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Input
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What belongs here
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Annual premium and fees
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Full charge for the selected policy term, including charges you want included in the comparison.
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Total bill
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One hypothetical invoice shared by both calculations.
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Eligible charges for each offer
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Only the part of that bill you assume qualifies under that offer, before deductible or percentage sharing.
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Deductible still to meet
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The remaining deductible relevant to this one episode, not automatically the original full deductible.
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Insurer reimbursement percentage
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The insurer’s share, not your percentage share.
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Remaining payout limit
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The maximum insurer payment still available for this scenario after earlier claims; leave blank only if unlimited.
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Keep the calculation order faithful to the policy. Some contracts subtract the deductible from eligible charges before applying the percentage; others apply the percentage first. The tool provides both simplified orders because selecting the wrong one can change the result. It does not automatically identify an insurer’s formula.
A benefit schedule, per-service sublimits, separate accident and illness limits, multiple condition deductibles or claims spanning policy periods may need a more detailed calculation. Do not use one blended number to hide those differences. Ask the insurer to explain the same example in writing.