Medical Bill Calculator

Estimate cost sharing for one covered in-network claim.

Medical Bill Calculator

The starting values are a hypothetical example, not actual prices or plan terms. Replace them with your bill and plan information.

Amount billed ($)

Estimate a covered in-network insurance claim

Allowed amount for this claim ($)

Find the allowed amount on your explanation of benefits (EOB), or ask your insurer. It is not a percentage of the billed amount.

Applicable deductible ($)

Deductible already met ($)

Your coinsurance (%)

Applicable out-of-pocket maximum ($)

Amount already counted toward that maximum ($)

Your Bill Breakdown

Amount billed$2,200.00

Allowed amount$850.00

Deductible on this claim, before OOP cap$850.00

Coinsurance, before OOP cap$0.00

Remaining out-of-pocket maximum$6,000.00

Estimated plan share of allowed amount$0.00

Estimated patient share$850.00

The patient share is limited to the remaining out-of-pocket maximum. Components above are shown before that cap and may not add up to the final share.

This is a simplified estimate for one covered in-network claim, not a bill. It excludes copays, noncovered services, out-of-network charges and other plan rules. Verify with your insurer and provider.

How to use this calculator

Replace the hypothetical starting values with the billed and allowed amounts for the claim. Find the allowed amount on your explanation of benefits (EOB), or ask your insurer for an estimate. Enter the applicable deductible and out-of-pocket maximum, amounts already counted toward each before this claim, and your coinsurance percentage. Use the relevant individual or family amounts for the same plan year and benefit category.

The tool applies the remaining deductible up to the allowed amount, then coinsurance to what remains, and caps their sum at the remaining out-of-pocket maximum. See the methodology for an example and limitations.

What is the allowed amount?

The allowed amount is the plan's payment allowance for a covered service; it is not the same as the amount the insurer pays. For covered in-network care, patient cost sharing is generally based on that allowance and plan terms. Check your EOB and provider agreement for adjustments. See HealthCare.gov's definition.

What if I don't use insurance?

Uncheck the insurance option to see the billed amount without an assumed discount. Ask the provider about self-pay rates, an itemized bill, payment plans, and financial assistance. Discounts and eligibility vary.