HDHP vs PPO Calculator
The two plans, and the year you expect
Your result will appear here
Fill in the fields and this updates as you type.
Know what this estimate is based on
- Jurisdiction
- United States — insurance is regulated state by state, so the rules behind a premium are your state's, not a federal schedule
- Rules and time period
- Premiums, limits and deductibles are the figures you enter. Health plan cost-sharing caps, Medicare amounts and state filings all reset annually.
- Scope and limitations
- Educational estimate only. Rates, required coverages and available discounts differ by where you live. Your premium is set by an insurer's own underwriting — driving record, claims history, credit-based insurance score where permitted, the property itself — and only a quote is binding. What a policy pays depends on its exclusions and limits, not on this estimate.
- Source links checked
- Sep 19, 2026
Built and regression-tested by Smart Tools Lab. It has not been individually reviewed by a licensed financial, tax, or legal professional.
How to use
- 01
Enter the medical bills you expect for the year — the total amount providers would bill, not your share. This is the input the whole comparison pivots on, so run it two or three times across a plausible range rather than betting the year on one estimate. A useful anchor is what you actually spent last year, adjusted for anything you already know is coming.
- 02
Enter each plan's monthly premium as it appears on your enrollment paperwork, taking care to use the same coverage tier for both — self-only against self-only, or family against family. Premiums are the one part of the comparison you know with certainty, and on most employer menus they are also the largest single difference between the two plans.
- 03
Add each plan's deductible and out-of-pocket maximum from its summary of benefits and coverage. The deductible sets where the plan starts contributing and the maximum sets where it takes over entirely; together they describe the whole shape of what you pay, and getting either one wrong moves the answer more than a premium error would.
- 04
Enter any money your employer puts into an HSA for you if you choose the high-deductible plan. It is real compensation that only exists on that side of the choice, so the page subtracts it from the HDHP total. Only a qualifying high-deductible plan lets you hold an HSA at all.
- 05
Read the winner and the margin, then look at the crossover point and the schedule below it. If the crossover shows a dash, one plan wins at every level of care and your estimate does not need to be right. If it shows a figure, that is the level of medical spending at which your answer changes, and how close your estimate sits to it tells you how much the guess matters.
Formula
Each plan's total for the year = the monthly premium × 12, plus your share of the bills, minus any employer HSA contribution on that plan. Your share of the bills follows the standard three-stage rule: below the deductible you pay everything; above it you pay the coinsurance percentage of the remainder; and the whole amount is capped at the out-of-pocket maximum. In one line, your share = min(out-of-pocket maximum, deductible + (bills − deductible) × coinsurance) when the bills exceed the deductible, and simply the bills when they do not. The page computes that for both plans at the care you entered and reports the difference. The crossover is found by walking the same calculation up in $100 steps and reporting the first point at which the winner changes; because both curves bend at the deductible and flatten at the maximum, they can cross once or not at all, which is why a dash is a real answer rather than a missing one. The worst case for each plan is the premium total plus the full out-of-pocket maximum, less the employer contribution.
Example
An employer offers a high-deductible plan at $120 a month with a $3,300 deductible, a $7,000 out-of-pocket maximum and $750 of employer HSA money, against a PPO at $310 a month with a $1,000 deductible and a $4,000 maximum, both at 20% coinsurance. Expecting $4,000 of bills, the HDHP costs $1,440 of premiums plus $3,440 of cost sharing less the $750 contribution, which is $4,130; the PPO costs $3,720 of premiums plus $1,600 of cost sharing, which is $5,320. The HDHP wins by $1,190. The schedule shows it winning at every level tested, from $690 against $3,720 at no care at all, to $7,690 against $7,720 at $30,000 — so the crossover reads as a dash and the decision does not depend on the estimate. Take the $750 away and the picture changes: the HDHP now costs $4,880, still ahead by $440, but a crossover appears at $18,300 and the PPO wins in a heavy year. Raise the HDHP premium to $210 with no employer contribution and the PPO wins outright by $640, with the crossover down at $2,600.
Definitions
- Medical bills you expect this year
- The total providers would bill for the year, before insurance. Last year's total is usually a better starting point than an optimistic estimate.
- HDHP
- A high-deductible health plan: lower premium, higher deductible. Only a plan meeting the IRS definition can be paired with a health savings account.
- PPO
- A preferred provider organization plan: higher premium, lower deductible, and usually some out-of-network benefit. Used here as the conventional alternative to the high-deductible option.
- Deductible
- What you pay in full before the plan begins to contribute. It resets every plan year.
- Out-of-pocket maximum
- The most the plan can charge you in a year for covered in-network care. Past it the plan pays everything, which makes it the figure that decides your worst case.
- Employer HSA contribution
- Money your employer deposits into a health savings account if you take the high-deductible plan. Subtracted from that plan's total because it exists only on that side of the choice.
- Coinsurance
- Your percentage share of covered costs after the deductible and before the maximum. Applied to both plans here so the comparison turns on the terms that actually differ.
- Crossover point
- The level of medical bills at which the cheaper plan changes. A dash means one plan wins at every level, so the estimate of future care does not affect the decision.
Frequently asked questions
Should I choose an HDHP or a PPO?
Run your own premiums, because the answer is arithmetic rather than a rule of thumb. On this page's defaults — an HDHP at $120 a month with a $3,300 deductible and $7,000 maximum plus $750 of employer HSA money, against a PPO at $310 a month with a $1,000 deductible and $4,000 maximum, at $4,000 of expected care — the HDHP costs $4,130 for the year and the PPO $5,320, so the HDHP wins by $1,190. That margin comes mostly from the $2,280 annual premium difference, which you pay whether or not you see a doctor.
What is the crossover point and why does mine say '—'?
The crossover is the level of medical bills at which the cheaper plan changes. A dash means there is no crossover in the range the page scans: one plan is cheaper at every level of care, so your estimate of next year's bills does not change the decision. That is what happens on the defaults, where the HDHP stays ahead even at $30,000 of bills, costing $7,690 against the PPO's $7,720. Remove the $750 of employer HSA money and a crossover appears at $18,300, because the HDHP has lost the subsidy that kept it ahead in a bad year.
How much does the employer's HSA contribution matter?
Enough to reverse the result on its own in a close comparison. It is counted only against the HDHP because that is the only plan it exists on. On the defaults it turns a $440 HDHP advantage into a $1,190 one, and it removes the crossover entirely — at $30,000 of care the HDHP with the contribution costs $7,690 against the PPO's $7,720, while without it the HDHP costs $8,440 and the PPO wins. Treat it as a discount on the premium rather than as a savings account balance.
Can the PPO win?
Easily, when the premium gap narrows. Raise the HDHP premium to $210 a month and remove the employer HSA contribution, leaving everything else alone: the PPO now costs $5,320 against the HDHP's $5,960 at $4,000 of care and wins by $640, with the crossover falling to $2,600 of bills. In other words, anyone expecting more than $2,600 of care that year is better off on the PPO. The general shape is that a high-deductible plan wins on premium and loses on usage, so the cheaper its premium advantage, the less care it takes to overturn it.
What does a bad year cost on each plan?
The premiums plus the full out-of-pocket maximum, less any employer HSA money. On the defaults that is $7,690 on the HDHP and $7,720 on the PPO — nearly identical, which is the genuinely surprising result here and the reason the HDHP wins at every level of care. A higher deductible is not automatically a worse worst case; what matters is where the maximum sits, not where the deductible does. Compare the worst cases before you compare the deductibles.
Does the tax saving on my own HSA contributions count?
Not in these figures, and that makes the comparison conservative toward the HDHP. Only the employer's contribution is counted. Money you put in yourself avoids federal income tax, and through payroll deduction also avoids Social Security and Medicare tax, so the real value of the high-deductible option is higher than the page shows by roughly your marginal rate on whatever you contribute. The exact benefit depends on your bracket and your state, which the page cannot know.