Health plan chooser: compare a PPO and an HSA plan by what a year costs

Which health plan costs me least over a year, and what is its worst case?

Compare health plans by a year of cost, not by premium

Enter each plan's premium and cost-sharing and how much care you expect to use. The lab adds up premiums and what you pay, subtracts the HSA or FSA tax savings, and shows a worst case. The values shown are samples.

Your year

Coverage

Care you expect to use

Your federal tax rate

Your state income tax rate (%)

Some states, such as California, tax HSA money. Enter 0 if unsure.

Contributions come out of my paycheck before tax

Payroll deductions also skip the 7.65% Social Security and Medicare tax.

Compare a third plan

Plan A

Plan A: monthly premium (your share)

Plan A: deductible

Plan A: out-of-pocket maximum

Plan A: your coinsurance after the deductible (%)

Plan A is an HSA plan (high-deductible)

Plan A: your health FSA contribution (a year)

2026 limit: $3,400.

Plan B

Plan B: monthly premium (your share)

Plan B: deductible

Plan B: out-of-pocket maximum

Plan B: your coinsurance after the deductible (%)

Plan B is an HSA plan (high-deductible)

Plan B: employer HSA contribution (a year)

Plan B: your HSA contribution (a year)

2026 limit, yours plus your employer's: $4,400.

$3,164

a year is the expected cost of Plan B at $4,000 of care, $1,636 less than Plan A. Its worst case is $5,504.

This week: find the deductible and out-of-pocket maximum on each plan's summary of benefits.

Expected cost for the year

Plan A$4,800
Plan B$3,164

Each plan for the year

Premiums, what you pay for care, employer HSA money, tax savings, expected cost and worst case for each plan
Item	Plan A	Plan B
Premiums for the year	$3,600	$1,800
You pay for care	$1,200	$2,160
Employer HSA money	$0	-$500
HSA or FSA tax savings	$0	-$297
Expected cost	$4,800	$3,164
Worst case	$7,600	$5,504

The worst case is a year when you reach each plan's out-of-pocket maximum. Plan B has the lowest worst case. An HSA contribution also saves 30% of each dollar at the rates you entered.

Educational estimate for tax year 2026. What it simplifies: one coinsurance rate after the deductible and no copays, in-network care only, one year with no carryover, premiums treated the same on every plan, and employer and HSA deposits counted as yours in full. The low, medium and high amounts are round samples, not averages. Limits used: HSA $4,400 self-only or $8,750 family (employer money counts), a high-deductible plan has a deductible of at least $1,700 or $3,400 and an out-of-pocket maximum of at most $8,500 or $17,000, and a health FSA is limited to $3,400. A general-purpose health FSA cannot be combined with an HSA. IRS rev. proc. 2025-19 · IRS rev. proc. 2025-32 · IRS publication 969 · HealthCare.gov: out-of-pocket maximum

How this calculator works

A plan's yearly cost is its premiums plus what you pay for care. You pay the deductible first, then your coinsurance share of the rest, until you reach the out-of-pocket maximum. After that the plan pays covered in-network care in full.
An HSA plan has a high deductible and lets you save in a health savings account. For 2026 the IRS limit is $4,400 self-only or $8,750 for a family, and your employer's contribution counts toward it. To qualify as a high-deductible plan, the deductible must be at least $1,700 self-only or $3,400 family, and the out-of-pocket maximum no more than $8,500 or $17,000.
The tax saving on money you put in an HSA is your federal rate, plus your state rate if your state allows it, plus 7.65% for Social Security and Medicare when it comes out of your paycheck. A health FSA works the same way up to $3,400 for 2026, but a general-purpose health FSA cannot be combined with an HSA.
The worst case is a year when your care reaches the out-of-pocket maximum. Marketplace-rule plans cap that maximum at $10,600 for one person and $21,200 for a family in 2026.
Low, medium and high use are round samples of $500, $4,000 and $15,000 of care at full price. They are not averages. Use the custom option for a number from your own year.

A $300 PPO against a $150 HSA plan at $4,000 of care

Plan A has a $300 monthly premium, a $500 deductible, 20% coinsurance, and a $4,000 maximum. Premiums are $3,600. Care of $4,000 costs you $500 plus 20% of $3,500, or $1,200, so the year is $4,800 and the worst case is $7,600. Plan B has a $150 premium, a $1,700 deductible, 20% coinsurance, a $4,500 maximum, and $500 from the employer into an HSA. Premiums are $1,800. Care costs you $1,700 plus 20% of $2,300, or $2,160. You add $1,000 of your own to the HSA, which at a 22% federal rate plus 7.65% saves $296.50. The year is $1,800 plus $2,160 minus $500 minus $296.50, or $3,163.50, and the worst case is $5,503.50.

What this assumes

The lab covers 2026 limits. They change each year.
One coinsurance rate applies after the deductible. Copays and separate drug deductibles are not modeled.
Care is in-network and happens in one plan year. HSA balances that roll over are not valued.
Premiums are treated the same on every plan for tax, so they do not change the ranking.
An employer's HSA deposit and your HSA tax savings are counted in full against the plan's cost.
Some states, such as California, tax HSA contributions. The state rate field covers that if you fill it in.

Finance Quest is educational. It is not financial advice, and no calculator here knows your full situation.

The mistake: choosing on the premium alone

The lower premium in the example is $150 a month, but the cheaper year depends on use. At $500 of care the HSA plan costs $1,503.50 against $4,100, and at $15,000 of care it costs $5,363.50 against $7,000. A plan with a lower premium and a higher deductible can still win, but the worst case is the check a family has to be able to write. The lab shows both.

Common questions

What are the 2026 HSA limits?

$4,400 for self-only coverage and $8,750 for family coverage, counting what your employer puts in. People 55 and older can add $1,000. The IRS sets the limits in Rev. Proc. 2025-19.

What makes a plan a high-deductible health plan?

For 2026 the deductible is at least $1,700 for self-only or $3,400 for family, and the out-of-pocket maximum is at most $8,500 or $17,000. A plan outside those numbers does not allow HSA contributions, and other coverage can also affect eligibility.

Can I have an HSA and a health FSA?

Not a general-purpose health FSA. A limited-purpose FSA that covers dental and vision, or care after the deductible, can be used with an HSA. The 2026 health FSA limit is $3,400, with up to $680 of carryover if the plan allows it.

What does the worst case mean?

It is the year's premiums plus the out-of-pocket maximum, less employer HSA money and tax savings. It is the most the plan can cost you for in-network covered care in a bad year.

Related labs

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Item

Plan A

Plan B

Premiums for the year

$3,600

$1,800

You pay for care

$1,200

$2,160

Employer HSA money

-$500

HSA or FSA tax savings

-$297

Expected cost

$4,800