Scan Health Plan Risk Calculator

How the Scan Health Plan Risk Calculator Works

The calculator evaluates your health insurance plan based on several key factors that determine your financial risk:

• Annual Premium: The amount you pay monthly or annually for your health insurance
• Deductible: The amount you must pay out-of-pocket before your insurance starts covering costs
• Out-of-Pocket Maximum: The most you'll pay for covered services in a year before your insurance covers 100% of costs
• Coverage Tier: The level of care your plan covers (e.g., Bronze, Silver, Gold, Platinum)
• Preventive Care Coverage: Whether your plan covers 100% of preventive services without cost-sharing

The calculator uses these inputs to determine your potential risk level and identify areas where you might be underinsured or overpaying.

How to Use This Calculator

1. Enter your annual premium - This is the total amount you pay for your health insurance each year
2. Input your deductible - The amount you must pay before your insurance starts covering costs
3. Provide your out-of-pocket maximum - The most you'll pay for covered services in a year
4. Select your coverage tier - Choose from Bronze, Silver, Gold, or Platinum
5. Indicate preventive care coverage - Check if your plan covers 100% of preventive services without cost-sharing
6. Click Calculate - The calculator will analyze your inputs and provide your risk assessment

After calculating, review the results to understand your health plan's financial and coverage risks.

How to Interpret Your Results

The calculator provides a risk assessment with three possible outcomes:

• Low Risk: Your health plan offers good coverage with reasonable out-of-pocket costs
• Moderate Risk: Your plan has some coverage gaps or higher-than-average costs
• High Risk: Your plan may leave you vulnerable to significant out-of-pocket expenses

Based on your results, consider comparing plans, adjusting your coverage, or exploring additional insurance options to better protect yourself against medical expenses.

Example Calculation

Let's look at an example to see how the calculator works:

• Annual Premium: $3,600
• Deductible: $1,500
• Out-of-Pocket Maximum: $6,350
• Coverage Tier: Silver
• Preventive Care Coverage: Yes

Using the formulas:

1. Monthly Premium = $3,600 / 12 = $300
2. Coverage Tier Value = 2 (for Silver)
3. Risk Score = $300 + $1,500 + ($6,350 / 2) - (2 × 1000) + 0 = $300 + $1,500 + $3,175 - $2,000 + $0 = $2,975
4. Since 2,975 ≥ 2,000, this would be classified as High Risk

This example shows a plan with high out-of-pocket costs relative to its coverage tier, indicating significant financial risk.