HSA-Eligible HDHP vs PPO Cost Calculator — Rex's Toolbox

Rex says

Money math without the spreadsheet headache. Plug in your numbers and I'll show you exactly where the dollars land.

Try a scenario

Click to load — tweak from there.

Inputs

HDHP monthly premium($)

PPO monthly premium($)

Expected annual medical spend($)

HDHP deductible($)

PPO deductible($)

Your annual HSA contribution($)

Employer HSA contribution($)

Marginal tax rate (fed+state+FICA)(%)

Result

HDHP+HSA advantage vs PPO

$2,100

HDHP after-tax annual cost

$4,740

PPO annual cost

$6,840

HSA tax savings this year

$640

HSA balance after 1 yr at 7% growth

$2,675

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How to use this

1Enter hdhp monthly premium ($).
2Enter ppo monthly premium ($).
3Enter expected annual medical spend ($).
4Enter hdhp deductible ($).
5Enter ppo deductible ($).
6Enter your annual hsa contribution ($).
7Enter employer hsa contribution ($).
8Enter marginal tax rate (fed+state+fica) (%).
9Read your hdhp+hsa advantage vs ppo on the right — it updates as you type.
10Hit Share to keep the scenario or send it to someone.

About this calculator

An HSA-eligible high-deductible plan looks more expensive on paper because you're exposed to more out-of-pocket cost before insurance kicks in. But the HSA contribution is pre-tax, grows tax-free, and — unlike an FSA — never expires, which can offset a meaningful chunk of the deductible risk. This calculator nets premiums, expected claims, and the tax value of your HSA contribution against a PPO's higher premium and lower deductible to show the real after-tax annual cost of each option at your expected medical spend. It also shows the employer HSA contribution as a straight discount, since that money is not yours to lose if you pick the PPO instead. Run this with a conservative, typical, and high medical-spend scenario since your answer can flip a few thousand dollars either way depending on how much care you actually use that year.

FormulaAfter-tax cost = premium×12 + memberClaimsShare − (HSA contribution × marginal tax rate) − employer HSA contribution.

Worked example

Using the values the calculator loads with:

Inputs

HDHP monthly premium: 210 $
PPO monthly premium: 450 $
Expected annual medical spend: 4000 $
HDHP deductible: 3200 $
PPO deductible: 800 $
Your annual HSA contribution: 2000 $
Employer HSA contribution: 500 $
Marginal tax rate (fed+state+FICA): 32 %

Results

HDHP+HSA advantage vs PPO: $2,100
HDHP after-tax annual cost: $4,740
PPO annual cost: $6,840
HSA tax savings this year: $640
HSA balance after 1 yr at 7% growth: $2,675

What each field means

Inputs

HDHP monthly premium ($): The hdhp monthly premium used in the calculation, measured in $. Starts at 210 $ so you have a working example on load.
PPO monthly premium ($): The ppo monthly premium used in the calculation, measured in $. Starts at 450 $ so you have a working example on load.
Expected annual medical spend ($): The expected annual medical spend used in the calculation, measured in $. Starts at 4000 $ so you have a working example on load.
HDHP deductible ($): The hdhp deductible used in the calculation, measured in $. Starts at 3200 $ so you have a working example on load.
PPO deductible ($): The ppo deductible used in the calculation, measured in $. Starts at 800 $ so you have a working example on load.
Your annual HSA contribution ($): The your annual hsa contribution used in the calculation, measured in $. Starts at 2000 $ so you have a working example on load.
Employer HSA contribution ($): The employer hsa contribution used in the calculation, measured in $. Starts at 500 $ so you have a working example on load.
Marginal tax rate (fed+state+FICA) (%): The marginal tax rate (fed+state+fica) used in the calculation, measured in %. Starts at 32 % so you have a working example on load. Accepted range: 0–55 %.

Results

HDHP+HSA advantage vs PPO: Returned as a money amount in US dollars and shown as the headline result. It recalculates instantly whenever you change an input, so you can compare scenarios without reloading.
HDHP after-tax annual cost: Returned as a money amount in US dollars. It recalculates instantly whenever you change an input, so you can compare scenarios without reloading.
PPO annual cost: Returned as a money amount in US dollars. It recalculates instantly whenever you change an input, so you can compare scenarios without reloading.
HSA tax savings this year: Returned as a money amount in US dollars. It recalculates instantly whenever you change an input, so you can compare scenarios without reloading.
HSA balance after 1 yr at 7% growth: Returned as a money amount in US dollars. It recalculates instantly whenever you change an input, so you can compare scenarios without reloading.

FAQ

Is unused HSA money wasted like an FSA?

No. HSA balances roll over indefinitely and stay yours even if you change jobs or plans. After age 65 you can withdraw for any purpose penalty-free (paying regular income tax on non-medical withdrawals), which makes it functionally a second retirement account.

What if I can't afford to hit the deductible in a bad year?

This is the real risk of HDHPs — a $3,200 deductible plus coinsurance up to the out-of-pocket max can hit within weeks of a surgery or ER visit. Keep the HSA balance or an emergency fund equal to at least your deductible before committing to an HDHP.

Does the employer HSA contribution count toward my IRS limit?

Yes. The 2024 individual HSA limit is $4,150 ($8,300 family), and employer contributions count against that cap, so subtract the employer amount before deciding how much more you can contribute yourself.

Why include a 7% growth assumption?

Many HSA providers let you invest balances above a small cash threshold in mutual funds once your balance is large enough. 7% approximates a conservative long-term equity blend, illustrating why maxing an HSA early is valuable even if you don't need the money for current care.

Accuracy and 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.

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Cite this calculator

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APA

RevenueLab. (2026). HSA vs PPO Total Cost Calculator. Retrieved from https://www.revenuelab.fyi/toolbox/hsa-vs-ppo-total-cost

HTML

<p>Source: <a href="https://www.revenuelab.fyi/toolbox/hsa-vs-ppo-total-cost" target="_blank" rel="noopener">HSA vs PPO Total Cost Calculator — RevenueLab</a> (2026).</p>

Markdown

Source: [HSA vs PPO Total Cost Calculator — RevenueLab](https://www.revenuelab.fyi/toolbox/hsa-vs-ppo-total-cost) (2026).