Out-of-Pocket Max Calculator

Calculate your maximum potential costs under a health insurance plan.

This calculator shows your maximum annual exposure under a health insurance plan by combining premiums and the out-of-pocket maximum. It also calculates how much in medical bills would trigger that maximum. After meeting your deductible, you pay coinsurance until reaching the out-of-pocket max. Once you hit that limit, the plan covers 100% of eligible expenses. Understanding this ceiling helps with financial planning.

Calculator

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Maximum Annual Cost
$10,800
Annual Premiums
$4,800
Deductible
$2,000
Out-of-Pocket Maximum
$6,000
Best Case (no claims)
$4,800
Worst Case (hit OOP max)
$10,800
Medical Bills to Hit Max
$22,000

Common use cases

  • Out-of-pocket max applies to in-network covered services
  • Premiums are not counted toward deductible or OOP max
  • Out-of-network services may have separate or no limits
  • Non-covered services are always out-of-pocket

This tool provides general informational estimates and is not insurance advice or a quote.