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. A single, healthy employee who sees a doctor once or twice a year.
Assumptions
| 2027 plan year | HSA plan | PPO |
|---|---|---|
| Self-only coverage, you pay / month | $160 | $230 |
| Deductible | $3,000 | $500 |
| Coinsurance after deductible | 20% | 20% |
| Out-of-pocket maximum | $5,000 | $3,000 |
| Copays (annual, flat) | $0 | $0 |
| Employer HSA deposit | $500 | $0 |
| You put in the HSA | $1,500 | $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 | $400 | $1,375 | $3,160 | HSA plan by about $1,785 |
| Moderate year | $2,500 | $3,475 | $3,660 | HSA plan by about $185 |
| Big year (injury, imaging, procedure) | $9,000 | $5,175 | $4,960 | PPO by about $215 |
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 $5,975 vs PPO $5,760. The two plans cost the same at about $2,731 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
- Your biggest lever is the premium difference: here the PPO costs $840 more a year before you use any care.
- A single person with a low-use year rarely gets near the deductible, so the HSA plan’s higher deductible rarely bites.
- The tail risk is a single bad year; keep the HSA plan’s out-of-pocket maximum ($5,000) in mind and whether you could cover the deductible ($3,000) from savings or the HSA.
Skipping the HSA plan can make sense if you are on a regular prescription with copays, have a planned procedure, or would struggle to pay a $3,000 deductible out of savings.
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.