Great Lakes HSA

HSATax Savings Calculator
 

 

This simple HSA calculator will

  • Assist you in estimating your potential medical expenses for the upcoming plan year, and
  • Estimate the potential tax savings realized through your participation in a HSA account. The expenses listed below are expenses NOT covered by any insuranace plan. Please refer to IRS publication 502, for the complete details on qualified expenses.
  • Remember, your annual contribution can not exceed your health plan deductable
Expense Description Annual Expense Amount
(not covered by insurance)
  Medical & Dental Deductible     
  Medical co-payments     
  Dental insurance co-payments     
  Dental and orthodontic expenses     
  Medically necessary elective surgery     
  Prescription drugs     
  Over the Counter Medication     
  Transportation to and from medical provider     
  Immunizations and vaccinations     
  Routine exams     
  Eye Examinations, glasses, and contacts     
  Other Expenses     
B. Total estimated, medical expenses for the year     
C. Change this number if you want to enter a different contribution for the year .     
  Number of paychecks received per year     
D This amount will be taken out of each paycheck and deposited into your HSA Account     
E Calculating your Tax Savings  
 
  • Adjusted Gross Income (before any plan deductions)
    		•      
     
  • Tax filing status
    		•
      Total Estimated Tax Savings