Estimate your yearly health cost from premium, deductible and coinsurance.
Uses your own plan numbers — calculated locally.
How do you estimate the total yearly cost of a health insurance plan?
Total yearly cost = premiums (×12) + out-of-pocket. You pay bills up to the deductible, then coinsurance × the remainder, but never more than the out-of-pocket maximum. For example, 400/month plus a 2,000 deductible and 20% of the next 8,000 (1,600) on 10,000 in bills = 4,800 + 3,600 = 8,400 total.
Understanding your result
Out-of-pocket is capped at the maximum you enter. Comparing plans this way reveals which is cheaper for your expected usage.
Formula and method
You pay bills up to the deductible, then coinsurance × the remainder — but never more than the out-of-pocket maximum. Total = premiums (×12) + that out-of-pocket amount.
Assumptions and limitations
The total is an estimate based on the premium, deductible, coinsurance and expected bills you enter, not financial or medical advice. Real costs depend on your actual care, network rules and plan details the tool cannot model. Use it to compare plans directionally, and read each plan's documents before deciding.
Worked example
400/month + (2,000 deductible + 20% of the next 8,000 = 1,600) on 10,000 bills → 4,800 premiums + 3,600 out-of-pocket = 8,400 total.
How to use this tool
- Enter the monthly premium, deductible, coinsurance and out-of-pocket maximum.
- Enter your expected annual medical bills.
- Press Calculate.
Common mistakes to avoid
- Comparing premiums alone and ignoring deductible and coinsurance.
About the Health Insurance Cost Estimator
Estimate the true yearly cost of a health plan by combining premiums with what you would pay out of pocket on your expected medical bills.
Who should use this tool
People choosing between health plans who want to see the true yearly cost, not just the headline premium. Useful during open enrolment or a plan change, especially when weighing a lower premium with a higher deductible against the opposite, based on expected medical use.
Benefits
- Combines premiums and out-of-pocket costs into one yearly figure
- Caps out-of-pocket spending at the maximum you set
- Reveals which plan is cheaper for expected usage
- Runs privately in your browser, no account needed
Practical use cases
- Comparing two plans at your expected level of care
- Weighing a low premium against a high deductible
- Estimating a year's total health spending for budgeting
- Reviewing your available options during open enrolment season
Frequently asked questions
Does the deductible count toward the out-of-pocket max?
In most plans, yes — the tool caps total out-of-pocket spending at the maximum you enter.
How does the out-of-pocket maximum protect me?
The out-of-pocket maximum is the most you would pay toward covered care in a year through deductible and coinsurance. Once your spending reaches it, the tool stops adding out-of-pocket costs, since the plan is designed to cover the rest. This is why very high bills do not increase the estimate without limit.
Why can a cheaper premium end up costing more overall?
A low premium often comes with a higher deductible and coinsurance, so you pay more when you actually use care. If you expect significant medical bills, those out-of-pocket costs can outweigh the premium saving. Adding both together, as this tool does, shows which plan is cheaper for your expected usage.