Rex says
Money math without the spreadsheet headache. Plug in your numbers and I'll show you exactly where the dollars land.
Try a scenario
Click to load — tweak from there.Inputs
Result
Estimated annual pediatric cost
$255
Well-visit copays
$0
Sick-visit copays
$120
Urgent care copays
$75
Monthly equivalent
$21
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How to use this
- 1Enter child's age group.
- 2Enter well-visit copay ($).
- 3Enter sick-visit copay ($).
- 4Enter expected sick visits per year.
- 5Enter urgent care copay ($).
- 6Enter expected urgent care visits per year.
- 7Enter prescription copays per year total ($).
- 8Read your estimated annual pediatric cost on the right — it updates as you type.
- 9Hit Share to keep the scenario or send it to someone.
About this calculator
The AAP recommends specific well-child visit counts by age — far more frequent in year one (about 6-7 visits) than later childhood (1 per year), plus sick visits that spike with daycare or school entry. This calculator multiplies expected visit counts by your plan's copay, adds an estimate for sick visits and one urgent care trip, and gives an annual pediatric cost estimate so you can budget it into your healthcare spending or HSA/FSA contribution decision.
Worked example
Using the values the calculator loads with:
Inputs
- Child's age group: Toddler (1-3 years) — ~4 well visits/yr
- Well-visit copay: 0 $
- Sick-visit copay: 30 $
- Expected sick visits per year: 4
- Urgent care copay: 75 $
- Expected urgent care visits per year: 1
- Prescription copays per year total: 60 $
Results
- Estimated annual pediatric cost: $255
- Well-visit copays: $0
- Sick-visit copays: $120
- Urgent care copays: $75
- Monthly equivalent: $21
What each field means
Inputs
- Child's age group
- Pick the option that matches your situation — the maths changes per option. Choices: Infant (0-12 months) — ~7 well visits/yr, Toddler (1-3 years) — ~4 well visits/yr, Child (4-10 years) — 1 well visit/yr, Teen (11-18 years) — 1 well visit/yr.
- Well-visit copay ($)
- The well-visit copay used in the calculation, measured in $. Starts at 0 $ so you have a working example on load.
- Sick-visit copay ($)
- The sick-visit copay used in the calculation, measured in $. Starts at 30 $ so you have a working example on load.
- Expected sick visits per year
- The expected sick visits per year used in the calculation. Starts at 4 so you have a working example on load. Accepted range: 0–15.
- Urgent care copay ($)
- The urgent care copay used in the calculation, measured in $. Starts at 75 $ so you have a working example on load.
- Expected urgent care visits per year
- The expected urgent care visits per year used in the calculation. Starts at 1 so you have a working example on load. Accepted range: 0–6.
- Prescription copays per year total ($)
- The prescription copays per year total used in the calculation, measured in $. Starts at 60 $ so you have a working example on load.
Results
- Estimated annual pediatric cost
- Returned as a money amount in US dollars and shown as the headline result. It recalculates instantly whenever you change an input, so you can compare scenarios without reloading.
- Well-visit copays
- Returned as a money amount in US dollars. It recalculates instantly whenever you change an input, so you can compare scenarios without reloading.
- Sick-visit copays
- Returned as a money amount in US dollars. It recalculates instantly whenever you change an input, so you can compare scenarios without reloading.
- Urgent care copays
- Returned as a money amount in US dollars. It recalculates instantly whenever you change an input, so you can compare scenarios without reloading.
- Monthly equivalent
- Returned as a money amount in US dollars. It recalculates instantly whenever you change an input, so you can compare scenarios without reloading.
FAQ
Are well-child visits really free?
Under the ACA, most non-grandfathered plans cover recommended preventive care, including well-child visits and standard vaccines, at $0 cost-sharing when done in-network. If your plan charges a well-visit copay, double check it's not billing a diagnosis code for something addressed during the visit, which can trigger a sick-visit charge instead.
Why do infants need so many more visits?
The AAP's Bright Futures schedule calls for checkups at 3-5 days, 1, 2, 4, 6, 9, and 12 months to track rapid growth and development and deliver the vaccine schedule on time. That front-loads well-visit frequency dramatically compared to later childhood.
How much do sick visits typically run without insurance?
A cash-pay pediatric sick visit commonly runs $100-200 depending on region and complexity, before any labs or strep/flu testing, which can add $30-80 each. This is why even a modest-copay insurance plan usually pays for itself quickly once a kid starts daycare or school and gets sick more often.
Accuracy and limitations
- Results are estimates before tax, fees, and inflation unless an input explicitly covers them.
- Rates are treated as fixed for the whole period — variable-rate products will drift from this projection.
- This is educational maths, not financial advice. Check anything contractual with the lender or your accountant.
Related tools
Cite this calculator
Writing about this topic? Grab a citation — every link helps keep these tools free.
RevenueLab. (2026). Pediatric Copay Budget Calculator. Retrieved from https://www.revenuelab.fyi/toolbox/pediatric-copay-budget
<p>Source: <a href="https://www.revenuelab.fyi/toolbox/pediatric-copay-budget" target="_blank" rel="noopener">Pediatric Copay Budget Calculator — RevenueLab</a> (2026).</p>
Source: [Pediatric Copay Budget Calculator — RevenueLab](https://www.revenuelab.fyi/toolbox/pediatric-copay-budget) (2026).