When it comes to health savings accounts, you have to separate the hype from the reality. One of the big myths: a high-deductible plan with an HSA means lower premiums.

In truth, it varies.  In some cases, an HSA-eligible plan may cost the same as a non-HSA high-deductible plan. In others, the premiums can actually be more expensive, a recent NHPI report finds.

As a matter of fact, a non-HSA plan offering similar coverage can carry a monthly per-employee premium that’s about $15 to $25 lower and a deductible that’s $500 to $1,000 lower than the HSA option.

Sometimes the difference is due to price-jacking: The HSA plans are the ones that’ve been hyped in radio commercials and mentioned in newspapers in recent years. Nowadays, fewer people exploring high-deductible plans ask first about the non-HSA, so insurance companies sometimes slash prices to drum up interest in those options, too. Another factor: Not all deductibles work the same.

Deductible cuts both ways

Two deductibles can look similar but work differently, and the cost scales can tilt in favor of either an HSA or a non-HSA plan. Example: HSAs by law can no longer allow first-dollar coverage of prescription drugs. But a non-HSA plan can.

On the flip side, HSAs often feature better preventive-care coverage. In some non-HSA plans, a person who has yet to meet the deductible must pay out of pocket for standard tests (example: cholesterol testing) that’re part of the routine physical. Only the office visit itself is covered.

Also, HSA-eligible plans have to follow rules that limit total out-of-pocket costs. But this can push up the premiums paid on the front end.

Best bet: Double-check with your broker to make sure you’re comparing apples to apples when reviewing the costs of HSA and non-HSA plans.