Underinsured Calculator

California’s Hospital Fair Pricing Act classifies people as underinsured if they spent more than 10% of their income on out-of-pocket medical expenses in the last 12 months.

The Commonwealth Fund classifies people as underinsured if they had insurance all year, and either:

  • spent more than 10% of their income on out-of-pocket medical expenses (OOPs), OR
  • had an income level below 200% FPL and spent more than 5% of income on OOPs, OR
  • had a deductible that took 5% or more of their income.

Use this tool to figure out whether you might qualify as underinsured using any of these definitions.

Annual Income
Monthly Premium

OUT OF POCKET COSTS (in the last 12 months)

Office Visits
Co-Pay:
# of visits:
If you paid full price until a deductible was met, enter the amount spent prior to meeting the deductible.
Total:
Rx (generic/brand name)
Co-Pay:
# of Rx filled:
If you paid full price until a deductible was met, enter the amount spent prior to meeting the deductible.
Total:
Other Costs
Diagnostic Procedures
Outpatient Surgery Copay
Emergency Room Copay
In-patient Cost Sharing
Maternity Care
Total Out of Pocket Costs:
Percent of Income: