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HSA vs FSA Calculator
Tax savings from an HSA or health FSA with your state's rules, and the FSA money you could lose.
Money tool · Open enrollment
HDHP vs PPO Calculator: Which Health Plan Costs You Less?
Enter your employer's plans and how much care you expect. See the total yearly cost of each, the worst case, the break-even point and what the HSA's tax savings are really worth.
Your plans and your situation
Cheapest plan for your expected bills
HDHP saves $642
a year, after premiums, out-of-pocket costs, employer HSA money and tax savings
Estimate · 2027 plan year
- Plan A: yearly cost
- $906 (HDHP)
- Plan B: yearly cost
- $1,548 (PPO)
- Plan C: yearly cost
- —
- Break-even bills (Plan A vs Plan B)
- $2,141
- Lowest worst case (after tax and HSA money)
- HDHP
- HDHP costs less if your medical bills stay under about $2,141 for the year; above that, PPO costs less.
- Worst case (you hit the out-of-pocket maximum): HDHP $4,078, PPO $4,148 after tax savings and HSA money. Cash you'd need to cover premiums and the maximum: HDHP $5,988, PPO $4,800.
- HDHP: $600 from your employer plus $300 of your own HSA money to pay your share of the bills, saving about $89 in tax. Putting in the remaining $3,600 (up to the $4,500 limit) would save about $929 more in tax and build savings you keep; that isn't counted in the plan's cost.
- PPO: putting $900 in a health FSA (sized to your expected costs) saves about $267 in tax. The election is fixed for the year: if your bills come in lower, money you don't spend is lost unless your plan has a carryover or grace period. The table and break-even assume you'd size the FSA to each level of bills.
- Copays are treated like coinsurance after the deductible. If a plan charges flat copays for visits and prescriptions before the deductible (common on PPOs), its cost in a low-use year is lower than shown.
| Medical bills | HDHP | PPO |
|---|---|---|
| $0 | $95 | $915 |
| $1,000 | $976 | $1,618 |
| $2,500 | $2,032 | $1,829 |
| $5,000 | $2,383 | $2,181 |
| $10,000 | $3,176 | $2,944 |
| $25,000 | $4,078 | $3,526 |
How this was calculated
Yearly cost = your premiums (per paycheck × paychecks) + what you pay toward the medical bills (all of it up to the deductible, then your coinsurance share, capped at the out-of-pocket maximum) − the employer's HSA deposit − the tax you save on premiums and on pre-tax HSA or FSA money (federal income tax, Social Security, Medicare and state tax). California and New Jersey tax HSA money, including the employer's deposit, and New Jersey also taxes premiums and FSA money. Premiums are assumed to come out of pay pre-tax, as they do in most employer plans.
Only the HSA money that pays your share of the bills (beyond the employer's deposit) counts toward the plan's cost; anything more is savings you keep, and the note shows the extra tax it would save. With a PPO you can pay costs through a health FSA, elected once for the year to match your expected costs (up to the $3,400 2026 limit). The table and break-even compare plans as if you'd sized the FSA for each level of bills; the worst case keeps the FSA you'd elect for your expected bills. The worst case is your cost when bills reach the out-of-pocket maximum; the notes also show the cash you'd need (premiums + maximum). Break-even points are found for Plan A vs Plan B, every crossing up to $200,000 of bills. Copays are treated like coinsurance after the deductible, which overstates a copay plan's cost in a low-use year. Family bills are one pool against the family deductible. Taxes use 2026 rules until the 2027 rules are final.
Calculation savings.health-plans v1.1.0.
Quick answer: is an HDHP or a PPO cheaper?
If you don't expect much care, the HDHP is often cheaper: lower premiums, employer HSA money and tax savings can outweigh the higher deductible. It depends on the plans: a PPO with flat copays for visits and prescriptions can cost less in a light year, and a PPO wins once your bills pass the break-even point, especially when its out-of-pocket maximum is much lower and you expect a big year. Half of people with employer coverage have under about $900 a year in total care costs (what insurers and patients pay together), and 20% have none (EBRI).
With the example plans in the calculator (single coverage, $70,000 salary, no state tax):
| Medical bills | HDHP | PPO | Cheaper |
|---|---|---|---|
| $0 | $95 | $915 | HDHP |
| $900 | $906 | $1,548 | HDHP |
| $2,500 | $2,032 | $1,829 | PPO |
| $5,000 | $2,383 | $2,181 | PPO |
| $10,000 | $3,176 | $2,944 | PPO |
| $25,000 | $4,078 | $3,526 | PPO |
Here the HDHP is cheaper if your bills stay under about $2,141; above that, the PPO's lower deductible and out-of-pocket maximum win. Each row assumes the PPO user puts the expected costs in a health FSA. Your employer's numbers will differ, so enter them.
How to compare health plans the right way
Comparing deductibles alone is the most common mistake. Add up the total yearly cost of each plan:
- Premiums: your share per paycheck × paychecks a year.
- Out-of-pocket costs: what you pay before the deductible is met, then your coinsurance share (often 20%), up to the out-of-pocket maximum (HealthCare.gov).
- Minus employer HSA money on an HDHP.
- Minus tax savings on premiums and on HSA or FSA money.
Then check the worst case (premiums + out-of-pocket maximum) to make sure you could afford a bad year, and the break-even point: the level of bills where the two plans cost the same.
2026 and 2027 HSA and HDHP limits
| 2026 | 2027 | |
|---|---|---|
| HSA contribution limit, self-only | $4,400 | $4,500 |
| HSA contribution limit, family | $8,750 | $9,000 |
| HSA catch-up, age 55+ | $1,000 | $1,000 |
| HDHP minimum deductible, self-only | $1,700 | $1,750 |
| HDHP minimum deductible, family | $3,400 | $3,500 |
| HDHP out-of-pocket maximum, self-only | $8,500 | $8,700 |
| HDHP out-of-pocket maximum, family | $17,000 | $17,400 |
| ACA out-of-pocket maximum (any plan), self-only | $10,600 | $12,000 |
| ACA out-of-pocket maximum (any plan), family | $21,200 | $24,000 |
Sources: Rev. Proc. 2025-19, Rev. Proc. 2026-24, HealthCare.gov and CMS. A plan must meet the HDHP deductible minimum and out-of-pocket maximum for you to contribute to an HSA. Employer HSA contributions count toward your limit.
What the HSA's tax savings are really worth
Money you put in an HSA through payroll skips federal income tax, Social Security and Medicare and, in most states, state income tax. It grows tax-free and comes out tax-free for medical costs (IRS Pub. 969). On a $70,000 salary in a state with no income tax that's up to about 30 cents saved per dollar (more with state tax), and unused money rolls over every year. After 65 you can withdraw for anything, paying income tax like a traditional IRA; before 65, non-medical withdrawals owe tax plus a 20% penalty.
California and New Jersey don't exclude HSA contributions from state income tax (Newfront); there you lose the state part of the saving on HSA money, and the employer's HSA deposit is taxed as state wages. New Jersey also taxes payroll health premiums and FSA money, because it doesn't follow the federal cafeteria-plan exclusion (NJ Division of Taxation); California does exclude those. Contributions made outside payroll still get the federal deduction but not the Social Security and Medicare saving.
When an HDHP makes sense, and when a PPO does
| An HDHP usually wins if… | A PPO usually wins if… |
|---|---|
| You expect few doctor visits or prescriptions | You have regular specialist visits or costly prescriptions that fall below the deductible |
| Your employer puts money in the HSA | The PPO's out-of-pocket maximum is much lower and you expect a big year |
| You can cover the deductible from savings | A surprise bill of a few thousand dollars would be hard to pay |
| You want to save extra for health costs in retirement | You need doctors that only the PPO network includes |
Preventive care (checkups, screenings, vaccines) is free on both. HDHPs can also cover some care for chronic conditions before the deductible, such as blood-pressure monitors, statins and glucometers (IRS Notice 2019-45), and insulin and continuous glucose monitors (IRS Notice 2024-75); check your plan's list.
Family coverage, deductibles and a baby on the way
Family HDHPs often have an aggregate deductible: the whole family must meet it before the plan pays. Others have an embedded deductible per person, which can't be below the family HDHP minimum ($3,500 in 2027). Either way, no one person can pay more than the ACA's self-only out-of-pocket cap ($12,000 in 2027) (DOL). The calculator treats family bills as one pool, which is the cautious case.
Pregnancy, childbirth and postpartum care average about $20,416 in total costs, with $2,743 paid out of pocket by people with employer coverage, and the newborn's first months add about $5,820 ($475 out of pocket) (Peterson-KFF). The calculator's "having a baby" option uses both: $26,236. With example family plans (HDHP: $3,120 premiums, $5,000 deductible, $10,000 maximum; PPO: $5,720 premiums, $2,000 deductible, $8,000 maximum), a birth year costs HDHP $8,591 vs PPO $10,425 after tax savings. Neither plan reaches its out-of-pocket maximum here (out-of-pocket costs HDHP $9,247, PPO $6,847); the HDHP comes out ahead on lower premiums, the employer's $1,300 HSA deposit and the HSA tax saving. If the due date is near January, costs can land in two plan years and two deductibles.
What employer plans look like in 2025
- Average yearly premiums: $9,818 single and $28,272 family for PPOs; $8,620 and $25,379 for HDHPs with savings options (total cost, including the employer's share).
- Among workers with a deductible, the average for single coverage was $1,886; typical copays $27 for primary care and $45 for a specialist, and coinsurance around 20%.
- 46% of covered workers were in PPOs and 33% in HDHPs with a savings option.
Source: KFF 2025 Employer Health Benefits Survey (summary); the 2026 survey is expected in late October.
New HSA rules from 2026
The 2025 tax law expanded HSAs starting in 2026 (IRS Notice 2026-5):
- HDHPs can cover telehealth before the deductible, permanently (for plan years from 2025).
- Bronze and catastrophic Marketplace plans count as HDHPs, so their members can open an HSA.
- Direct primary care memberships up to $150 a month ($300 for a family) don't block HSA contributions and can be paid from the HSA.
Open enrollment checklist
- Get each plan's summary of benefits: premium per paycheck, deductible, coinsurance, copays and out-of-pocket maximum.
- Check that your doctors and prescriptions are in each network and formulary.
- Estimate next year's care from this year's bills and anything planned (surgery, a baby).
- Compare total yearly cost and the worst case in the calculator.
- If you pick the HDHP, set your HSA contribution (the HSA and FSA calculator shows the tax saved per paycheck); if you pick a PPO, consider a health FSA.
Common questions
Is an HDHP worth it if I'm healthy?
Often, yes: you usually pay less in premiums, may get employer HSA money, and save tax on what you put in. But compare the actual plans, since a PPO with low copays can still win, and make sure you could cover the deductible if something happens.
What's the difference between a deductible and an out-of-pocket maximum?
The deductible is what you pay before the plan starts sharing costs; the out-of-pocket maximum is the most you'll pay in a year for in-network care, after which the plan pays 100%.
Can I switch plans mid-year?
Usually only at open enrollment or after a qualifying life event like marriage, a birth or losing other coverage.
Does the HSA money go away if I change jobs?
No. The HSA is yours, including employer contributions once deposited, and you can keep spending it even without an HDHP.
Sources
- Revenue Procedure 2025-19 (2026 HSA and HDHP amounts) — Internal Revenue Service. Accessed October 15, 2026.
- Revenue Procedure 2026-24 (2027 HSA and HDHP amounts) — Internal Revenue Service. Accessed October 15, 2026.
- Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans — Internal Revenue Service. Accessed October 15, 2026.
- Notice 2026-5 (HSA changes under the 2025 law) — Internal Revenue Service. Accessed October 15, 2026.
- IRS expands list of preventive care for HSA participants (Notice 2019-45) — Internal Revenue Service. Accessed October 15, 2026.
- Notice 2024-75 (more preventive care for HDHPs, including insulin) — Internal Revenue Service. Accessed October 15, 2026.
- Out-of-pocket maximum/limit — HealthCare.gov. Accessed October 15, 2026.
- 2027 premium adjustment percentage and maximum out-of-pocket guidance — Centers for Medicare & Medicaid Services. Accessed October 15, 2026.
- ACA FAQs Part 27 (self-only out-of-pocket limit within other coverage) — U.S. Department of Labor. Accessed October 15, 2026.
- 2025 Employer Health Benefits Survey — KFF. Accessed October 15, 2026.
- 2025 Employer Health Benefits Survey, Summary of Findings — KFF. Accessed October 15, 2026.
- Most insured individuals use relatively little health care (Fast Facts #550) — Employee Benefit Research Institute. Accessed October 15, 2026.
- Health costs associated with pregnancy, childbirth and postpartum care — Peterson-KFF Health System Tracker. Accessed October 15, 2026.
- California and New Jersey HSA state income tax — Newfront. Accessed October 15, 2026. Benefits consultant summary.
- TB-39(R): Cafeteria plans and New Jersey gross income tax — New Jersey Division of Taxation. Accessed October 15, 2026.
- Coinsurance — HealthCare.gov. Accessed October 15, 2026.
The example plans are illustrations, not averages. Research checked October 15, 2026. This is an estimate, not insurance or tax advice.