Health Plan Cost Per Paycheck Comparison Calculator
Compare two employer health plans per paycheck: premium, deductible, coinsurance, HSA seed, and pre-tax savings. Get total 2026 cost and the breakeven.
Health Plan Cost Per Paycheck Comparison Calculator
Your situation
These four answers set your marginal rate, which is what the pre-tax premium break is worth, plus the level of care each plan gets priced at.
Sets your federal bracket rate and whether Social Security still applies to your top dollars.
Only changes how the per-paycheck premium is annualized. It does not rescale what you typed.
Picks the 2026 HSA limit and the HDHP deductible and out-of-pocket thresholds.
Enter 0 if you live in Alaska, Florida, Nevada, New Hampshire, South Dakota, Tennessee, Texas, Washington, or Wyoming. Pennsylvania and New Jersey run their own cafeteria-plan rules, so enter 0 there too if your premium is not state-tax free.
Allowed amounts before insurance pays anything, excluding premiums. Last year's total is usually the best guess.
Plan A
Copy these straight off the benefits summary. Enter the employee share of the premium, not the full cost.
Your share, not the plan's. A summary that reads "plan pays 80%" means you enter 20.
Plan B
Copy these straight off the benefits summary. Enter the employee share of the premium, not the full cost.
Your share, not the plan's. A summary that reads "plan pays 80%" means you enter 20.
Plan C
Copy these straight off the benefits summary. Enter the employee share of the premium, not the full cost.
Your share, not the plan's. A summary that reads "plan pays 80%" means you enter 20.
2026 estimate. The premium is treated as pre-tax under a Section 125 cafeteria plan, so the saving is valued at your federal bracket rate on income above the standard deduction, plus the FICA rate that applies to your salary, plus the single flat state rate you enter. That is a marginal-rate simplification: it does not re-run your return, and it assumes the whole premium sits in one federal bracket. Out-of-pocket costs assume in-network allowed amounts with no copay-only services. Not filing-grade or plan-grade advice: read your Summary of Benefits and Coverage for the terms that actually bind.
Why the premium per paycheck is the wrong number to compare
Open enrollment shows you one number per plan in the same unit as your paycheck: the premium per pay period. Everything else on the screen is annual, buried a click deeper, or written in a Summary of Benefits nobody opens. So the premium anchors the decision, and the cheapest premium looks like the cheapest plan.
It is one of six levers. The other five are the deductible, your coinsurance share after it, the out-of-pocket maximum that caps the whole thing, the employer HSA or HRA seed, and the tax you stop paying because the premium comes out pre-tax. A plan that costs $125 more per paycheck can still be the cheaper plan, and a plan with a $1,000 employer seed can start the year ahead of a plan with no premium at all.
What the pre-tax break is actually worth on your check
Employer health premiums almost always run through a Section 125 cafeteria plan, which means the money leaves your gross pay before federal income tax, Social Security, Medicare, and (in nearly every state) state income tax are calculated (IRS Pub. 15-B). Your taxable wages shrink by the premium, so your take-home drops by less than you paid.
Work it at a 22 percent federal marginal rate, 7.65 percent FICA, and a 5 percent state rate. That is a combined 34.65 percent, so a $200 premium per paycheck costs you about $131 of take-home. Over 26 checks the $5,200 premium is really about $3,400. Skip that step and treat the premium as a flat after-tax expense, and you overstate how far ahead the low-premium plan is.
One wrinkle above the Social Security wage base of $184,500: the premium reduces your top dollars, and those dollars were not subject to Social Security anyway, so the FICA piece of your saving falls from 7.65 percent to 1.45 percent. The calculator handles that switch from your salary. If the marginal rate itself is the confusing part, the marginal vs effective tax rate calculator shows why the saving runs at the marginal rate and not the effective one.
Reading the breakeven claims number
The breakeven is the level of medical spending where the two plans cost you exactly the same for the year. Below it, the low-premium plan is cheaper. Above it, the low-deductible plan takes over. It is the number most people are really after when they ask which plan is cheaper.
Both cost curves flatten once you hit the out-of-pocket maximum, because from that point every additional dollar of care is on the plan. That is why some pairs of plans have no breakeven at all: one plan is cheaper at every level of spending from zero to catastrophic, and the tool says so instead of inventing a crossing point. When there is no breakeven, the decision is already made.
The worst-case row is the other half of the answer. It is the full year of premiums plus the out-of-pocket maximum, which is the most that plan can cost you. Two plans can have the same expected cost and very different worst cases, and that gap is what you are really buying when you pay a higher premium.
The 2026 HDHP and HSA rules that move the math
A plan is a qualified high-deductible health plan for 2026 if the deductible is at least $1,700 self-only or $3,400 family and the out-of-pocket maximum is no more than $8,500 self-only or $17,000 family, per IRS Rev. Proc. 2025-19. Tick the HSA-eligible box on a plan and the calculator runs both tests, because a plan that fails either one cannot fund an HSA no matter what the enrollment site implies.
The employer seed is the swing factor people undercount. It is excluded from your income under IRC section 106(d), so it comes off the cost of the plan at face value with no tax to gross it up or down by. It also eats your own contribution room: the combined 2026 HSA limit is $4,400 self-only and $8,750 family, so a $1,000 seed leaves you $3,400 of self-only room, and the $1,000 age-55 catch-up sits on top of that. Once you have picked a plan, model your own contribution with the HSA and FSA paycheck impact calculator, price the whole benefits package with the total compensation offer calculator, and check that the premium line on your first stub matches enrollment with the paycheck deduction checker.
This page is a planning estimate built around one flat state rate and a single federal bracket. For exact per-state withholding on the paycheck the premium comes out of, plus saved profiles for weighing offers side by side, download the Stub44 Salary Calculator app.
Frequently Asked Questions
Common questions about health plan cost per paycheck comparison calculator
How do I compare two health plans from my employer?
Compare total cost, not the premium line. Multiply the premium per paycheck by your number of pay periods, subtract the tax you no longer pay on it (the premium is pre-tax), subtract any employer HSA or HRA contribution, then add what you would pay out of pocket at a realistic level of care. The plan with the lower total wins at that level of care, and the winner can flip once you change the care assumption.
Is an HDHP or a PPO cheaper for me?
The HDHP usually wins in a light-use year, because the premium gap plus the employer HSA seed outruns the higher deductible. The PPO tends to win if you have a chronic condition, a planned pregnancy, or any year where you expect to clear the deductible early. Enter both plans above at your realistic claims level and the tool names the cheaper one.
How much medical spending is the breakeven between a high-deductible plan and a PPO?
There is no universal number. A range of roughly $3,000 to $6,000 is the usual rule of thumb, and it is only a byproduct of what typical plan gaps look like. Your breakeven depends on your premium gap, the two deductibles, the coinsurance, the out-of-pocket maximums, and the employer seed. The calculator solves it from your own numbers and prints it above.
Does my health insurance premium come out of my paycheck before taxes?
For nearly all employer group plans, yes. The premium runs through a Section 125 cafeteria plan (often called a premium-only plan), so it escapes federal income tax, Social Security, Medicare, and state income tax in nearly every state (IRS Pub. 15-B). Pennsylvania and New Jersey apply their own cafeteria-plan rules, so set the state rate to 0 if your premium is not state-tax free.
Why does my take-home pay drop by less than my premium?
Because of that pre-tax treatment. The premium shrinks your taxable wages, so you stop paying income tax and FICA on it. At a 22 percent federal marginal rate, 7.65 percent FICA, and a 5 percent state rate, a $200 premium reduces your check by roughly $131. The paycheck deduction checker is a quick way to confirm the premium line on your stub matches what enrollment promised.
Should I count my employer's HSA contribution when comparing plans?
Yes. An employer HSA contribution is excluded from your gross income under IRC section 106(d), so it is tax-free money that offsets the deductible dollar for dollar. It also counts against your combined 2026 HSA limit of $4,400 self-only or $8,750 family, so a $1,000 seed leaves $3,400 of self-only room for your own contributions. Model your own contribution on top with the HSA and FSA paycheck impact calculator.
What are the 2026 HDHP deductible and out-of-pocket limits?
For 2026 a plan qualifies as a high-deductible health plan with a deductible of at least $1,700 self-only or $3,400 family, and an out-of-pocket maximum no higher than $8,500 self-only or $17,000 family (IRS Rev. Proc. 2025-19). Mark a plan HSA-eligible above and the calculator checks both tests and flags a plan that fails either one.
Does the out-of-pocket maximum include my deductible?
Yes. The deductible, copays, and coinsurance all count toward the out-of-pocket maximum. Premiums never do, which is why a plan's true worst case is the out-of-pocket maximum plus a full year of premiums. The results panel shows that worst-case row for each plan so you can price the downside as well as the year you expect.