Deductible Impact Calculator

Work out deductible impact instantly with clear inputs, formula shown and shareable results.

About Deductible Impact Calculator

Cost sharing runs in a fixed order: you pay the deductible in full, then a coinsurance percentage of the balance, until the annual out-of-pocket maximum is reached — after which the insurer pays everything. The maximum is the figure that actually caps your financial exposure.

Formulas

Your cost before the cap

Your cost = min(Deductible, Claim) + (Claim - Deductible) x Coinsurance %

Final cost

Final cost = min(Your cost, Out-of-pocket maximum)

Worked example

With the default values below, Deductible Impact Calculator returns Your total cost of $120,000.00. Change any input above and every figure here is recalculated in your browser.

Inputs used

Claim amount: 400,000
Deductible: 50,000
Coinsurance share you bear above the deductible: 20
Annual out-of-pocket maximum: 120,000

Results

Your total cost: $120,000.00
Insurer pays: $280,000.00
Coinsurance element: $70,000.00
Out-of-pocket cap status: Below the out-of-pocket maximum

Step by step

1Values used
2Your cost before the cap
3Final cost
4Your total cost= 120,000.00
5Insurer pays= 280,000.00
6Coinsurance element= 70,000.00
7Out-of-pocket cap status= Below the out-of-pocket maximum

Assumptions and limits

The result is derived only from the 4 inputs listed above. Anything not among them is not part of the calculation.
In particular, this calculator does not take inflation or fees or charges into account.
Figures are rounded for display to 2 decimal places, so totals built from several rounded parts can differ slightly from the unrounded arithmetic.
Indicative estimate only. Fees, entitlements, limits and formulas vary by jurisdiction, statute, policy wording and the facts of the case. This is not legal, tax, insurance or financial advice — confirm with a qualified professional or the relevant authority.

How these calculators are built and tested is described on the Methodology page. If a figure looks wrong, please report it.

Indicative estimate only. Fees, entitlements, limits and formulas vary by jurisdiction, statute, policy wording and the facts of the case. This is not legal, tax, insurance or financial advice — confirm with a qualified professional or the relevant authority.

Frequently Asked Questions

Does the deductible count towards the out-of-pocket maximum?

In most designs yes, along with coinsurance and copayments. Premiums never do.

Is a higher deductible worth the premium saving?

Compare the annual premium saving with the extra exposure. It pays off if you can absorb the deductible and claim infrequently.