{"uid":"cap_eazw81oSIIqdSXFBIu1vw","slug":"saylor-innovations-insurance-deductible-cost-share-calculator-5c86ede2","name":"Saylor Innovations Insurance Deductible Cost-Share Calculator","description":"Insurance deductible cost-share calculator - member cost and plan cost from allowed amount and coinsurance","url":"https://saylorinnovations.com/api/insurance/deductible?utm_source=zero.xyz","method":"GET","headers":{},"bodySchema":{"type":"object","$schema":"https://json-schema.org/draft/2020-12/schema","required":["input"],"properties":{"input":{"type":"object","required":["type","method"],"properties":{"type":{"type":"string","const":"http"},"method":{"enum":["GET"],"type":"string"},"queryParams":{"type":"object","required":["allowed_amount","deductible_remaining","coinsurance_percent"],"properties":{"allowed_amount":{"type":"string","description":"required positive allowed or negotiated amount (query)"},"coinsurance_percent":{"type":"string","description":"required coinsurance percentage from 0 to 100 (query)"},"deductible_remaining":{"type":"string","description":"required non-negative deductible remaining (query)"}}}},"additionalProperties":false},"output":{"type":"object","required":["type"],"properties":{"type":{"type":"string","const":"json"},"example":{"type":"object","required":["allowed_amount","deductible_remaining","coinsurance_percent","deductible_applied","estimated_member_cost","scope_note"],"properties":{"formula":{"type":"string","description":"Formula used for the calculation"},"scope_note":{"type":"string","description":"What this data covers and what it leaves out"},"allowed_amount":{"type":"number","description":"Allowed amount"},"coinsurance_amount":{"type":"number","description":"Coinsurance amount"},"deductible_applied":{"type":"number","description":"Deductible applied"},"coinsurance_percent":{"type":"number","description":"Coinsurance, as a percentage"},"estimated_plan_cost":{"type":"number","description":"Estimated plan cost"},"deductible_remaining":{"type":"number","description":"Deductible remaining"},"estimated_member_cost":{"type":"number","description":"Estimated member cost"},"out_of_pocket_remaining":{"type":["number","null"],"description":"Out of pocket remaining"}}}}}}},"responseSchema":null,"example":null,"exampleRequest":null,"tags":["x402"],"displayCostAmount":"0.01","displayCostAsset":"USDC","priceDynamic":false,"priceHint":null,"priceStatus":"priced","priceSource":"probe","requiresHandshake":false,"reviewCount":0,"rating":{"score":"0.00","successRate":"0.00","reviews":0,"stars":null,"state":"unrated"},"availabilityStatus":"unknown","priceObserved":null,"sessionDeposit":null,"pricing":{"kind":"static","summary":"$0.01/call","primary":{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.01","per":"call","confidence":"exact"},"accepted":[{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.01","per":"call","confidence":"exact"}]},"paymentMethods":[{"uid":"pm_1XMmSnubv_6fmFqd58gJr","protocol":"x402","methodType":"crypto","chain":"base","mode":"charge","costAmount":"0.01","costPer":"request","priority":0,"asset":"0x833589fCD6eDb6E08f4c7C32D4f71b54bdA02913","unit":"request","depositMicros":null,"planRef":null}],"brandName":null,"brandSlug":null,"brandBaseUrl":null,"brandDocsUrl":null,"whatItDoes":"Calculates member cost and plan cost from an allowed/negotiated amount, deductible remaining, and coinsurance percentage for health insurance claims","exampleAgentPrompt":"My doctor's visit has a negotiated allowed amount of $350, I have $200 left on my deductible, and my coinsurance is 20% — can you calculate exactly how much I'll owe versus what my insurance plan will cover?","exampleUseCases":[{"title":"Patient out-of-pocket estimate before procedure","prompt":"I'm having an outpatient procedure with a negotiated allowed amount of $1,200. I still have $400 left on my deductible and my plan's coinsurance is 30%. Can you tell me how much I'll need to pay out of pocket and how much my insurance will cover?"},{"title":"Benefits advisor explaining member cost share","prompt":"A member is asking about a $650 allowed amount claim. They have $0 deductible remaining and their coinsurance is 20%. Break down the estimated member cost and what the plan will pay."},{"title":"HR tool calculating employee cost for annual enrollment","prompt":"For our enrollment comparison tool, calculate the cost share on a $500 allowed amount with $150 deductible remaining and 10% coinsurance so we can show employees their estimated out-of-pocket cost."}],"resultDescription":"A JSON object containing the original inputs echoed back (allowed_amount, deductible_remaining, coinsurance_percent), plus the computed deductible_applied, coinsurance_amount, estimated_member_cost, estimated_plan_cost, out_of_pocket_remaining, the formula used for the calculation, and a scope_note explaining what the estimate covers and excludes.","failureModes":["Missing required query parameters (allowed_amount, deductible_remaining, or coinsurance_percent) returns an error","Non-numeric or negative values for allowed_amount may cause validation errors","coinsurance_percent outside the 0-100 range may return an error or unexpected results","Negative deductible_remaining values rejected as invalid","Payment failure or missing x402 payment header returns 402 Payment Required"],"whenToPreferThis":"Choose this endpoint when you need a quick, single-claim insurance cost-share breakdown — splitting an allowed/negotiated amount into member and plan portions accounting for deductible and coinsurance. It is ideal for patient-facing cost estimators, benefits advisors, HR tools, or any agent that needs to explain healthcare cost-sharing in real time. It does not model out-of-pocket maximums exhaustively or handle capitation/bundled payments.","instructions":null,"reviewSummary":null,"reviewSummaryHighlights":null,"reviewSummaryConcerns":null,"reviewSummaryGeneratedAt":null,"activationCount":0,"lastUsedAt":null,"lastSuccessfullyRanAt":null,"lastHealthCheckAt":"2026-10-17T12:41:29.809Z","isFirstParty":false,"canonicalSlug":"saylor-innovations-insurance-deductible-cost-share-calculator-5c86ede2"}