Tool · Investor Sam Insurance

HDHP vs PPO True Total Cost Calculator

July 1, 2026 • By the Investor Sam Editorial Team • Reviewed by Berly Sam Varghese, Editor
Most HDHP-vs-PPO comparisons stop at premiums. The true winner varies by utilization: how often you visit a doctor, what your deductibles look like, and whether your employer seeds your HSA. This calculator runs the full-year math at your expected utilization level so you pick the plan that costs less, not just the one that looks cheaper on the brochure.

Example: HDHP monthly premium (your share): 150 $ · HDHP annual deductible: 3000 $ · HDHP coinsurance after deductible: 20 % · HDHP out-of-pocket maximum: 6550 $ · PPO monthly premium (your share): 350 $ · PPO annual deductible: 1000 $ · PPO coinsurance after deductible: 20 % · PPO out-of-pocket maximum: 4000 $ · Employer HSA contribution (annual): 800 $ · Expected annual medical claims: 2000 $

HDHP saves vs PPO (positive = HDHP wins)$2,400
HDHP true annual cost$3,000
PPO true annual cost$5,400
Claim level where PPO becomes cheaper$500

Worked example

With $2,000 in expected claims: HDHP = $150/mo × 12 + $2,000 oop − $800 HSA employer seed = $2,800. PPO = $350/mo × 12 + $1,000 deductible + 20% of $1,000 = $5,400. HDHP saves $2,600 this year. The PPO only wins once claims exceed roughly $6,000, at which point the lower PPO out-of-pocket maximum caps your exposure sooner.

Frequently asked questions

What is an HSA and why does it matter here?

A Health Savings Account lets you contribute pre-tax dollars (2024 limit: $4,150 individual / $8,300 family) that grow tax-free and can be withdrawn tax-free for qualified medical expenses. The HSA triple-tax advantage tilts the math further toward HDHPs for healthy savers.

What counts as an expected annual claim?

Add up last year's medical bills before insurance paid: doctor visits, prescriptions, labs, therapy, imaging, urgent care. If you have a chronic condition requiring regular care, use a higher estimate. The Kaiser Family Foundation reports the average employer-plan enrollee incurs about $2,800 in claims per year.

Does the HDHP always win for healthy people?

Not always. The break-even claim level varies by your specific premiums and deductibles. Some PPO plans have low enough premiums that they compete even at low utilization. Run the numbers with your actual plan values every open enrollment season.

Can I use an FSA with an HDHP?

A standard Flexible Spending Account (FSA) disqualifies you from contributing to an HSA. You may pair an HDHP with a limited-purpose FSA (restricted to dental and vision) while preserving HSA eligibility.

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Sources

Berly Sam Varghese · Editor, Investor Sam

Berly Sam Varghese is an engineer who treats money the way he treats any hard problem — something to be engineered, not gambled on. He funded years of education and built real financial stability the patient way, by living below his means and investing rather than borrowing. He writes for the person trying to work out whether they’re even covered for what matters. He reviews and approves every article on Investor Sam and checks the figures against primary sources before anything is published. More about our standards.