Example Calculation
Bill: $5,000. Deductible: $2,000 ($0 met). Coinsurance: 20%. OOP max: $7,000. You pay $2,000 deductible first, then 20% of remaining $3,000 = $600 coinsurance. Total out-of-pocket: $2,600. Insurance pays $2,400. If you'd already met $1,500 of your deductible, you'd only pay $500 more deductible + $800 coinsurance = $1,300.
FAQ
Is this medical bill estimator free?
Yes, completely free with no signup required. This is an estimate — actual bills depend on your specific plan contracts and negotiated rates.
What is a deductible?
A deductible is the amount you pay for covered services before your insurance begins to pay. For example, with a $2,000 deductible, you pay the first $2,000 of covered services each year.
What is coinsurance?
Coinsurance is your share of costs after you've met your deductible. If your coinsurance is 20% and you've met your deductible, you pay 20% of covered costs and your insurance pays 80%.
What is an out-of-pocket maximum?
The out-of-pocket maximum is the most you'll have to pay for covered services in a plan year. After you reach this limit, your insurance covers 100% of covered services for the rest of the year.
What is a copay vs coinsurance?
A copay is a fixed amount (e.g., $30 for a doctor visit). Coinsurance is a percentage (e.g., 20% of the bill). Many plans have both: a copay for office visits and coinsurance for hospitalizations.