Hyperbaric Oxygen Therapy Insurance Gap Calculator

Translate a hyperbaric oxygen therapy plan into out-of-pocket dollars by combining session volume, clinic pricing, coinsurance, and the deductible you still owe. Optional fields cap the projection at your plan's out-of-pocket maximum and break the remaining responsibility into a monthly savings target for HSA, FSA, or sinking-fund planning.

Number of hyperbaric oxygen therapy sessions your care plan prescribes this year.
Clinic cash rate or allowed amount billed for each session.
Coinsurance percentage applied after you satisfy the deductible or prior authorization conditions.
Portion of your annual deductible still unpaid before therapy begins.
Optional — defaults to $0.00. Enter your plan's out-of-pocket maximum to cap total patient responsibility.
Optional — defaults to 12 months when blank so you can pace HSA, FSA, or savings contributions.

Coverage terms vary widely by insurer and diagnosis. Confirm preauthorization requirements and reimbursement policies before committing to treatment.

Examples

  • Example 1 — 40 sessions at $275.00, 60% coverage, $1,200.00 deductible remaining ⇒ Patient responsibility: $5,120.00 | Insurance reimbursement: $5,880.00 | Average out-of-pocket per session: $128.00 | Save $426.67 per month over 12 months
  • Example 2 — 24 sessions at $320.00, 50% coverage, $900.00 deductible remaining, saved across 6 months ⇒ Patient responsibility: $4,290.00 | Insurance reimbursement: $3,390.00 | Average out-of-pocket per session: $178.75 | Save $715.00 per month over 6 months

FAQ

What if my plan reimburses a lower allowed amount?

Enter the contracted or allowed amount instead of the clinic's standard cash rate so the calculation mirrors your insurer's reimbursement ceiling and coinsurance split.

How do I account for travel or lodging costs?

Add anticipated travel, lodging, or caregiver expenses to the deductible field before running the calculation, or rerun it with those amounts added to your patient responsibility output.

Can I compare in-network versus out-of-network quotes?

Yes. Run the calculator twice with each provider's rate, coverage percentage, and deductible rules to contrast the resulting patient responsibility and monthly savings target.

Should I include medical financing interest?

If you plan to finance HBOT, add estimated interest charges to the deductible input so the patient responsibility reflects repayment costs as well.

Additional Information

  • Total billed amount equals the session count multiplied by the clinic's per-session rate or allowed amount.
  • Deductible remaining is applied first, reducing the portion eligible for coinsurance sharing with the insurer.
  • Insurance reimbursement reflects the balance after the deductible multiplied by your coverage percentage.
  • Average out-of-pocket per session helps compare HBOT providers, facility types, or bundled pricing offers side by side.
  • Monthly savings guidance divides your total exposure across the selected saving window for HSA, FSA, or personal budgeting.

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