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Hsa Vs Ppo Healthcare Calculator
US • 2026 • HDHP + HSA vs PPO

HSA vs PPO Healthcare Calculator

Compare annual premiums and out-of-pocket costs, then subtract estimated HSA tax savings to see which plan is cheaper.

Inputs

Use your plan’s SBC. Run multiple spend scenarios for confidence.

PPO plan inputs
HDHP + HSA inputs
2026 HDHP eligibility check (simplified)
Required minimum deductible: $1,700 • Required maximum OOP: $8,500
Your HDHP numbers are within 2026 IRS thresholds for HSA-eligible HDHP (deductible & OOP max).
Tax assumptions (HSA savings)

Result (annual)

Winner
HDHP + HSA
Difference: -$2,418 (HDHP+HSA minus PPO).
PPO net annual cost
$7,300
Premium $6,000 + medical OOP $1,300
HDHP + HSA net annual cost
$4,882
Premium $4,200 + medical OOP $1,860 − tax savings $1,178
HSA tax savings (estimate)
$1,178
Employee contribution used: $3,400 at effective rate 34.65%

Break-even point

At about $35,590 of allowed medical spend, the plans are roughly equal (with your tax assumptions).

Sensitivity (net annual cost)

Allowed spend$0
PPO
$6,000
HDHP + HSA
$3,022
Difference (HDHP − PPO): -$2,978.10
Allowed spend$2,500
PPO
$7,300
HDHP + HSA
$4,882
Difference (HDHP − PPO): -$2,418.10
Allowed spend$5,000
PPO
$7,800
HDHP + HSA
$5,382
Difference (HDHP − PPO): -$2,418.10
Allowed spend$10,000
PPO
$8,800
HDHP + HSA
$6,382
Difference (HDHP − PPO): -$2,418.10
Calculator inputs stay on your device (local processing).

Disclaimer: All calculators on this website are provided for informational and illustrative purposes only. The results do not constitute professional advice (including legal, tax, financial, medical, or other advice). Despite careful programming, we assume no liability for the accuracy, completeness, or timeliness of the results. For matters requiring professional advice, we recommend consulting an appropriate specialist (e.g., a tax advisor, lawyer, accountant, or physician).

Notes & tables

2026 HSA & HDHP limits (quick table)


Item
Self-only
Family
HSA contribution limit (2026)
$4,400
$8,750
Catch-up (age 55+)
+$1,000
+$1,000
HDHP minimum deductible (HSA-eligible)
$1,700
$3,400
HDHP out-of-pocket max (HSA-eligible)
$8,500
$17,000

Note: These are federal IRS limits for HSA eligibility and contribution caps.


What this calculator does (and what it simplifies)


This tool estimates your annual net cost for:


•PPO (premiums + estimated out-of-pocket)
•HDHP + HSA (premiums + estimated out-of-pocket − estimated HSA tax savings)

It uses a standard plan model:


•You pay 100% of allowed medical spend up to the deductible.
•After deductible, you pay your coinsurance percentage.
•Your medical out-of-pocket is capped by the plan out-of-pocket maximum (premiums excluded).

It does not perfectly model copays, Rx tiers, out-of-network rules, or employer-specific plan quirks. Use it for planning and compare against your Summary of Benefits (SBC).


HSA tax savings (how to think about it)


HSA has “triple tax advantage” when used for qualified medical expenses:


•Contributions can be pre-tax (federal income tax; many states too).
•Growth is tax-free.
•Qualified withdrawals are tax-free.

This calculator focuses on the contribution tax savings piece, because it’s the most immediate and measurable for year‑to‑year plan comparison.


Payroll HSA contributions can also avoid FICA in many cases (depends on setup). Toggle it on if your contributions are taken from payroll pre‑FICA.


Where to find plan numbers fast (SBC cheat sheet)


Input
Where to find it
Tip
Annual premium (your share)
Pay stub / benefits portal
Use employee-only cost, not total employer cost
Deductible
Summary of Benefits & Coverage (SBC)
Choose in‑network if you mostly use in‑network
Coinsurance
SBC
Enter your share (e.g., 20% = 0.20)
Out-of-pocket maximum
SBC
Premiums usually not included
Expected allowed spend
Your past claims / best estimate
Run multiple scenarios (low/medium/high)

When HDHP + HSA tends to win vs PPO


HDHP + HSA often looks better when:


•Premium difference is large (PPO premium much higher).
•Your expected medical spend is low to moderate (often below or near the HDHP deductible).
•You can contribute meaningfully to HSA (higher marginal tax rate → larger tax benefit).
•You can handle higher upfront out-of-pocket if needed (cash-flow tolerance).

Related tools (internal links)


•Estimating take-home pay: [US Paycheck Calculator](/us/salary/paycheck-calculator)
•Planning retirement contributions: [401(k) vs IRA Calculator](/us/retirement/401k-vs-ira-calculator)
•Year-end moves: [401(k) / IRA Tax Savings](/us/taxes/401k-ira-tax-savings)

FAQ (9)

Does an HSA always beat a PPO because of tax savings?

Not always. Tax savings can be significant, but PPO can still be cheaper if its premium difference is small and/or the PPO plan design produces much lower out-of-pocket spending for your expected care.

What medical spend should I enter?

Use your best estimate of total allowed in-network medical costs for the year (including prescriptions if the plan treats them as medical spend). If unsure, run multiple scenarios (e.g., $0, $1k, $5k, $10k).

Do premiums count toward out-of-pocket maximum?

Typically no. Most plans define out-of-pocket max as medical cost-sharing (deductible, coinsurance, copays) and exclude premiums. Always confirm in your SBC.

Should I include employer HSA contributions in tax savings?

Employer HSA contributions are generally excluded from your taxable income already, but the primary tax savings you control comes from your own pre-tax contributions. This calculator applies tax savings to your employee contribution.

Do HSAs avoid state income tax?

In most states yes, but some states may treat HSA contributions differently. This calculator lets you turn off state tax benefit if your state doesn’t allow it.

Is the break-even point exact?

It’s an estimate based on the deductible/coinsurance/OOP max model. Real plans can have copays, Rx tiers, and network rules that change the curve.

Can I use HSA funds for premiums?

Usually not for regular health insurance premiums, with limited exceptions (e.g., certain COBRA, Medicare, unemployment situations). This calculator treats premiums as paid outside the HSA.

What happens if I don’t spend my HSA money?

Unused HSA funds generally roll over and remain yours. Many people invest HSA balances long-term, but investment options depend on the HSA provider.

Does this tool verify that my HDHP is HSA-eligible?

It checks your plan’s deductible and out-of-pocket max against the 2026 minimum/maximum thresholds. Eligibility also depends on additional IRS rules (like coverage details), so confirm with your plan documents.