Tools Health Cost Readiness Calculator
Could I cover my out-of-pocket maximum?
Your plan’s out-of-pocket maximum is the most you’d pay in a year for covered, in-network care. This calculator shows how much of it your HSA and medical savings could cover today, how far short you are, how long it would take to close the gap, and how much HSA room you have left for 2026.
Your result
What to focus on next
Beyond the bill
Being able to pay for care is one part of medical wealth. Getting care when you need it is the rest.
The free Medical assessment looks at your insurance coverage, emergency readiness, preventive care and advance directives, and scores your preparedness from 0 to 100 with prioritized next steps. It takes about two minutes and needs no sign-up. Medical is one of eight dimensions that make up your Wealth Score.
- Financial
- Retirement
- Security
- Medical
- Physical
- Mental
- Social
- Time
Want the bigger picture first? Read what medical wealth means, or see how your Wealth Score is calculated.
How this calculator works
Covered today = (HSA balance + cash set aside) ÷ out-of-pocket maximum
Your deductible is what you pay before your plan shares costs. After that you pay copays and coinsurance until you reach the out-of-pocket maximum, and then the plan pays 100% of covered, in-network care for the rest of the plan year. So the out-of-pocket maximum is the most a bad year should cost you, not counting premiums. For 2026, plans that follow the Affordable Care Act can set it no higher than $10,600 for one person or $21,200 for a family. If you’re new to these terms, start with our guide to deductibles, copays and out-of-pocket maximums.
The result has three bands: Exposed if your savings don’t cover the deductible, Deductible covered once they do, and Fully covered at the out-of-pocket maximum. The time to cover it divides the shortfall by your monthly amount and leaves out investment growth, so an invested HSA may get there sooner.
For an HSA, the IRS limits for 2026 are $4,400 with self-only coverage and $8,750 with family coverage, plus $1,000 at 55 or older. Employer contributions count toward the limit. A plan is HSA-eligible if its deductible is at least $1,700 (self-only) or $3,400 (family) and its out-of-pocket maximum is no more than $8,500 or $17,000, and from 2026 bronze and catastrophic plans qualify too. Compare accounts in the best HSA providers, and see how an HSA fits with retirement saving in Roth vs traditional, plus HSA basics.
Words you’ll see
- Deductible
- The amount you pay for covered care each year before your plan starts to pay its share. Many preventive services are covered before you meet it.
- Out-of-pocket maximum
- The most you pay in a plan year for covered, in-network care: deductible, copays and coinsurance. Premiums, out-of-network care and uncovered services don’t count toward it.
- HSA (health savings account)
- A tax-advantaged account for people on an HSA-eligible plan. Contributions are tax-deductible, growth is tax-free, and withdrawals for qualified medical costs are tax-free. The money is yours to keep, even if you change jobs.
- HDHP (high-deductible health plan)
- A plan that meets the IRS deductible floor and out-of-pocket ceiling for the year, which makes you eligible to contribute to an HSA.
- Catch-up contribution
- An extra $1,000 a year you can add to an HSA if you are 55 or older by the end of the year and not enrolled in Medicare.
Common questions
What is the out-of-pocket maximum for 2026?
For 2026, a plan that follows the Affordable Care Act can make you pay no more than $10,600 for one person or $21,200 for a family in a year for covered, in-network care. Your own plan’s limit may be lower, and it is listed on your Summary of Benefits and Coverage. Premiums, out-of-network care and services your plan doesn’t cover don’t count toward it.
What are the HSA contribution limits for 2026?
For 2026 you can put up to $4,400 in an HSA with self-only coverage or $8,750 with family coverage, plus an extra $1,000 if you are 55 or older by the end of the year. The limit includes anything your employer puts in. You need an HSA-eligible plan to contribute: from 2026 that includes bronze and catastrophic plans, as well as plans with a deductible of at least $1,700 (self-only) or $3,400 (family).
How much should I save for medical expenses?
Start with enough to pay your deductible, because that is what you pay before your plan starts sharing costs. Then build toward your plan’s out-of-pocket maximum, the most a bad year of covered, in-network care could cost you. For comparison, the average deductible for single coverage at work was $1,886 in 2025, according to KFF.
Does an HSA count toward my emergency fund?
It can cover medical emergencies, since you can withdraw it tax-free for qualified medical costs at any time. It is a poor fit for other emergencies: non-medical withdrawals before age 65 are taxed as income plus a 20% penalty. Keep a separate cash emergency fund for job loss and other surprises.
Sources
- Revenue Procedure 2025-19: 2026 HSA and HDHP limits, Internal Revenue Service
- Publication 969: Health Savings Accounts and Other Tax-Favored Health Plans, Internal Revenue Service
- Treasury, IRS provide guidance on new tax benefits for health savings account participants under the One, Big, Beautiful Bill, Internal Revenue Service
- Out-of-pocket maximum/limit, HealthCare.gov, Centers for Medicare & Medicaid Services
- 2025 Employer Health Benefits Survey, KFF
This tool is for informational and educational purposes only. It is not financial, tax, medical, or legal advice. Consult a qualified professional for guidance specific to your situation.