Annual Out-of-Pocket Cost Estimator
The premium is only part of your cost. This tool adds expected care to your premium, applying your deductible, coinsurance, and out-of-pocket maximum to estimate your total annual spend in a typical year.
Your details
Your estimate
In a year with $4,000 of care, your estimated total cost is about $6,800 — $3,600 in premiums plus $3,200 in care.
- Annual premiums
- $3,600
- Your share of care costsDeductible plus coinsurance.
- $3,200
- Estimated total annual cost
- $6,800
- Worst-case total (hit OOP max)Premiums plus the full out-of-pocket maximum.
- $11,600
This is an educational estimate, not a quote or medical or financial advice. Actual costs depend on your specific plan, state, age, and health. Figures use published federal tables and typical market ranges as of 2026-01-15.
Frequently asked questions
- What is an out-of-pocket maximum?
- The most you pay for covered in-network care in a year. After you reach it, the plan pays 100% of covered costs. Premiums do not count toward it.
- Why compare worst-case cost?
- A low-premium plan can have a high out-of-pocket max. Comparing premium plus OOP max shows your true maximum exposure in a bad year.
Sources
- HealthCare.gov — the official ACA Health Insurance Marketplace · reviewed 2026-01-15
- OLYRON HealthMatch editorial methodology — how we source and rate options · reviewed 2026-01-15
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