Health Insurance
Premiums, deductibles, copays, coinsurance, and out-of-pocket maximums work as a system. Knowing each piece helps you read a plan summary.
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The premium
The premium keeps the plan active. Employer contributions, marketplace subsidies, and Medicaid or Medicare rules can change what you personally pay. This site does not decide eligibility for public programs.
Deductibles, copays, and coinsurance
You generally pay covered costs until the deductible is met, though many plans cover certain preventive care sooner. Copays are flat fees. Coinsurance is a percentage of allowed amounts after deductible rules apply.
The out-of-pocket maximum
This cap usually limits in-network cost sharing for covered services during the plan year. Premiums typically do not count. Use current plan documents for this year’s numbers.
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Frequently asked questions
Can this calculator enroll me in a plan?
No. It only illustrates how the numbers you enter can add up.