These are made-up example plans, not recommendations. Numbers are illustrations of how the math works for one assumed situation. Your plans, prices, doctors and health will differ. Two adults on one family-coverage plan with a limited number of visits and prescriptions.
Assumptions
| 2027 plan year | HSA plan | PPO |
|---|---|---|
| Family coverage, you pay / month | $330 | $450 |
| Deductible | $4,000 | $1,000 |
| Coinsurance after deductible | 20% | 20% |
| Out-of-pocket maximum | $8,000 | $5,000 |
| Copays (annual, flat) | $0 | $0 |
| Employer HSA deposit | $800 | $0 |
| You put in the HSA | $2,500 | $0 |
| Tax rate used | 22% federal + 7.65% FICA |
Total yearly cost at three levels of care
| Year of care | Medical spending | HSA plan, net / yr | PPO, net / yr | Lower cost |
|---|---|---|---|---|
| Low-use year | $2,000 | $4,419 | $6,600 | HSA plan by about $2,181 |
| Moderate year | $7,000 | $7,019 | $7,600 | HSA plan by about $581 |
| Big year (one partner has a procedure) | $16,000 | $8,819 | $9,400 | HSA plan by about $581 |
Net cost = premiums + your share of care (deductible, then coinsurance, up to the out-of-pocket maximum, plus copays) − employer HSA money − tax savings on your HSA deposit. Worst case (both maximums reached): HSA plan $10,419 vs PPO $10,400. The two plans cost the same at about $23,906 of care; the HSA plan is cheaper below that. Unspent HSA money stays yours and is not counted above.
Open this example in the HSA vs PPO calculator and change any number to match your own plans.
What matters in this situation
- The family HSA limit ($9,000) is shared by the couple: how married couples split it.
- If both spouses have an employer plan, comparing both employers’ plans (and the family glitch rule for tax credits) can matter more than HSA vs PPO.
- The out-of-pocket maximum applies to the family; with two people it is usually reached only when one person has a big year.
If one spouse has a planned procedure or pregnancy, see the baby example or the chronic-condition example.
Also see all HSA vs PPO situations, the four basic examples, how health plan costs work and 2027 HSA limits.
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.