Health Insurance Deductible Calculator
Know the true cost of your health plan.
Calculate health insurance true cost including deductible and coinsurance. See expected and worst-case annual cost. Enter premium and see the result instantly.
What this tool does
This tool calculates the total annual cost of a health insurance plan including premium, deductible hits, coinsurance on covered claims, and out-of-pocket maximum. Useful for comparing plans at open enrollment.
Enter Values
Formula Used
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Disclaimer
Results are estimates for educational purposes only. They do not constitute financial advice. Consult a qualified professional before making financial decisions.
Health insurance deductibles create a gap between premium paid and actual cost if medical care is needed. A low-premium high-deductible plan might cost 2,400/year in premium but leave 5,000 out-of-pocket if something happens. This calculator shows the expected and worst-case annual cost.
2,400 premium with 5,000 deductible, 3,000 expected claims, 20% coinsurance: under-deductible cost 3,000, coinsurance on the 0 above deductible = 0, total OOP 3,000. Total annual cost 5,400. Worst case hitting out-of-pocket max is usually 5,000-8,000 plus premium.
The tool helps compare plans. A 150/month HMO with 500 deductible might beat a 100/month HDHP with 6,000 deductible for families expecting regular medical care. Without expected claims, high-deductible often wins on premium savings alone.
Run it with sensible defaults
Using annual premium of 2,400, deductible of 5,000, expected medical claims of 3,000, coinsurance of 20%, the calculation works out to 5,400.00. Nudge the inputs toward your own situation and the output recalculates instantly. The defaults are meant as a starting point, not a recommendation.
The levers in this calculation
The inputs — Annual Premium, Deductible, Expected Medical Claims, Coinsurance %, and Out-of-Pocket Max — do not pull with equal force. Not every input has equal weight. Flip one at a time toward extreme values to feel which ones move the needle most for your situation.
How the math works
Under-deductible = min(claims, deductible). Coinsurance = claims above deductible × rate. OOP = min(under-deductible + coinsurance, max). Total = premium + OOP. The working is transparent — you can verify every step yourself in the formula section below. No black box, no opaque "proprietary model".
Using this as a check-in
Re-run this every three months. A single reading tells you where you stand; four readings tell you whether things are improving. The trend matters more than any individual snapshot.
What this doesn't capture
The score is a composite of the inputs you provide. Life context — job security, family obligations, health, housing — doesn't appear in the math but shapes the real picture. Use the number as a prompt, not a verdict.
£2,400 £ premium + £5,000 £ deductible with £3,000 £ claims = $5,400.00.
Inputs
This example uses typical values for illustration. Adjust the inputs above to match a specific situation and see how the result changes.
Sources & Methodology
Methodology
Under-deductible = min(claims, deductible). Coinsurance = claims above deductible × rate. OOP = min(under-deductible + coinsurance, max). Total = premium + OOP.
Frequently Asked Questions
HDHP vs low-deductible?
Does public healthcare apply?
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