Educational Tool
See how much you have accumulated and how much remains before reaching your health plan limits.
Enter the values shown in your insurance carrier portal or plan documents. You do not need to complete both sections — the calculator will show the progress for each block independently.
Enter the value from your carrier portal or plan documents. This value is independent of your deductible.
Both values are independent. Some copays or expenses may count toward the out-of-pocket maximum without counting toward the deductible, depending on your plan. Enter each value as it appears in your carrier portal or plan documents.
The deductible is the amount you may have to pay for certain covered services before the plan begins sharing certain costs. Not every service is necessarily subject to the deductible, and plan rules vary.
The out-of-pocket maximum is the plan's limit on certain cost-sharing expenses for covered in-network care during the plan year. Which expenses count toward this limit depends on the plan rules.
Monthly premiums generally do not count toward the out-of-pocket maximum.
Reaching your deductible does not necessarily mean you stop paying for all services. Copays or coinsurance may continue to apply depending on the plan.
Likewise, reaching the out-of-pocket maximum applies to expenses that count toward that limit under the plan's rules.
If the amounts do not match across documents, confirm directly with your insurance carrier.
Have questions?
We can help you review your benefits, deductible, copays, coinsurance, and out-of-pocket maximum.
Privacy: The values you enter are used only in your browser and are not stored or transmitted.
Important notice: This tool is for educational purposes only and uses the values you enter. It does not determine coverage, benefits, eligibility, or how much you will pay for medical care. Expenses that count toward the deductible and out-of-pocket maximum depend on your specific plan rules. Always review your official plan documents or confirm with your insurance carrier.