| Page | In one line | Example in this series |
|---|---|---|
| Deductible vs out-of-pocket maximum | Start-up amount vs yearly cap | $2,000 / $6,000: you stop paying at $22,000 of care |
| Coinsurance vs copay | Percentage vs flat fee | Same year of care costs $850 vs $1,650 on two plan designs |
| Embedded vs non-embedded deductible | Per person vs shared family deductible | $6,800 vs $9,600 when one member has $20,000 of care |
| What counts toward the maximum | Which dollars count | $6,000 counted out of $15,300 spent |
Limits that apply to the plan you pick
- ACA out-of-pocket maximum: $12,000 / $24,000 for 2027 (details).
- HSA-eligible plans: deductible at least $1,750 / $3,500 and maximum no more than $8,700 / $17,400 (2027 limits hub).
To see how these ideas change which plan costs less over a whole year, use the HSA vs PPO calculator or the situation examples. Definitions are also in the glossary.
This is general information, not tax or insurance advice. Confirm details with your plan documents, the IRS and a qualified professional.
General education, not insurance, tax or legal advice. Figures from IRS and HHS publications; confirm with your plan documents.