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Health Insurance Claim Calculator
Verified formula Updated Jun 2026 Private — runs on your device
Verified formula
Private
Your out-of-pocket cost
₹28,000
- Insurer pays
- ₹72,000
For general information only — not financial, tax, legal or medical advice. Verify before you rely on it.
How to use the Health Insurance Claim Calculator
The Health Insurance Claim Calculator works out your your out-of-pocket cost, along with 1 related figure in an instant. Enter total hospital bill, deductible and co-pay on the rest and the result updates as you type — it is free, needs no sign-up, and runs entirely in your browser so your figures stay private.
- Enter the total hospital bill.
- Enter the deductible.
- Enter the co-pay on the rest.
- Read off your your out-of-pocket cost, together with insurer pays — the calculator updates automatically, with no button to press.
Formula
The Health Insurance Claim Calculator uses the formula:
Your out-of-pocket cost = Deductible + (Total hospital bill - Deductible) × Co-pay on the rest ÷ 100
Worked example
For example, with total hospital bill of ₹100,000, deductible of ₹10,000 and co-pay on the rest of 2%, the your out-of-pocket cost is ₹28,000.
| Total hospital bill | ₹100,000 |
|---|---|
| Deductible | ₹10,000 |
| Co-pay on the rest | 2% |
| Your out-of-pocket cost | ₹28,000 |
|---|---|
| Insurer pays | ₹72,000 |
Results are estimates for educational use, not professional advice.
Frequently asked questions
Pay the deductible, then a co-pay percentage of the rest. On a 1,00,000 bill with a 10,000 deductible and 20% co-pay, you pay 28,000.
It is the fixed amount you pay before insurance contributes. A higher deductible usually means a lower premium.
Co-pay is the share of the remaining bill you pay after the deductible, with the insurer covering the rest.
Not if there is a co-pay. With co-pay, you and the insurer split the amount above the deductible.
Enter the total hospital bill. Enter the deductible. Enter the co-pay on the rest. Read off your your out-of-pocket cost, together with insurer pays — the calculator updates automatically, with no button to press.
Related guides
Health Insurance Claim Table: Your out-of-pocket cost by Total hospital bill
Reference table of out-of-pocket cost for Health Insurance Claim across a range of total hospital bill values — exact, engine-computed figures you can read off at a glance.
How to Calculate Health Insurance Claim: Formula, Steps & Examples
Learn how to calculate Health Insurance Claim — the formula explained step by step, with worked examples and a free calculator to check your answer.