Braces Cost Calculator

What this calculator estimates

Braces Cost Calculator

Inputs and units

Use the units shown for Number of treatment cases, Cost per unit or treatment ($), Provider or specialist fee ($), Facility, imaging or laboratory fees ($), Other related costs ($), Estimated insurance coverage after deductible (%), Remaining deductible ($), Additional patient copay within the entered bill, not already in the percentage ($). Required fields cannot be blank. Use zero only where that field and the model allow it. Select Calculate after changing a scenario.

Method and assumptions

Add units × unit cost, provider, facility and other allowed charges. Subtract the remaining deductible before applying the entered insurer coverage percentage. Add an extra copay only if it is not already represented in that percentage, and cap patient cost at the entered bill. Insurer share is the bill less patient share.

Worked example

For allowed charges 1,000, remaining deductible 200, insurer coverage 80% and additional copay 50, patient cost is 410 and insurer share is 590. With no insurer coverage, patient cost cannot exceed the same entered allowed charges.

Limitations

Use insurer-allowed charges for covered services. The model does not apply an annual benefit cap, out-of-pocket maximum, prior spending, exclusions or balance billing. Add non-covered charges separately. Confirm copay/coinsurance treatment with the plan to avoid counting one cost twice.

Sources and background

HealthCare.gov: allowed amount

HealthCare.gov: out-of-pocket limits