Coinsurance Calculator

About this calculator

Once a health plan's deductible is met, coinsurance is the percentage split of remaining costs between patient and insurer — for example, an 80/20 plan means the insurer covers 80% and the patient covers the remaining 20% — which is distinct from a flat-dollar copay.

Coinsurance payments, together with the deductible and any copays, count toward the patient's out-of-pocket maximum, the point after which the plan covers 100% of costs for the rest of the plan year. This calculator is used by patients estimating what they'll actually owe for a procedure, and by HR and benefits staff explaining plan costs during open enrollment.