About the HDHP vs PPO Calculator
This HDHP vs PPO calculator compares the real yearly cost of the two most common employer health plan choices. For each plan it adds your share of the premiums to what you would pay out of pocket for the care you expect, capped at the plan’s out-of-pocket maximum. For the high-deductible plan it then subtracts the employer’s HSA contribution and the income tax you save by putting your own money into a health savings account.
Use it during open enrollment, when switching jobs, or when a family’s medical needs change. The chart shows how both plans’ costs move as medical spending rises, so you can see where the lines cross and how bad a worst-case year would be on each plan.
Office visits on the PPO are modelled as flat copays that do not count toward the deductible, while on the HDHP every visit is paid at the negotiated price until the deductible is met. HSA contributions, including employer money, are capped at the IRS limit for the plan year you pick: $4,400 self-only or $8,750 family for 2026 (Rev. Proc. 2025-19) and $4,500 or $9,000 for 2027 (Rev. Proc. 2026-24). The $1,000 catch-up for people 55 and older is not added automatically. Out-of-network care, prescription tiers and the time value of HSA money are not modelled.
With the default inputs, the hdhp saves you (negative = ppo is cheaper) is $1,140.00. Change any value above to recalculate instantly.
How to use the hdhp vs ppo calculator
- 1Estimate your doctor visits and other medical costs for the year.
- 2Enter each plan’s premium, deductible, coinsurance and out-of-pocket maximum.
- 3Enter the employer HSA deposit and how much you would contribute yourself.
- 4Set your tax rate, including FICA if you contribute through payroll.
- 5Compare the net costs and check the chart for how the answer changes in a bad year.
Formula and method
Out-of-pocket cost on each plan is the deductible (or the whole bill if smaller) plus coinsurance on the rest, capped at the out-of-pocket maximum. On the HDHP all care, including office visits at their negotiated price, runs through the deductible. On the PPO office visits cost a flat copay and only the other costs run through the deductible; copays count toward the out-of-pocket maximum.
The HDHP total is then reduced by the employer’s HSA deposit (free money) and by the tax you avoid on your own HSA contributions, at your marginal rate t. Money left in the HSA is yours to keep and invest, so the comparison is about yearly cost, not the balance you build.
- OOP
- Out-of-pocket cost: deductible + coinsurance, capped at the maximum
- t
- Marginal tax rate saved on HSA contributions
- HSA
- Health savings account contributions, capped at the plan year’s IRS limit
Worked examples
Healthy single employee
On the HDHP $2,900 of care costs $2,500 deductible + 20% of $400 = $2,580; premiums add $720, minus $500 employer HSA and $600 tax saved = $2,200. The PPO costs $180 in copays + $750 + 20% of $1,250 = $1,180 plus $2,160 premiums = $3,340. The HDHP saves $1,140.
Family with a major medical year
HDHP out-of-pocket is $5,000 + 20% of $21,800 = $9,360; with $2,400 premiums, minus $1,000 employer HSA and $2,100 tax saved, the net is $8,660. The PPO costs $480 copays + $1,500 + 20% of $23,500 = $6,680 plus $6,600 premiums = $13,280, so the HDHP still wins by $4,620.
No HSA money and similar premiums
Without HSA contributions and with only a $20 monthly premium difference, the HDHP’s higher deductible dominates: $1,800 premiums + $3,780 out-of-pocket = $5,580, versus $2,040 + $2,380 = $4,420 for the PPO. The PPO is $1,160 cheaper.
2026 family plan, HSA contribution over the limit
The 2026 family HSA limit is $8,750 including the $1,000 employer deposit, so only $7,750 of the planned $9,000 counts, saving $2,325 of tax at 30%. The HDHP net cost is $2,400 + $9,360 − $1,000 − $2,325 = $8,435, against $13,280 for the PPO, a $4,845 saving.
Frequently asked questions
Is an HDHP or a PPO better?+
An HDHP is usually cheaper for people with low to moderate medical costs, especially when the employer funds the HSA and you can afford to contribute. A PPO tends to win when you expect frequent visits, ongoing prescriptions or a planned procedure and the premium gap is small.
What counts as a high-deductible health plan in 2026 and 2027?+
For 2026 the IRS requires a minimum deductible of $1,700 for self-only or $3,400 for family coverage, with out-of-pocket maximums no higher than $8,500 and $17,000. For 2027 the figures are $1,750 and $3,500, with maximums of $8,700 and $17,400. Only HSA-qualified plans let you contribute to a health savings account.
How much can I put in an HSA in 2026 and 2027?+
The 2026 limits are $4,400 for self-only coverage and $8,750 for family coverage; for 2027 they rise to $4,500 and $9,000. Both include employer contributions. People 55 or older can add a $1,000 catch-up contribution.
Why is the HSA tax saving so valuable?+
HSA contributions are deductible (and escape FICA when made through payroll), grow tax-free, and come out tax-free for qualified medical expenses. That triple tax advantage can offset a large part of the higher deductible.
What happens to unused HSA money?+
It rolls over forever and stays yours if you change jobs or plans. You can invest it, and after age 65 you can withdraw it for any purpose, paying ordinary income tax on non-medical withdrawals without a penalty.
Results are estimates for educational purposes and are not financial advice. Rates, fees and terms vary — confirm with your lender or a licensed advisor before making decisions.