Accumulator

An accumulator is a running total of your out-of-pocket costs (opens in new tab) for covered services (opens in new tab), as processed by your health insurance company. This total is based on the claims your doctors and facilities submit to your insurer, and includes amounts you owe for copays, coinsurance, and deductibles for covered services. It does not include your monthly premium (opens in new tab) payments.

Your health insurance company collects this information from the medical claims (opens in new tab) submitted by your doctors for care you received. Since it can sometimes take awhile for these claims to be submitted, your accumulator total will likely lag behind your actual out-of-pocket spending.

Once your accumulator hits the plan’s deductible amount, your health care costs will change based on your plan design. Once you hit your out-of-pocket max, your insurance company will be responsible for all of your covered medical costs for the rest of the year.

Word to the wise. If you switch to a new plan or metal tier at the same insurer within the same calendar year, your accumulator amount will generally stay the same. If you switch insurers, move into a Medicare plan, or go from a family plan to an individual plan, your accumulator amount won’t transfer over.