These are example plans, not real ones. Premiums, deductibles and employer contributions are made up to show how the math works. Check your own plan’s Summary of Benefits and Coverage and put your numbers in the HSA vs PPO calculator.
The four examples at a glance
| Example | Medical spending | HSA plan, net / yr | PPO, net / yr | Result |
|---|---|---|---|---|
| Single, low use | $500 | $1,235 | $2,900 | HSA plan saves about $1,665 |
| Single, surgery year | $20,000 | $5,735 | $5,400 | PPO saves about $335 |
| Family, typical year | $5,000 | $7,910 | $7,960 | Too close to call (within $50) |
| Family, chronic condition | $30,000 | $11,910 | $11,260 | PPO saves about $650 |
How the math works
Net yearly cost = premiums you pay + your share of medical costs (deductible, then coinsurance, up to the out-of-pocket maximum) − employer HSA money − tax savings on your own HSA deposit. Every number on this page comes from the same calculation the calculator runs. Assumptions: 2027 plan year; payroll-deducted HSA contributions, so tax savings use a 22% federal and state bracket plus 7.65% FICA; the HSA plan is HSA-eligible (2027 minimum deductible $1,750 self-only / $3,500 family; maximum out-of-pocket $8,700 / $17,400); the 2027 HSA limit is $4,500 self-only / $9,000 family (details), and employer money counts toward it. Copays, networks, drug tiers and HSA investment growth are not modeled.
Single, low use: $500 of care
A healthy single employee with a checkup and one urgent-care visit. HSA plan saves about $1,665.
| Example plan | You pay / month | Deductible | Coinsurance | Out-of-pocket max | Employer HSA | You put in HSA |
|---|---|---|---|---|---|---|
| HSA plan | $140 | $3,000 | 20% | $5,000 | $500 | $1,500 |
| PPO | $200 | $500 | 20% | $3,000 | $0 | $0 |
| Yearly cost | HSA plan | PPO |
|---|---|---|
| Premiums | $1,680 | $2,400 |
| Your share of $500 of care | $500 | $500 |
| Employer HSA money | −$500 | $0 |
| Tax savings on your HSA deposit | −$445 | $0 |
| Net cost | $1,235 | $2,900 |
Worst case (out-of-pocket maximums hit): HSA plan $5,735 vs PPO $5,400. The plans cost the same at about $2,581 of care; the HSA plan is cheaper below that, the PPO above it. Open this example in the HSA vs PPO calculator and change any number.
Single, surgery year: $20,000 of care
The same single employee has outpatient surgery and follow-up care. PPO saves about $335.
| Example plan | You pay / month | Deductible | Coinsurance | Out-of-pocket max | Employer HSA | You put in HSA |
|---|---|---|---|---|---|---|
| HSA plan | $140 | $3,000 | 20% | $5,000 | $500 | $1,500 |
| PPO | $200 | $500 | 20% | $3,000 | $0 | $0 |
| Yearly cost | HSA plan | PPO |
|---|---|---|
| Premiums | $1,680 | $2,400 |
| Your share of $20,000 of care | $5,000 | $3,000 |
| Employer HSA money | −$500 | $0 |
| Tax savings on your HSA deposit | −$445 | $0 |
| Net cost | $5,735 | $5,400 |
Worst case (out-of-pocket maximums hit): HSA plan $5,735 vs PPO $5,400. The plans cost the same at about $2,581 of care; the HSA plan is cheaper below that, the PPO above it. Open this example in the HSA vs PPO calculator and change any number.
Family, typical year: $5,000 of care
A family of four with routine visits, a few prescriptions and one ER trip. Too close to call (within $50).
| Example plan | You pay / month | Deductible | Coinsurance | Out-of-pocket max | Employer HSA | You put in HSA |
|---|---|---|---|---|---|---|
| HSA plan | $400 | $5,000 | 20% | $9,000 | $1,000 | $3,000 |
| PPO | $480 | $1,500 | 20% | $5,500 | $0 | $0 |
| Yearly cost | HSA plan | PPO |
|---|---|---|
| Premiums | $4,800 | $5,760 |
| Your share of $5,000 of care | $5,000 | $2,200 |
| Employer HSA money | −$1,000 | $0 |
| Tax savings on your HSA deposit | −$890 | $0 |
| Net cost | $7,910 | $7,960 |
Worst case (out-of-pocket maximums hit): HSA plan $11,910 vs PPO $11,260. The plans cost the same at about $21,747 of care; the HSA plan is cheaper below that, the PPO above it. Open this example in the HSA vs PPO calculator and change any number.
Family, chronic condition: $30,000 of care
A family where one member has a chronic condition with ongoing treatment and prescriptions. PPO saves about $650.
| Example plan | You pay / month | Deductible | Coinsurance | Out-of-pocket max | Employer HSA | You put in HSA |
|---|---|---|---|---|---|---|
| HSA plan | $400 | $5,000 | 20% | $9,000 | $1,000 | $3,000 |
| PPO | $480 | $1,500 | 20% | $5,500 | $0 | $0 |
| Yearly cost | HSA plan | PPO |
|---|---|---|
| Premiums | $4,800 | $5,760 |
| Your share of $30,000 of care | $9,000 | $5,500 |
| Employer HSA money | −$1,000 | $0 |
| Tax savings on your HSA deposit | −$890 | $0 |
| Net cost | $11,910 | $11,260 |
Worst case (out-of-pocket maximums hit): HSA plan $11,910 vs PPO $11,260. The plans cost the same at about $21,747 of care; the HSA plan is cheaper below that, the PPO above it. Open this example in the HSA vs PPO calculator and change any number.
What the examples teach
- Low use favors the HSA plan because you pay lower premiums and keep the tax savings and employer money even if you barely use care.
- A big year can flip it when the PPO has a much lower out-of-pocket maximum than the HSA plan. The size of the gap between the two maximums matters more than the deductibles.
- Employer HSA money moves the break-even: every extra dollar of employer contribution is a dollar off the HSA plan in every scenario.
- HSA money you do not spend stays yours and can grow; the calculator shows this separately, and these totals do not count it. See is an HSA worth it?
Also see the HSA vs PPO calculator, compare 2–4 plans, and 2027 open enrollment deadlines.
General education, not insurance, tax or legal advice. Figures from IRS and HHS publications; confirm with your plan documents.