Healthcare Cost Savings Calculator

Compare an HDHP + HSA against a PPO — see which plan actually costs you less, your HSA tax savings, and your break-even. Free, no signup.

Sets the 2026 HSA contribution limit and out-of-pocket maximums used below.

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Lower premium, higher deductible — and the only plan type that lets you open an HSA. For 2026 an HDHP needs a deductible of at least $1,700 self-only / $3,400 family.

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Higher premium, lower deductible and more predictable cost-sharing — but no HSA. Copays can be folded into your expected spend below.

$3,000

Your best guess at the year's covered costs — visits, tests, prescriptions, procedures. The break-even result shows how sensitive the answer is to this number.

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Free money many employers add to your HSA with an HDHP. It lowers the HDHP's net cost and counts toward your annual contribution limit.

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2026 limit: $4,400 self-only — your contribution plus the employer's must stay within this.

HSA contributions cut income tax (and FICA if made through payroll). Note: a few states — notably California and New Jersey — still tax HSA contributions, so verify your state.

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A pre-tax FSA you can pair with the PPO. It cuts income tax on the amount you contribute, but it is mostly use-it-or-lose-it, so don't over-fund it.

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A good year and a bad year. The scenario strip shows which plan wins in each, so you can see how robust the recommendation is.

Changes formatting only; it does not convert your figures at live exchange rates. The 2026 tax limits assume U.S. dollars.

For educational purposes only. This calculator illustrates the math of health-plan costs and HSA tax savings — it is not medical, tax, insurance, or financial advice and should not be the sole basis for choosing a health plan. It simplifies real plans (copays, prescription tiers, provider networks, per-member details) and all figures are estimates based on what you enter. Check your official plan documents and, for tax questions, a qualified professional — and note that a few states tax HSA contributions.

This free healthcare cost savings calculator answers the question every open enrollment raises: is the HDHP with an HSA actually cheaper than the PPO? It compares the true net annual cost of each — premiums, out-of-pocket spend, the employer's HSA money and your tax savings — and shows the break-even where the answer flips.

Pick Basic for a fast answer or Advanced for the full picture. Enter both plans and your expected spend, click Compare, and every number updates instantly — your figures never leave your browser. Updated with 2026 IRS limits.

From Two Plans to a Clear Answer in Three Steps

No account, no email, no limits. Just a clear, dollar-for-dollar comparison of what each plan really costs you.

1

Enter Both Plans

Add each plan's monthly premium, deductible, coinsurance and out-of-pocket max — straight from your benefits summary — plus any employer HSA contribution.

2

Estimate Your Year

Set your expected medical spend. In Advanced mode, add your HSA contribution, tax bracket and FICA so the HSA tax break counts too.

3

See Which Plan Wins

Get each plan's net annual cost, your yearly savings, the break-even spend, and a chart of how the two costs cross as spending rises.

What 2026 Health Coverage Really Costs

Premiums, deductibles and tax limits set the whole comparison. A few figures worth knowing before you decide.

$9,325
average annual premium for single employer coverage in 2025 ($26,993 for a family)
KFF 2025 Employer Health Benefits Survey
$4,400
2026 HSA contribution limit for self-only coverage — $8,750 for a family, plus $1,000 catch-up at 55+
IRS Rev. Proc. 2025-19
$1,700
2026 minimum HDHP deductible (self-only); $3,400 for family — the threshold that makes you HSA-eligible
IRS Rev. Proc. 2025-19
~$2,700+
tax a family can save by maxing a $8,750 HSA in a 24% bracket plus FICA on payroll contributions
Illustrative, this calculator's math

The Cheaper Sticker Price Isn't Always the Cheaper Plan

Picking by premium alone — or by deductible alone — can cost you four figures a year. The only way to know is to add it all up.

Compare the Whole Year

Premium, deductible, coinsurance and the out-of-pocket max all interact. We total them at your expected spend so you see the real cost, not the headline.

Know Your Break-Even

There's a spending level where the two plans tie. Below it the HDHP wins; above it the PPO does. We solve for it so you can judge your own year.

Capture the HSA Tax Break

The HSA's triple tax advantage can tip the math toward the HDHP — and, invested, it doubles as a tax-free retirement account. We count both.

Stress-Test a Bad Year

A healthy year and a heavy one can favor different plans. The scenario view shows which plan wins in each, so you choose with eyes open.

How Health Plan Costs Actually Work

Five moving parts decide what a plan costs you. Understanding how they stack is the whole game.

Your total cost for a year is the premium you pay no matter what plus the share of your medical bills the plan makes you cover. That second part climbs as you spend — but only up to a ceiling.

Cost pieceWhat it isWhen it bites hardest
PremiumThe fixed amount you pay every month to have the planAlways — even in a year you never see a doctor
DeductibleYou pay 100% of covered costs until you reach itLower-spend years; HDHPs have the highest deductibles
CoinsuranceYour percentage share of the bill after the deductible (e.g. 20%)The middle band of spending
CopayA flat fee per visit or prescriptionFrequent visits and ongoing medications
Out-of-pocket maxThe hard ceiling on what you'll pay in a year; the plan then covers 100%High-spend years — it caps the damage

So an HDHP's low premium is offset by a high deductible, while a PPO's higher premium buys a lower deductible and more predictable copays. Which is cheaper depends entirely on how much care you use — which is exactly what the calculator models.

HDHP + HSA vs PPO, Side by Side

Same coverage, opposite shapes. One bets on a healthy year; the other buys predictability.

HDHP + HSAPPO
Monthly premiumLowerHigher
DeductibleHigher (2026: ≥ $1,700 self / $3,400 family)Lower
Cost predictabilityLess, until you hit the out-of-pocket maxMore — flat copays from day one
HSA eligibleYes — triple tax-advantagedNo (an FSA is the usual pairing)
Unused moneyStays yours, rolls over, can be investedYou simply paid a higher premium
Best forHealthy/low spenders & long-term investorsSteady or high medical needs

The HDHP wins when you spend little (you bank the premium difference and the HSA tax break); the PPO wins when you spend a lot (its lower deductible caps your costs sooner). The break-even spend is the dividing line — and a generous employer HSA contribution pushes that line in the HDHP's favor.

The HSA Triple Tax Advantage

No other account is tax-free on the way in, while it grows, and on the way out. That's what can tip the whole comparison.

1 · Going in

Contributions are tax-deductible — or pre-tax through payroll, which also dodges the 7.65% FICA tax.

2 · Growing

Invested or not, the balance grows 100% tax-free — no tax on interest, dividends or gains, ever.

3 · Coming out

Spending on qualified medical care is tax-free at any age. After 65, anything else is taxed like a traditional IRA.

A 401(k) is taxed when you withdraw it; a Roth is taxed going in. Only the HSA escapes tax at all three stages — which is what can quietly turn it into a retirement account.

HSA vs FSA vs HRA

HSA · yours

Requires an HDHP, owned by you, rolls over in full forever, and can be invested. The only one that's truly yours to keep and grow.

FSA

Pairs with any plan but is employer-owned, capped at $3,400 for 2026, mostly use-it-or-lose-it, and can't be invested.

HRA

Fully employer-funded and employer-owned; it reimburses qualified expenses under rules your employer sets.

The 2026 Numbers, in One Place

Set by IRS Revenue Procedure 2025-19 (and the 2026 FSA limit). These drive the calculator's defaults and caps.

2026 figureSelf-onlyFamily
HSA contribution limit$4,400$8,750
HSA catch-up (age 55+)+$1,000+$1,000
HDHP minimum deductible$1,700$3,400
HDHP out-of-pocket max$8,500$17,000
Health FSA limit$3,400$3,400

To be HSA-eligible, your plan's deductible must be at or above the minimum and its out-of-pocket max at or below the ceiling. Your contribution plus your employer's must stay within the annual limit. Figures from the IRS via SHRM; FSA limit via IRS guidance.

Which Plan Fits Your Situation?

A rough guide. Run your real numbers above — but this is usually how it shakes out.

Your situationOften the better fit
Healthy, rarely use care beyond check-upsHDHP + HSA
Want to invest the HSA and grow it tax-freeHDHP + HSA
Your employer adds a generous HSA contributionHDHP + HSA
Chronic condition or frequent specialist visitsPPO
Planning a baby, surgery, or major procedurePPO
Costly brand-name prescriptions every monthPPO
Your expected spend lands near the break-evenWhichever has the better network and cash flow

Cash flow matters too: an HDHP can leave you facing a big bill before the deductible is met, so a fully-funded HSA (or savings) to cover that gap is part of choosing it wisely.

An HSA Is a Stealth Retirement Account

If you can pay today's smaller bills out of pocket and leave the HSA invested, the math gets powerful.

Invest, don't spend

Most providers let you invest the HSA balance above a small cash buffer. Pay current costs from cash flow and the account compounds tax-free.

Tax-free for medical, forever

Save receipts and you can reimburse yourself tax-free years later — and retirees face large lifetime medical costs the HSA is built to cover.

Like an IRA after 65

From age 65, non-medical withdrawals are just taxed as income — no penalty — so the HSA works like a traditional IRA with a medical superpower.

See it projected

Turn on HSA growth in Advanced mode to project the tax-free balance at retirement and the share that's pure investment growth.

How to Lower Your Healthcare Costs

Beyond picking the right plan, a handful of habits quietly save real money every year.

Use tax-advantaged dollars. Pay medical costs from an HSA or FSA so every dollar is pre-tax — an instant 20–35% discount at most brackets.
Choose generics and 90-day fills. Generic drugs and mail-order 90-day supplies are dramatically cheaper than brand-name, single-month refills.
Stay in-network and use telehealth. Out-of-network care can blow past your out-of-pocket-max protections; telehealth visits are often a fraction of an in-person copay.
Ask for an itemized bill and negotiate. Hospital bills contain errors and inflated charges; itemized bills, cash-pay rates and payment plans can cut them substantially.
Take the free preventive care. ACA-compliant plans cover preventive visits, screenings and vaccines at no cost — catching problems early is the cheapest care there is.
Check marketplace subsidies. Without employer coverage, premium tax credits and cost-sharing reductions on HealthCare.gov can sharply lower your net costs.
Invest the HSA. If your cash flow allows, leave the HSA invested and let the triple-tax-free growth compound for decades.

Common Health-Plan Mistakes

The errors that quietly cost people the most at enrollment.

Picking by premium alone. The lowest premium can be the most expensive plan once a high deductible is in play.
Ignoring the employer's HSA contribution. Free employer money can more than offset an HDHP's higher deductible — always count it.
Forgetting the out-of-pocket max. Even a terrible health year is capped; the HDHP's downside is smaller than the deductible alone suggests.
Over-funding an FSA. Unlike an HSA, most FSA money is use-it-or-lose-it — contribute only what you're confident you'll spend.
Leaving the HSA in cash. An un-invested HSA forfeits its biggest advantage; for money you won't need soon, invest it.
Using HSA funds for non-qualified expenses before 65. That triggers income tax plus a 20% penalty — keep withdrawals to qualified medical costs.
One transparent model, not a quote. Real plans add copays, separate prescription tiers, provider networks and per-family-member details this tool simplifies. Use it to understand the trade-off and narrow the choice — then confirm the specifics in your official plan documents.

How the Comparison Is Calculated

No black box. Here is exactly what happens to your numbers.

The tool compares the net annual cost of each plan. Net cost is what the year actually takes out of your pocket: the premiums you pay plus your share of medical bills, minus the money the HDHP gives back through the employer's HSA contribution and your tax savings.

It totals each plan's cost

For each plan: net cost = 12 × monthly premium + out-of-pocket(spend) − employer HSA − tax savings. The lower number wins. The PPO side subtracts any FSA tax savings instead of HSA savings.

It models out-of-pocket the way real plans do

Your out-of-pocket cost rises in three stages: you pay 100% up to the deductible, then your coinsurance share of everything above it, until you hit the out-of-pocket maximum and the plan covers the rest: OOP = min( deductible + coinsurance × (spend − deductible), out-of-pocket max ).

HDHP + HSA PPO break-even low spend high spend
As spending rises, the HDHP's cost climbs faster. Where the lines cross is the break-even spend.

It counts the HSA tax break (Advanced)

Your HSA contribution is multiplied by your tax shield — marginal income tax + state tax (+ 7.65% FICA if via payroll) — capped so your contribution plus the employer's stays within the 2026 limit ($4,400 self-only / $8,750 family, +$1,000 at 55+). The PPO can take a parallel FSA tax deduction (2026 limit $3,400).

It finds the break-even and stress-tests it (Advanced)

It scans the full range of medical spend to find where the two net-cost curves cross — the break-even — and reports which plan wins in a low, expected and high spend year so you can see how robust the recommendation is.

It projects the HSA as an investment (Advanced)

If you choose to invest the HSA, it compounds your annual contribution at your chosen return for the years you set — all tax-free — and shows the projected balance, total contributed, and pure growth, with an optional today's-dollars adjustment.

A worked example

Family coverage; HDHP at $250/mo with a $3,400 deductible and $7,000 out-of-pocket max, vs a PPO at $560/mo with a $1,500 deductible; $1,000 employer HSA; $6,000 expected spend; 24% bracket:

  1. HDHP premiums are ~$3,720/yr lower than the PPO's — a big head start.
  2. At $6,000 of spend the HDHP's out-of-pocket is higher, but the employer's $1,000 and the HSA tax savings narrow the gap.
  3. The tool reports each plan's net cost, the cheaper one, and the break-even spend where they tie.
  4. The Show example button loads a starting point like this instantly.
A note on estimates. This is an educational model, not advice. It uses the assumptions you enter and simplifies real plans — copays, separate prescription tiers, provider networks and per-member details. It is not medical, tax, insurance or financial advice. A few states (notably California and New Jersey) tax HSA contributions at the state level. Confirm specifics in your official plan documents and, for tax questions, with a qualified professional. sem.chat does not provide medical, tax, or financial advice.

Sources & Further Reading

The official limits and published data behind the figures on this page.

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Frequently Asked Questions

HDHP, HSA, PPO and the 2026 rules — answered in plain English.

An HDHP (high-deductible health plan) has a lower monthly premium but a higher deductible, and it's the only plan type that lets you open a Health Savings Account (HSA). A PPO usually costs more in premium but has a lower deductible and more predictable copays. The HDHP+HSA tends to win if you're healthy and don't spend much, or if you can invest the HSA; a PPO often wins if you have steady, higher medical costs. This calculator compares the true net annual cost of each using your own numbers.
For 2026 the IRS defines an HDHP as a plan with a minimum deductible of $1,700 for self-only coverage or $3,400 for family coverage, and an out-of-pocket maximum no higher than $8,500 (self-only) or $17,000 (family). Only an HDHP makes you eligible to contribute to an HSA.
For 2026 you can contribute up to $4,400 with self-only HDHP coverage or $8,750 with family coverage, plus an extra $1,000 catch-up if you're 55 or older. Any money your employer adds counts toward these limits, so your own room is the limit minus the employer contribution.
Often yes if you're relatively healthy: the lower premium plus the HSA tax break can beat a PPO even after paying more out of pocket, and anything you don't spend stays yours and can be invested tax-free. It's usually not worth it if you have high, predictable medical costs that push you to the out-of-pocket maximum every year. The calculator's break-even spend shows exactly where the trade-off flips for your plans.
A PPO tends to cost less overall when your annual medical spend is high and steady — chronic conditions, regular specialist visits, pregnancy, or expensive prescriptions — because its lower deductible and copays cap your costs sooner. If you reliably spend above the break-even point this tool calculates, the PPO usually wins.
It's the level of annual medical spending at which the two plans cost you exactly the same once premiums, out-of-pocket costs, employer HSA money and tax savings are all counted. Below it the HDHP+HSA is cheaper; above it the PPO is cheaper. This calculator solves for that number so you can judge which side of it you're likely to fall on.
HSA contributions are tax-deductible (or pre-tax through payroll), the balance grows tax-free, and withdrawals for qualified medical expenses are tax-free too — three tax breaks in one account, which no other account offers. That's what can make an HSA more valuable than the premium gap alone suggests.
Yes. Many HSA providers let you invest the balance above a small cash threshold in funds, and the growth is tax-free. If you can pay current medical costs out of pocket and leave the HSA invested, it can become a powerful long-term, tax-free medical and post-65 retirement fund. Advanced mode projects this growth over the years to retirement.
An HSA requires an HDHP, is owned by you, rolls over fully every year, and can be invested. A health FSA (limit $3,400 for 2026) is employer-owned, mostly use-it-or-lose-it apart from a small carryover, and can't be invested — but you can pair one with a PPO. Advanced mode lets you add FSA tax savings to the PPO side.
After 65 you can withdraw HSA funds for any reason without the 20% penalty; non-medical withdrawals are simply taxed as ordinary income, like a traditional IRA, while withdrawals for qualified medical expenses stay tax-free at any age. That's why an invested HSA doubles as a retirement account.
Most doctor visits, prescriptions, dental and vision care, and many other IRS-listed health costs qualify for tax-free HSA or FSA spending; IRS Publications 502 and 969 have the full list. Using HSA money for non-qualified expenses before age 65 triggers income tax plus a 20% penalty.
Yes. Any money your employer puts into your HSA counts against the annual limit ($4,400 self-only or $8,750 family for 2026), so your own contribution room is the limit minus what your employer adds. The calculator caps your contribution so the total stays within the limit.
In Advanced mode you can include the 7.65% FICA savings that apply when HSA contributions are made through payroll, and enter a state tax rate. Note that a few states — notably California and New Jersey — tax HSA contributions at the state level, so verify your state's rules, as the tool can't track every state.
It's a clear, transparent model based on the numbers you enter: premiums, deductible, coinsurance, out-of-pocket maximum, expected spend, contributions and tax rate. Real plans have copays, separate prescription tiers, provider networks and per-family-member nuances it simplifies, so treat it as a strong estimate to inform a decision, not an exact quote.
No. It's a free educational tool that illustrates the math of health-plan costs and HSA tax savings. It's not medical, tax, insurance or financial advice and doesn't account for your full situation. Confirm specifics with your plan documents and a qualified professional before deciding.
Yes — 100% free with no signup. Everything is calculated instantly in your browser and your numbers never leave your device. sem.chat is an AI chat and voice product; this tool is a free resource, not a lead form.

Health Plan Terms, in Plain English

The concepts behind the calculator — what they mean and why they matter.

HDHP (high-deductible health plan)
A plan with a higher deductible and lower premium; for 2026, a deductible of at least $1,700 self-only or $3,400 family — and the only plan type that allows an HSA.
HSA (Health Savings Account)
A tax-advantaged account paired with an HDHP, owned by you, that rolls over every year and can be invested tax-free.
PPO (Preferred Provider Organization)
A plan with a higher premium but a lower deductible and copays, and a flexible provider network.
Premium
The fixed amount you pay each month to have coverage, whether or not you use any care.
Deductible
The amount you pay out of pocket each year before the plan starts sharing the cost of covered care.
Coinsurance
The percentage of a covered bill you pay after meeting the deductible, until you reach the out-of-pocket maximum.
Copay
A fixed dollar amount you pay for a specific service, such as $30 for a doctor visit.
Out-of-pocket maximum
The most you'll pay for covered care in a year; after reaching it the plan pays 100%. For 2026 an HDHP's can't exceed $8,500 self-only / $17,000 family.
FSA (Flexible Spending Account)
An employer-owned, pre-tax health account (2026 limit $3,400) that's mostly use-it-or-lose-it and can pair with a PPO.
HRA (Health Reimbursement Arrangement)
An employer-funded, employer-owned account that reimburses qualified medical expenses.
Triple tax advantage
The HSA's unique combination of tax-deductible contributions, tax-free growth, and tax-free withdrawals for qualified medical expenses.
Qualified medical expense
An IRS-approved health cost — doctor visits, prescriptions, dental, vision and more — that can be paid tax-free from an HSA or FSA.
Catch-up contribution
An extra $1,000 per year that HSA holders aged 55 and older can contribute on top of the standard limit.
Marginal tax rate
The income-tax rate on your next dollar of income; it sets how much each HSA or FSA dollar saves you in tax.
FICA
The 7.65% Social Security and Medicare payroll tax; HSA contributions made through payroll also avoid it.
Break-even spend
The annual medical spend at which the HDHP+HSA and the PPO cost the same; below it the HDHP wins, above it the PPO wins.

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