# Health Insurance Out-of-Pocket Calculator — United States

> Model a deductible-and-coinsurance contract using confirmed policy values rather than infer subsidy eligibility or national underwriting prices. USD planning view; stated limitations apply.

Page: https://askcalculators.com/us/health-insurance/
Definition: https://askcalculators.com/us/health-insurance/definition.json
JSON Schema: https://askcalculators.com/us/health-insurance/schema.json
Version: 20.16.0
Maintained by: AskCalculators (software project; not a credentialed reviewer)
Qualified review: pending. Automated checks do not establish professional approval.
Page status: Live
Review status: Pending

## Use
Open the calculator page and enter values. Query-string parameters can restore and bookmark a calculation.
Example: https://askcalculators.com/us/health-insurance/?annualPremium=6000&confirmedSubsidy=0&eligibleSpending=8000&deductible=2000&coinsurance=20&outOfPocketMax=6000&excludedSpending=0

## Inputs
- annualPremium: Annual premium before confirmed subsidy; type=money; required; default=6000; min=0; max=1000000000000
- confirmedSubsidy: Confirmed annual premium subsidy; type=money; required; default=0; min=0; max=1000000000000
- eligibleSpending: Eligible covered in-network charges; type=money; required; default=8000; min=0; max=1000000000000
- deductible: Annual deductible; type=money; required; default=2000; min=0; max=1000000000000
- coinsurance: Patient coinsurance after deductible; type=percent; required; default=20; min=0; max=100
- outOfPocketMax: Applicable covered out-of-pocket maximum; type=money; required; default=6000; min=0; max=1000000000000
- excludedSpending: Excluded or non-covered spending; type=money; required; default=0; min=0; max=1000000000000

## Outputs
- netPremium: Premium after confirmed subsidy; format=currency
- coveredOutOfPocket: Modeled covered out-of-pocket; format=currency
- annualTotal: Premium and modeled medical spending; format=currency; primary

## Formula
covered out-of-pocket = minimum(maximum, minimum(charges, deductible) + maximum(0, charges − deductible) × coinsurance).

Inputs are converted to canonical units before evaluating this stated formula.

## Rules
- Empty optional inputs are undefined, not zero.
- Hidden conditional inputs are ignored.
- Do not invent missing required inputs.

Notice: Illustrative defaults are not local quotes or verified legal rules. Dated reference components and user-entered assumptions are explicitly distinguished. Professional review is pending.