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Patient tool · Insurance & visit costs

HDHP vs PPO calculator

Compare a high-deductible plan with an HSA against a traditional PPO for your expected care.

Editorial review in progress · How we review

Uses 2026 figures
$

The insurer-negotiated price of your care before insurance pays.

Your top federal bracket. Most households earning $50k–$200k are in the 12%, 22% or 24% bracket.

%

Enter 0 if your state has no income tax (for example Texas, Florida or Washington).

High-deductible plan (HDHP)
$
$
%
$
$
$
PPO
$
$
%
$

Your results will appear here.
Adjust the numbers, then press Calculate.

Assumptions
  • Care is applied to the deductible first, then coinsurance, up to the out-of-pocket maximum. Copays are not modeled separately.
  • HSA benefit = employer money + the tax you save on your own contribution (federal, state and FICA through payroll).
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Choosing a health plan during open enrollment often comes down to two options: a high-deductible health plan (HDHP) that comes with a Health Savings Account, or a PPO with higher premiums and lower costs when you get care. This calculator compares them for the care you expect.

How it works

For each plan you enter your yearly premium (your share), the deductible, the coinsurance you pay after the deductible, and the out-of-pocket maximum. Then enter the full cost of the care you expect this year.

The calculator works out what you'd pay under each plan: the premium plus your share of the care. For the HDHP, it subtracts the benefits of the HSA: your employer's contribution and the taxes you save on your own contribution.

It also shows a worst case for each plan: the premium plus the full out-of-pocket maximum. That's the most you could spend in a year on covered, in-network care.

Example

With $3,000 of expected care:

  • HDHP: $1,200 premium plus $3,000 of care (all under the $3,400 deductible), minus $500 from the employer and about $673 in tax savings on a $2,000 HSA contribution = about $3,027.
  • PPO: $3,000 premium plus the $1,000 deductible and 20% of the remaining $2,000 = $4,400.

The HDHP costs about $1,373 less. In the worst case, the HDHP costs about $7,027 and the PPO $8,000.

Things this doesn't capture

Copays, prescription tiers and which doctors are in each network can matter as much as the numbers. Check that your doctors and medications are covered before you switch.

FAQ

Frequently asked questions

What makes a plan HSA-eligible in 2026?

The deductible must be at least $1,700 for self-only or $3,400 for family coverage, and the out-of-pocket maximum can't be above $8,500 or $17,000. Your plan's summary of benefits will say if it's HSA-eligible.

Where do I find the numbers to enter?

Your employer's benefits guide or each plan's Summary of Benefits and Coverage lists the premium, deductible, coinsurance and out-of-pocket maximum.

What if I'm not sure how much care I'll need?

Try a few amounts: a quiet year, a typical year and a bad year. The worst-case numbers show what you'd pay if you hit the out-of-pocket maximum.

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