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Health Savings Account (HSA) Calculator

GLO-MBR-HSA Calculator

This tool can help you estimate and compare your anticipated out-of-pocket expenses for a High Deductible Health Plan (HDHP) with another plan type (for example, an HMO or PPO).

Select Coverage Type
Choose Coverage Type
How often are you paid? (What is your pay period?)
Choose a Pay Period

HDHP

Other Plan

How much will You Pay toward the plan premium
$ .00
$.00

$ .00
$ .00

What does the policy* require for: (see Help Link for guidance)

Help

HDHP

Other Plan

Deductible**
$ .00
$ .00
Out of pocket maximum**
$ .00
$ .00
Coinsurance amount**
(after you meet your deductible)
%
%

* Refer to the benefit summary provided by your employer or view our standard offerings

** Out of pocket deductibles, maximums and coinsurance may not apply to certain plan types, such as HMOs

How much will You Pay toward Doctor or Specialist Visits?
Consider the number of visits you anticipate each family member for the benefit period, and whether you'll pay just a copayment or if you'll be responsible for the complete costs:

Help     More Help

HDHP

Other Plan

Family Member 1
$ .00
$ .00
Family Member 2
$ .00
$ .00
Family Member 3
$ .00
$ .00
Family Member 4
$ .00
$ .00
For All Other Family Members
$ .00
$ .00
Other Expenses (medical supplies and equipment, etc)
$ .00
$ .00

Subtotal of Medical Costs
$ .00
$ .00

How much will You Pay toward Prescription Drug Costs?
Consider the amount you expect to pay for prescription drugs for each family member for the benefit period, and whether you'll pay just a copayment or if you'll be responsible for the complete costs:

Help

HDHP

Other Plan

Family Member 1
$ .00
$ .00
Family Member 2
$ .00
$ .00
Family Member 3
$ .00
$ .00
Family Member 4
$ .00
$ .00
For All Other Family Members
$ .00
$ .00

Subtotal of Prescription Drugs Costs:
$ .00
$ .00

HDHP

Other Plan

Company Contribution
$ .00
$ .00

Your Total Estimated Costs (includes the premium you expect to pay and costs relating to health care services)

Category Annually Per Pay Period
Total Estimated Costs for High Deductible Health Plan:
$0.00
$0.00
Total Estimated Costs for Other Plan:
$0.00
$0.00

Besides offering savings on your premium, an HDHP can offer other benefits when paired with a Health Savings Account (HSA) or Health Reimbursement Account (HRA). Be sure to speak with your benefit administrator to see what types of funding accounts are available to you.

Disclaimer: This tool is intended only as a guide. Your out-of-pocket expenses may vary based on your specific benefit design and changes in your health status.