Health Plan Comparison Calculator
HSA vs PPO: which plan costs you less for the year?
Enter two plans from your open enrollment materials. The calculator adds a year of premiums to what you would pay for care, then subtracts employer HSA money and the tax you save on your own HSA contributions, for a light, moderate, and heavy year of care.
What comes out of your paycheck
What comes out of your paycheck
2027 limit incl. employer money: $4,500 self / $9,000 family
Federal + state + 7.65% FICA if paid through payroll
Total billed cost of care you expect this year
| Year of care | Plan A | Plan B | Cheaper |
|---|---|---|---|
| Light year ($500 of care: checkups, a few prescriptions) | $2,300 | -$280 | Plan B by $2,580 |
| Moderate year ($5,000 of care: specialist visits, imaging, minor procedure) | $3,600 | $2,940 | Plan B by $660 |
| Heavy year ($30,000 of care: surgery, hospital stay, or childbirth) | $5,800 | $6,220 | Plan A by $420 |
Disclaimer: This calculator provides estimates for educational and informational purposes only. It does not constitute tax, legal, financial, or medical advice. Results depend on individual circumstances and may not reflect your actual costs. Always consult a qualified professional (CPA, licensed insurance agent, or financial advisor) for decisions about your specific situation. Data reflects approximate 2026 figures from IRS, CMS, and HHS sources.
How to Choose Between an HSA Plan and a PPO
At open enrollment, the plan with the lowest premium is not always the cheapest, and the plan with the lowest deductible is not always the safest bet. What matters is your total yearly cost: premiums plus what you pay for care, minus any HSA money. Because nobody knows in advance whether they will have a quiet year or a hospital stay, the calculator shows all three and the point where the answer flips.
Worked example (the calculator's default plans)
- Plan A (PPO): $150/month, $1,000 deductible, 20% coinsurance, $4,000 out-of-pocket max.
- Plan B (HDHP with HSA): $60/month, $3,400 deductible, 20% coinsurance, $7,000 out-of-pocket max, $750 employer HSA contribution, and you put in $2,500 at a 30% tax rate (saving $750).
| Year of care | Plan A total | Plan B total | Cheaper |
|---|---|---|---|
| Light ($500 of care) | $2,300 | -$280 | B by $2,580 |
| Moderate ($5,000) | $3,600 | $2,940 | B by $660 |
| Heavy ($30,000) | $5,800 | $6,220 | A by $420 |
Plan B stays cheaper until you use about $19,300 of care in a year. Above that, Plan A's lower out-of-pocket maximum wins, but by at most $420 in this example. In a light year Plan B's net cost is negative: the HSA money is larger than its premiums and care, and the difference stays in your HSA.
When the HSA Plan Usually Wins
- You are generally healthy and expect light to moderate care.
- Your employer puts money into the HSA.
- You can afford to cover the higher deductible from savings if something happens.
- You want to save for future medical costs or retirement: HSA money rolls over and can be invested. See the 2027 HSA limits ($4,500 self, $9,000 family).
When the PPO Usually Wins
- You expect a big medical year: a planned surgery, pregnancy, or ongoing treatment.
- You fill expensive prescriptions every month and the PPO has low drug copays.
- The premium difference is small, so the HSA plan's savings don't cover its higher out-of-pocket risk.
- Your doctors are in the PPO's network but not the HSA plan's.
Related Tools
Check a single bill with the Out-of-Pocket Cost Calculator, see your tax savings in detail with the HSA Tax Savings Calculator, or, if your employer offers an FSA instead, use the FSA Calculator. For the full open enrollment checklist, read Open Enrollment 2027 and HSA vs FSA.
Sources: IRS Publication 969 and Revenue Procedure 2026-24 (HSA and HDHP rules and 2027 limits); HealthCare.gov (deductible, coinsurance, out-of-pocket maximum). Example plans are illustrative. Estimates for comparison only; check each plan's Summary of Benefits and Coverage.
Frequently Asked Questions
Is an HSA plan or a PPO cheaper?
It depends on how much care you use. A high-deductible HSA plan usually has lower premiums and comes with tax savings and often employer HSA money, so it tends to win in light and moderate years. A PPO has a lower deductible and out-of-pocket maximum, so it can win in a year with large medical bills. The calculator finds the spending level where the cheaper plan switches.
How do I compare two health insurance plans?
Add up the yearly premiums you pay, then add what you would pay for care: the deductible first, then your coinsurance share, up to the out-of-pocket maximum. For an HSA plan, subtract your employer's HSA contribution and the tax you save on your own contributions. Do this for a light, typical, and bad year, since you can't know in advance which you will have.
What is a break-even point between two plans?
It is the amount of medical care in a year at which both plans cost you the same in total. Below it, the plan with lower premiums is usually cheaper; above it, the plan with the lower deductible and out-of-pocket maximum wins.
Can the total cost of an HSA plan be negative?
Yes. If your employer's HSA contribution plus your tax savings are larger than your premiums and medical costs, the net cost shows as negative. That money is not lost: unused HSA funds stay in your account, roll over every year, and can be invested.
What tax rate should I use for HSA savings?
Add your federal bracket, your state income tax rate, and 7.65% for Social Security and Medicare tax if you contribute through payroll. For example, 22% federal + 5% state + 7.65% FICA is about 35%. California and New Jersey tax HSA contributions at the state level, so leave state tax out there.
Does this include copays and out-of-network care?
No. It models the deductible, coinsurance, and out-of-pocket maximum for in-network care, which drive most of the cost difference between plans. If one plan has generous copays for visits or drugs you use often, factor that in, and check that your doctors are in each plan's network.