See what a medical bill really costs you.
Enter the bill, your deductible, your coinsurance and your out-of-pocket max. See exactly what you pay, what insurance pays, and how your share is capped once you hit the out-of-pocket max.
Your plan and bill
Coinsurance is the percentage of the bill you pay after the deductible. In-network amounts only. Premiums are separate and do not count toward the out-of-pocket max.
How this bill breaks down
You pay first, then insurance takes over
Walk through the bill
Your cost flattens at the out-of-pocket max
This bill at a glance
Your cost at different bill sizes
Same deductible, coinsurance and out-of-pocket max, applied to bills of different sizes. Once the bill is large enough, your cost stops rising.
| Medical bill | You pay | Insurance pays | Your share |
|---|
Out-of-pocket costs, explained
Total Cost vs Premium
Monthly premium is fixed. Cost share varies with usage. True annual cost = 12× premium + your cost share for the year. Low premium plans often cost more when you use healthcare.
Out-of-Pocket Max Protection
OOP max caps your annual exposure. Once hit, insurance covers 100% for rest of year. Critical protection against catastrophic illness. 2025 max: $9,450 self / $18,900 family.
HDHP vs Traditional
HDHP: low premium, high deductible, qualifies for HSA. Best if healthy + want HSA tax savings. Traditional: higher premium, lower deductible. Better if high known medical usage.
Plan Comparison Strategy
Calculate total cost at 3 scenarios: minimal usage (no medical), moderate usage (typical year), catastrophic (max out-of-pocket). Best plan often differs by scenario.
Common questions
Does premium count toward OOP max?
No, premium is separate. OOP max only counts what you pay for actual care (deductible, copays, coinsurance).
What about out-of-network costs?
Usually don't count toward OOP max (or have separate, much higher OOP max). Stay in-network when possible.
Is dental/vision included?
Usually no, separate from medical plan. Track separately.
How is coinsurance different from copay?
Coinsurance = percentage (20%, 30% of billed). Copay = fixed dollar amount ($30/visit). Most plans use both depending on service.
What if I rarely use healthcare?
HDHP usually wins on total cost for healthy people. Plus HSA tax savings on top.
Estimates for planning only. Real costs depend on your plan's exact terms, whether care is in-network, separate copays, and how much of your deductible and out-of-pocket max you have already met this year. Check your plan documents and Explanation of Benefits.