Health Care Insurance Cost Calculator
You can use this free health care costs calculator to compare healthcare options that you might be offered at work or when comparison shopping for health insurance. This calculator allows you to compare two health care plans at a time, with consideration for monthly premiums, copayments, deductibles, and coinsurance payments.
The variables used in our online calculator are defined in detail below, including how to interpret the results.
Medical Care Use
These first three variables used by this calculator have to do with the amount of medical care you expect to receive each year. You can find this historical information in your medical expense records for prior years. The assumption here is that you'd use the same amount of medical care, regardless of the health care insurance provider selected.
Office Visits (Annual)
These are the total number of office visits you think you'll make in a year. This value is used to compute the copayment values.
In Network Care ($ / Year)
This is the total amount of in-network care you expect to receive. This value becomes important if the health care insurance you're evaluating has a deductible.
Out of Network Care ($ / Year)
This is the total amount of out-of-network care you expect to receive in a year. If you decide that all of the medical care you'll receive will be through doctors participating in the network, then this value would be zero.
Health Insurance Options
This calculator can be used to directly compare the cost of two health insurance policies. The information you enter will be broken down into two subcategories of expenses. The money associated with in-network expenses, and those costs that occur when you go out of network (if coverage applies). For example, if one of the health insurance policies you're comparing does not offer out-of-network reimbursements, then the coinsurance rate would be 0% if you decide to go out of network.
Monthly Premiums ($ / Month)
This is your monthly payments required to be covered by this health care insurance policy, stated in dollars per month.
Copayment ($ / Event)
This is the copayment you need to make for each medical event (for example, a doctor's office visit). If the plan you're evaluating does not require a copayment, then this field should be zero.
Standard Deductible ($ / Year)
This is the standard deductible you'd have to pay before your healthcare insurer would start to share in the cost of your healthcare expenses.
Coinsurance Rate (% Cost Sharing)
If the health insurance plan you're evaluating allows you to go out-of-network and shares in your out-of-network costs then enter the percentage of fees they will pay. If they do not provide for out-of-network services, then enter zero.
Coinsurance Deductible ($ / Year)
If the plan has a separate deductible that applies to out-of-network expenses, then enter that value here.
Out of Pocket Maximums ($ / Year)
Some health insurance plans place a cap on your out-of-network costs. If so, then enter your maximum out-of-pocket expense here.
Calculator Results - Health Care Insurance Options
In this section of the calculator you can make a direct comparison of costs between each of the two health insurance plans you're analyzing.
Monthly Premiums ($ / Year)
This is the total annual premiums you will pay for this healthcare insurance.
Copayment ($ / Year)
This value is the total of all the copayments you'll make in a year. This value is found by multiplying the number of office visits times the copayment charge.
Standard and Coinsurance Deductibles ($ / Year)
These two values represent your annual estimate of the deductibles you will have to pay or satisfy before the sharing of health care costs with your insurance company begins.
Coinsurance Payments ($ / Year)
This is the value of all your coinsurance payments each year. This value is calculated by taking your expected out-of-network costs and multiplying them by the cost sharing percentage that you're responsible for.
Total Cost Health Insurance ($ / Year)
This is your total out of pocket expenses associated with health care insurance including premiums, copayment, coinsurance, and deductibles based on the assumptions you've entered into this model. This value can be used to compare costs when choosing between health insurance plans.
Health Care Insurance Cost Calculator
Disclaimer: These online calculators are made available and meant to be used as a screening tool for the investor. The accuracy of these calculations is not guaranteed nor is its applicability to your individual circumstances. You should always obtain personal advice from qualified professionals.