Plan type
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Optional. Only the part you spend this year is counted as tax saved.
Copays
Leave at 0 if the service is “deductible, then coinsurance”.
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Open enrollment helper
Which health plan costs you less?
Enter the 2–4 plans from your employer’s benefits guide. See your total yearly cost (premiums + what you pay for care − employer HSA money − tax savings) for a light, normal and heavy year, plus the worst case.
1Who is covered and how you’re paid
Coverage tier
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Used only to estimate the tax you save on HSA / FSA money. Pre-tax premiums are left out because they are pre-tax under every plan.
2Your plan options
Copy the numbers from your benefits guide or the Summary of Benefits and Coverage (SBC) for each plan. The two starting plans are made-up examples; replace them. The share link carries only plan numbers, never your tax rate or usage.
Plan type
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Pre-tax through payroll. See the HSA limits below.
Copays
Leave at 0 if the service is “deductible, then coinsurance”.
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Saved in this browser only (local storage). Nothing is uploaded.
3Total yearly cost
A few doctor and specialist visits, urgent care, labs, one scan · medical bills before insurance $3,380
In this scenario, Example HDHP + HSA costs the least: $1,667 for the year. It also has the lowest worst case.
| Plan | Premiums | Care (OOP) | Employer HSA | Tax saved | Net cost | Worst case |
|---|---|---|---|---|---|---|
| Example PPO | $2,080 | $1,285 | — | — | $3,365 | $6,080 |
| Example HDHP + HSA | $650 | $2,113 | −$750 | −$347 | $1,667 | $4,554 |
Worst case = a year’s premiums + the in-network out-of-pocket max − employer HSA money − tax saved. Out-of-network care, non-covered services and balance billing can cost more.
What this scenario includes, and the prices used
Prices are placeholders, not data. Negotiated prices vary several-fold by insurer, city and provider. Replace them with numbers from your insurer’s cost estimator (usually found after you log in to your insurer’s website or app).
| Service | Times | Price each |
|---|---|---|
| Preventive checkup | 1 | $ |
| Primary care visit | 3 | $ |
| Specialist visit | 2 | $ |
| Urgent care visit | 1 | $ |
| Generic drug fill | 12 | $ |
| Lab test / X-ray | 2 | $ |
| MRI / CT scan | 1 | $ |
Cost as your medical bills grow
Each line is your net yearly cost if you have that many dollars of bills that go through the deductible and coinsurance (copays ignored here). Lines flatten once a plan hits its out-of-pocket max.
How this is calculated, and what it leaves out
- Premiums = your per-paycheck premium for the selected tier × paychecks per year.
- Care: in-network preventive care is $0. Services with a copay cost the copay (skipping the deductible unless you mark the plan “deductible first”); everything else goes to the deductible, then coinsurance, capped at the out-of-pocket max.
- Family tiers: the whole household’s bills are pooled against the family deductible and out-of-pocket max. Many plans also have a lower per-person (embedded) limit, which can make your real cost lower than shown.
- Tax saved: on an HDHP, your whole HSA contribution × (federal + state + FICA rate); the money stays yours if unspent. On other plans, your health FSA contribution counts only up to what you spend on care that year, because unspent FSA money can be forfeited.
- Not modeled: out-of-network care, separate drug deductibles, per-service limits, HRA rules, wellness incentives, spousal surcharges, mid-year changes, and the time value of HSA investing.
HSA and FSA: limits and how much to put in
HSA calculator
Year
HDHP coverage
- Total limit (you + employer)
- $4,500
- Employer puts in · Example HDHP + HSA
- $750
- You can still add
- $3,750
- Tax saved if you max it
- $1,299
Tax saved uses your settings in step 1: 34.7% combined. IRS Rev. Proc. 2026-24IRS Publication 969
Why an HSA is called “triple tax-free”
- Money goes in before tax (through payroll it also skips the 7.65% FICA tax).
- Interest and investment growth inside the account are tax-free.
- Withdrawals for qualified medical expenses are tax-free, in any year. The money is yours and rolls over forever, even if you change jobs.
IRS Publication 969IRS Publication 15 (Circular E)
Who can contribute
- You must be covered by an HSA-eligible HDHP and have no other health coverage (a spouse’s regular PPO or a general-purpose health FSA counts as other coverage; dental, vision and limited-purpose FSAs are fine).
- Not enrolled in Medicare, and not claimed as someone else’s dependent.
- New from 2026: bronze and catastrophic Marketplace plans count as HSA-eligible, and direct primary care memberships no longer disqualify you. IRS Notice 2026-5IRS: guidance on new HSA benefits und…
State tax exceptions
California does not follow the federal HSA rules: contributions are not deductible, employer contributions are taxable, and earnings are taxed each year on your state return. New Jersey’s income tax instructions exclude only Archer MSAs and list no HSA exclusion, so NJ residents should expect state tax on HSA contributions too. California FTB Publication 1001 (2025)New Jersey NJ-1040 instructions (2025)
| 2026 | 2027 | |
|---|---|---|
| HSA limit, self-only | $4,400 | $4,500 |
| HSA limit, family | $8,750 | $9,000 |
| Catch-up, age 55+ | $1,000 | $1,000 |
| HDHP minimum deductible (self / family) | $1,700 / $3,400 | $1,750 / $3,500 |
| HDHP max out-of-pocket (self / family) | $8,500 / $17,000 | $8,700 / $17,400 |
| ACA out-of-pocket limit, any plan (self / family) | $10,600 / $21,200 | $12,000 / $24,000 |
IRS Rev. Proc. 2025-19IRS Rev. Proc. 2026-24IRS Publication 969CMS: 2027 premium adjustment percenta…HealthCare.gov: out-of-pocket maximum/limit
Health FSA
$3,400 limit for 2026
- Use it or lose it, with one of two plan-chosen escapes: carry over up to $680 into the next year, or a grace period of up to 2½ months. A plan can offer one, not both (or neither).
- The full year’s amount is available from day one of the plan year.
- With an HSA, you can only have a limited-purpose FSA (dental and vision).
- 2027 limit: not yet published by the IRS as of Oct 18, 2026.
Dependent care FSA
$7,500 per household, from 2026
- Raised from $5,000 by the 2025 One Big Beautiful Bill Act. $3,750 if married filing separately.
- For daycare, preschool, before/after-school care or summer day camp so you (and your spouse) can work. Not for medical bills.
- Choose between it and the child and dependent care credit for the same dollars; you can’t use both on the same expense.
Plain-language glossary
- Premium 保费
- What you pay to have the plan, every paycheck, whether or not you see a doctor. HealthCare.gov: premium
- Deductible 免赔额（起付线）
- What you pay for covered care each year before the plan starts sharing the cost. Example: $1,500 deductible, $3,000 MRI → you pay the first $1,500. HealthCare.gov: deductible
- Copay (copayment) 固定自付额
- A flat amount for a service, like $30 per doctor visit or $10 per generic prescription. HealthCare.gov: copayment
- Coinsurance 共付比例
- Your percentage of the bill after the deductible. Example: 20% coinsurance on the remaining $1,500 of that MRI → you pay $300. HealthCare.gov: coinsurance
- Out-of-pocket maximum 自付上限（封顶额）
- The most you pay for covered in-network care in a year (deductible + copays + coinsurance). After that the plan pays 100%. Premiums don’t count toward it. HealthCare.gov: out-of-pocket maximum/limit
- In-network / out-of-network 网络内 / 网络外
- In-network doctors and hospitals have contracted prices with your plan. Out-of-network care costs more, may not count toward your limits, and HMOs/EPOs usually don’t cover it at all except emergencies. HealthCare.gov: network
- Prior authorization 事先授权（预授权）
- Approval the plan requires before certain services, drugs or scans. Skip it and the plan can refuse to pay. HealthCare.gov: preauthorization (prior authoriz…
- Balance billing 差额账单
- When an out-of-network provider bills you for the difference between their charge and what your plan pays. HealthCare.gov: balance billing
- PPO / HMO / EPO / POS 计划类型
- PPO: see anyone, cheaper in-network, no referrals. HMO: in-network only, primary doctor refers you to specialists. EPO: in-network only, usually no referrals. POS: HMO-style referrals with some out-of-network coverage. HealthCare.gov: network
- HDHP 高免赔额计划
- A plan with a deductible at least the IRS minimum (2027: $1,750 self / $3,500 family). Lower premiums; lets you open an HSA. HealthCare.gov: high deductible health plan
- HSA 健康储蓄账户
- Your own tax-free savings account for medical costs, paired with an HDHP. Unused money rolls over and can be invested. IRS Publication 969
- Health FSA 医疗灵活支出账户
- Pre-tax money set aside through your employer for medical costs this year. Mostly use-it-or-lose-it. IRS Publication 969
- HRA 健康报销安排
- Employer-funded money for your medical costs. You can’t contribute, and it usually stays with the employer if you leave. IRS Publication 969
- Embedded deductible 内嵌（单人）免赔额
- On family coverage, a per-person deductible inside the family deductible, so one sick person’s costs start being shared sooner.
- SBC 保障摘要
- Summary of Benefits and Coverage: a standard document every plan must give you, listing deductibles, copays and examples. The best place to copy numbers from. HealthCare.gov: summary of benefits and coverage
ACA Marketplace for visa holders
Can I buy a Marketplace plan on a visa?
Yes, if you are “lawfully present.” HealthCare.gov lists people with valid nonimmigrant visas among those who qualify; that covers common statuses such as H-1B, H-4, L-1, F-1 and J-1 (HealthCare.gov doesn’t name each visa, so check your own status on its list). HealthCare.gov
Subsidies change in 2027
- From Jan 1, 2027, premium tax credits and cost-sharing reductions are limited to U.S. citizens and nationals, green card holders, Cuban/Haitian entrants and COFA migrants. Other lawfully present people (H-1B, F-1, etc.) can still enroll, but pay full price. CMS guidance
- Since 2026, lawfully present people with income under 100% of the poverty line who can’t get Medicaid because of immigration status no longer get the credit. CMS FAQ: OBBBA §71302, no premium tax cre…
- The enhanced (larger) credits of 2021–2025 expired; for 2026 onward the original ACA rules apply, with no repayment cap. IRS: questions and answers on the pre…
The employer-coverage affordability rule
If your employer offers coverage that meets minimum value and your share of the cheapest self-only plan costs no more than 9.96% of household income in 2026 (10.22% in 2027), it counts as affordable and you can’t get a premium tax credit on the Marketplace. Family members are judged by the cost of family coverage. IRS Rev. Proc. 2025-25IRS Rev. Proc. 2026-26IRS: eligibility for the premium tax…
From 2027, this matters mainly for citizens and green card holders, since most other visa holders can’t get the credit anyway.
Deadlines outside open enrollment
- Lose job-based coverage (layoff, quitting): 60 days before or after to pick a Marketplace plan. HealthCare.gov
- Employer plan: marriage, birth, adoption or losing other coverage gives at least 30 days to enroll or add family (federal minimum; your plan may allow more). U.S. Department of Labor
- State-run exchanges (e.g. Covered California, NY State of Health) set their own open enrollment dates, which can end later than HealthCare.gov. HealthCare.govCMS statement (Jul 27, 2026)
Official sources
Every limit and rule on this page comes from these documents, checked on Oct 18, 2026.
- IRS Rev. Proc. 2025-19: 2026 HSA limits and HDHP definition (IRB 2025-21)
- IRS Rev. Proc. 2026-24: 2027 HSA limits and HDHP definition
- IRS Rev. Proc. 2025-32 §3: 2026 health FSA limit and carryover
- IRS Publication 969: HSAs and other tax-favored health plans (eligibility, catch-up, FSA grace period)
- IRS Publication 15-B (2026): dependent care assistance $7,500 limit; HSA payroll treatment
- IRS Publication 15 (Circular E): cafeteria-plan HSA contributions are not subject to employment taxes
- IRS Publication 503: child and dependent care expenses (what care qualifies; no double benefit with a dependent care FSA)
- IRS: eligibility for the premium tax credit (employer coverage affordability, family members)
- IRS Notice 2026-5: bronze and catastrophic Marketplace plans and direct primary care are HSA-compatible from 2026
- IRS: guidance on new HSA benefits under the One Big Beautiful Bill (IR-2025-119)
- California FTB Publication 1001 (2025): California does not conform to federal HSA rules
- New Jersey NJ-1040 instructions (2025): only Archer MSAs are excluded; no HSA exclusion listed
- HealthCare.gov: dates and deadlines for 2027 coverage
- CMS statement (Jul 27, 2026): open enrollment Nov 1, 2026 – Jan 15, 2027 after City of Columbus v. Kennedy
- HealthCare.gov: coverage for lawfully present immigrants
- CMS guidance: noncitizen eligibility for APTC and CSRs, plan year 2027 (OBBBA §71301)
- CMS FAQ: OBBBA §71302, no premium tax credit under 100% FPL for people ineligible for Medicaid due to immigration status
- IRS Rev. Proc. 2025-25: 2026 required contribution percentage 9.96%
- IRS Rev. Proc. 2026-26: 2027 required contribution percentage 10.22%
- IRS: questions and answers on the premium tax credit (enhanced credits were for 2021–2025)
- CMS: 2027 premium adjustment percentage and maximum out-of-pocket guidance
- HealthCare.gov glossary: out-of-pocket maximum/limit
- HealthCare.gov: special enrollment period (60 days after losing job-based coverage)
- U.S. Department of Labor: HIPAA special enrollment FAQs (30 days for employer plans)
- HealthCare.gov: preventive care benefits covered without cost sharing in-network
- HealthCare.gov glossary: deductible
- HealthCare.gov glossary: coinsurance
- HealthCare.gov glossary: copayment
- HealthCare.gov glossary: network
- HealthCare.gov glossary: preauthorization (prior authorization)
- HealthCare.gov glossary: balance billing
- HealthCare.gov glossary: premium
- HealthCare.gov glossary: high deductible health plan
- HealthCare.gov glossary: summary of benefits and coverage
What we could not verify
- 2027 health FSA limit and carryover: not published by the IRS as of the check date.
- New Jersey HSA treatment: inferred from the NJ-1040 instructions (only Archer MSAs are excluded). We found no NJ page that addresses HSAs directly. Other states were not checked.
- Specific visa types: HealthCare.gov says “valid nonimmigrant visas” without naming H-1B, F-1 and so on.
- Open enrollment: CMS kept Nov 1 – Jan 15 after a June 2026 court ruling; an appeal could change future years.
- The example plans and per-service prices are made-up illustrations, not data about any real plan or provider.