{
  "slug": "hdhp-vs-ppo-total-cost",
  "title": "HDHP vs PPO Total Cost Calculator",
  "heading": "High-Deductible Health Plan vs PPO Cost Calculator",
  "category": "financial",
  "url": "https://www.revenuelab.fyi/toolbox/hdhp-vs-ppo-total-cost",
  "summary": "Compare projected total annual cost between an HDHP+HSA and a traditional PPO plan.",
  "description": "Choosing between a high-deductible health plan and a PPO during open enrollment comes down to total expected annual cost, not just the premium difference most people focus on. An HDHP has a lower premium but shifts more cost to you until you hit the deductible, while unlocking HSA contributions with their triple tax advantage. A PPO has a higher premium but lower deductibles, copays for routine visits, and less financial risk in a bad health year. This calculator projects total annual cost under each plan across your estimated healthcare utilization, including the HSA tax savings on your HDHP contribution, so you can see which plan wins at your actual usage level rather than a generic recommendation, and where the breakeven utilization point sits between the two.",
  "formula": "Total cost = annual premium + min(expected medical spend, deductible) × coinsurance adjustment + spend beyond deductible up to OOP max − HSA tax savings (HDHP only).",
  "dateModified": "2026-09-30",
  "run_url": "https://www.revenuelab.fyi/api/public/calc?tool=hdhp-vs-ppo-total-cost",
  "inputs": [
    {
      "id": "hdhpPremium",
      "label": "HDHP annual premium",
      "kind": "number",
      "hint": null,
      "default": 3600,
      "unit": "$",
      "min": 0,
      "max": null
    },
    {
      "id": "hdhpDeductible",
      "label": "HDHP deductible",
      "kind": "number",
      "hint": null,
      "default": 3500,
      "unit": "$",
      "min": 0,
      "max": null
    },
    {
      "id": "ppoPremium",
      "label": "PPO annual premium",
      "kind": "number",
      "hint": null,
      "default": 6600,
      "unit": "$",
      "min": 0,
      "max": null
    },
    {
      "id": "ppoDeductible",
      "label": "PPO deductible",
      "kind": "number",
      "hint": null,
      "default": 1000,
      "unit": "$",
      "min": 0,
      "max": null
    },
    {
      "id": "expectedMedicalSpend",
      "label": "Expected annual medical spend (billed)",
      "kind": "number",
      "hint": null,
      "default": 4000,
      "unit": "$",
      "min": 0,
      "max": null
    },
    {
      "id": "hsaContribution",
      "label": "HSA contribution (HDHP only)",
      "kind": "number",
      "hint": null,
      "default": 2000,
      "unit": "$",
      "min": 0,
      "max": null
    },
    {
      "id": "marginalTaxRate",
      "label": "Marginal tax rate",
      "kind": "number",
      "hint": null,
      "default": 24,
      "unit": "%",
      "min": 0,
      "max": 50
    }
  ],
  "outputs": [
    {
      "id": "hdhpTotal",
      "label": "HDHP total annual cost",
      "format": "currency",
      "hint": null,
      "primary": true
    },
    {
      "id": "ppoTotal",
      "label": "PPO total annual cost",
      "format": "currency",
      "hint": null,
      "primary": false
    },
    {
      "id": "difference",
      "label": "PPO cost minus HDHP cost",
      "format": "currency",
      "hint": null,
      "primary": false
    },
    {
      "id": "hsaTaxSavings",
      "label": "HSA contribution tax savings",
      "format": "currency",
      "hint": null,
      "primary": false
    }
  ],
  "worked_example": {
    "inputs": [
      "HDHP annual premium: 3600 $",
      "HDHP deductible: 3500 $",
      "PPO annual premium: 6600 $",
      "PPO deductible: 1000 $",
      "Expected annual medical spend (billed): 4000 $",
      "HSA contribution (HDHP only): 2000 $",
      "Marginal tax rate: 24 %"
    ],
    "outputs": [
      "HDHP total annual cost: $6,720",
      "PPO total annual cost: $8,500",
      "PPO cost minus HDHP cost: $1,780",
      "HSA contribution tax savings: $480"
    ]
  },
  "how_to": {
    "title": "How to use this",
    "steps": [
      "Enter hdhp annual premium ($).",
      "Enter hdhp deductible ($).",
      "Enter ppo annual premium ($).",
      "Enter ppo deductible ($).",
      "Enter expected annual medical spend (billed) ($).",
      "Enter hsa contribution (hdhp only) ($).",
      "Enter marginal tax rate (%).",
      "Read your hdhp total annual cost on the right — it updates as you type.",
      "Hit Share to keep the scenario or send it to someone."
    ]
  },
  "scenarios": [
    {
      "name": "Conservative",
      "description": "Lower-end numbers — what if things land soft?",
      "values": {
        "hdhpPremium": 2200,
        "hdhpDeductible": 2000,
        "ppoPremium": 4000,
        "ppoDeductible": 500,
        "expectedMedicalSpend": 2500,
        "hsaContribution": 1250,
        "marginalTaxRate": 14
      }
    },
    {
      "name": "Typical",
      "description": "Defaults — the most common real-world setup.",
      "values": {
        "hdhpPremium": 3600,
        "hdhpDeductible": 3500,
        "ppoPremium": 6600,
        "ppoDeductible": 1000,
        "expectedMedicalSpend": 4000,
        "hsaContribution": 2000,
        "marginalTaxRate": 24
      }
    },
    {
      "name": "Ambitious",
      "description": "Higher-end numbers — what if things really pop?",
      "values": {
        "hdhpPremium": 5800,
        "hdhpDeductible": 5500,
        "ppoPremium": 10600,
        "ppoDeductible": 1500,
        "expectedMedicalSpend": 6500,
        "hsaContribution": 3250,
        "marginalTaxRate": 38
      }
    }
  ],
  "limitations": [
    "Results are estimates before tax, fees, and inflation unless an input explicitly covers them.",
    "Rates are treated as fixed for the whole period — variable-rate products will drift from this projection.",
    "This is educational maths, not financial advice. Check anything contractual with the lender or your accountant."
  ],
  "faq": [
    {
      "q": "What's the real advantage of the HSA that comes with an HDHP?",
      "a": "HSAs offer triple tax advantage: contributions are pre-tax, growth is tax-free, and withdrawals for qualified medical expenses are tax-free too, unlike an FSA which you can lose at year end. Unused HSA balances roll over indefinitely and can even be invested, functioning as a supplemental retirement account for future medical costs after age 65."
    },
    {
      "q": "At what usage level does a PPO usually win?",
      "a": "PPOs tend to win when you have predictable, moderate-to-high medical usage — chronic conditions requiring regular specialist visits, ongoing prescriptions, or a planned surgery — because the lower deductible and copay structure caps your exposure sooner. Healthy individuals or families with mostly preventive-care usage usually come out ahead on an HDHP."
    },
    {
      "q": "Does employer HSA contribution change this calculation?",
      "a": "Yes significantly — if your employer contributes $500-$1,500 to your HSA, that's free money that should be subtracted from your effective HDHP cost before comparing. Add any employer HSA contribution to your own contribution in this calculator's HSA field to see the full tax-advantaged benefit reflected in the total cost."
    },
    {
      "q": "Can I contribute to both an HSA and FSA in the same year?",
      "a": "Generally no, with an exception for a 'limited purpose FSA' that only covers dental and vision expenses, which is compatible with HSA eligibility. Contributing to a general-purpose FSA while also having HSA-eligible HDHP coverage disqualifies your HSA contributions for that tax year, so check your plan's FSA options carefully during enrollment."
    }
  ],
  "related": [
    "https://www.revenuelab.fyi/toolbox/cobra-vs-aca-marketplace-cost",
    "https://www.revenuelab.fyi/toolbox/medigap-plan-cost-compare"
  ],
  "license": "CC-BY-4.0",
  "citation": "RevenueLab — HDHP vs PPO Total Cost Calculator (https://www.revenuelab.fyi/toolbox/hdhp-vs-ppo-total-cost)"
}