Enter the annual deductible, the amount met so far and this claim’s allowed amount to see what applies, what remains, and when it’s met.
The deductible stage, isolated
The deductible is stage one of every cost-share calculation: until the patient has paid the annual amount in allowed charges, they pay allowed amounts in full. Enter the plan’s deductible, what’s accumulated so far, and this claim’s allowed amount — the calculator shows how much of the claim the patient pays toward the deductible, what spills past it to the coinsurance stage, and the remaining balance after.
How to use it
- Enter the annual deductible from the plan.
- Enter the amount met year-to-date (from eligibility verification — accumulators move daily).
- Enter this claim’s allowed amount.
The logic
A worked example
A $1,500 deductible with $1,100 met leaves $400. A $250 allowed claim applies entirely to the deductible — the patient owes all $250, and $150 remains before the deductible is met. Make the claim $600 instead and $400 finishes the deductible while $200 spills over to coinsurance — the split this calculator makes visible, and the front desk’s most common estimate error.
Estimates only — payer contracts, plan documents, published fee schedules and the EOB are the source of truth, and nothing here is billing, legal or medical advice. The calculator runs entirely in your browser: no patient data is entered, transmitted or stored.