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HDHP vs PPO Break-Even Calculator

Whether an HDHP (paired with an HSA) beats a PPO comes down to total annual cost: premiums plus the care you actually use, after the HSA tax break. HDHPs have lower premiums but higher deductibles, so they tend to win in low- and moderate-use years and when an employer funds the HSA; PPOs can win in high-use years with predictable copays. This calculator adds up premiums, expected out-of-pocket care, your HSA tax savings and any employer HSA money to estimate which plan costs less. It is a simplified estimate, not insurance advice.

Source: IRS Rev. Proc. 2025-19 (2026 HDHP limits). Data as of 2026-06-14.

HDHP + HSA
PPO
Shared assumptions

HDHP net annual cost:

PPO net annual cost:

Lower-cost plan:

Estimate only — not insurance or tax advice. Simplified model: care is paid out of pocket up to the deductible, the HDHP's costs are reduced by the income tax saved on HSA contributions and by employer HSA money, and copays/coinsurance above the deductible are ignored. Compare real plan documents and out-of-pocket maximums before choosing.

How it works

Enter each plan's premium and deductible, your expected medical bills, your tax rate, and any HSA contributions. The HDHP's net cost is premiums plus care up to the deductible, minus the income tax saved on your HSA contribution and minus employer HSA money. The PPO's cost is premiums plus care up to its deductible. The lower total is highlighted. This model ignores coinsurance above the deductible and out-of-pocket maximums — compare real plan documents before deciding.

Important: This tool is a general estimate for educational purposes only and is not medical, tax, insurance, or financial advice. Figures use the published 2026 limits but your situation may differ. Verify with the primary source and a qualified professional. See our full disclaimer and methodology.

Frequently asked questions

Is an HDHP always cheaper than a PPO?

No. HDHPs usually win in low-to-moderate-use years thanks to lower premiums and the HSA tax break, but a PPO can be cheaper in a high-cost year with frequent care. Run your own expected spending through the calculator.

What makes a plan a qualifying HDHP for 2026?

For 2026 the plan must have a minimum deductible of at least $1,700 (self-only) or $3,400 (family), and an out-of-pocket maximum no higher than $8,500 / $17,000 (IRS Rev. Proc. 2025-19). Only a qualifying HDHP lets you contribute to an HSA.

Does the calculator include the HSA tax advantage?

Yes — it reduces the HDHP's cost by the income tax you save on your HSA contribution and by any employer HSA contribution, which is often what tips the decision toward the HDHP.

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Last updated: 2026-06-14