NICU Stay Out-of-Pocket Estimator
Translate NICU stay projections into actual cash exposure. Provide the contracted daily charge, your baby's expected length of stay, and your coinsurance rate. Add optional deductible and out-of-pocket maximum details to see how the bill is split, the cash you owe, and the daily burn rate.
Educational projection only. Confirm benefits, case rates, and policy exclusions with your insurer and hospital billing office.
Examples
- $5,200 allowed daily charge, 18-day stay, 20% coinsurance, $2,500 deductible left, $6,800 out-of-pocket cap ⇒ Allowed hospital charges $93,600.00 • Deductible applied $2,500.00 • Coinsurance responsibility $18,220.00 • Patient out-of-pocket $6,800.00 (capped by remaining out-of-pocket max) • Plan payment $86,800.00 • Average patient cost per day $377.78 • Coinsurance rate applied 20.00%
- $4,800 allowed daily charge, 12-day stay, 10% coinsurance, optional fields blank ⇒ Allowed hospital charges $57,600.00 • Deductible applied $0.00 • Coinsurance responsibility $5,760.00 • Patient out-of-pocket $5,760.00 • Plan payment $51,840.00 • Average patient cost per day $480.00 • Coinsurance rate applied 10.00%
FAQ
Does this include physician billing?
No. Neonatology and anesthesiology professional charges usually bill separately—add those estimates on top of this facility projection.
How do I handle multiple policies?
Run the calculation for the primary policy first, then apply secondary coordination of benefits to the remaining balance based on that policy's deductible and coinsurance.
Can I estimate savings with a negotiated payment plan?
Yes. Use the Patient out-of-pocket result as the starting balance and divide it by your proposed payment term to budget monthly cash flow.
What if my plan waives the deductible?
Leave the deductible field blank or enter $0.00 so the tool focuses on coinsurance only.
Additional Information
- Allowed charges reflect the negotiated in-network rate, not the hospital's sticker price.
- Coinsurance applies after the deductible is satisfied; many plans set NICU coinsurance between 10% and 30%.
- If twins share the NICU, run the calculator per child because insurers often apply separate deductibles and caps.