American Chartered

HSA Calculator HSA Calculator

It will be helpful to have your insurance information available while using this calculator. If you have any questions regarding what to input into the calculator, please click on the "help" link located in each step.

At any time you may reset the calculator to its default settings by clicking the Reset Form key at the bottom of the calculator.

Step 1: Outline Your Current Health Plan (Help) Enter Benefits, Copays, and Costs of traditional plan
Benefits (Help)
Deductible
Co-Insurance
Annual Out-of-Pocket Maximum
Co-Payments (Help)
Doctors Office Visits
Emergency Room
Hospital Inpatient
Prescription Drugs (Help)
Brand Name
Generic
Monthly Participant Cost (Help)
Participant Only
Participant and Spouse
Participant and Children
Participant, Spouse, & Children

Step 2: Outline a Consumer Directed Plan (Help) Enter Benefits and Costs of HSA plan
Benefits
Deductible
Co-Insurance
Annual Out-of-Pocket Maximum
Monthly HSA Contributions from Employer (if applicable)
Employee Only
Employee and Spouse
Employee and Children
Employee, Spouse, & Children
Monthly Participant Cost
Participant Only
Participant and Spouse
Participant and Children
Participant, Spouse, & Children

Step 3: Estimate your Medical Costs (Help) Estimate annual medical costs before plan
Choose a claims scenario below or enter values directly. (Help)
Activity	Volume		Unit Cost*	Total
Doctor's Office Visits		@
Lab / X-Ray(s)		@
Inpatient Surgery(ies)		@
Outpatient Surgery(ies)		@
Emergency Room Visit(s)		@
Brand Name Prescriptions		@
Generic Prescriptions		@
Total Medical Costs Before Plan

*Costs are estimated and may not be accurate. Ask your health care provider for more information.

Step 4: Customize Coverage (Help)
Choose who is covered: Monthly Cost Savings: Include monthly cost savings as HSA Contribution

Step 5: Review Results (Help)
	Traditional	HSA Plan
Annual Premium
Medical Costs (After including copays, benefits, and deductibles.)
Deductible Exceeded?
Out of Pocket Maximum Reached?
Less:
Employer HSA Contribution
Annualized HSA Cost Savings (from step 4)
Net Expenses:
HSA Plan Out-of-Pocket Savings (Loss):
Plus:
Year Ending HSA Balance
Total Annual HSA Benefit:

Note: The above calculations do not include the pre-tax status of HSA contributions.

Although this HSA Calculator depicts outcomes in several sitautions, actual results may vary. If you have any questions regarding your health benefits plan, American Chartered Bank encourages you to seek advice from your employer's benefits specialist or health insurance provider.

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