Health Plan Comparison Calculator: HDHP vs PPO

Open enrollment season is here. Enter the details of two health plans from your employer's benefits guide — premiums, deductible, coinsurance, out-of-pocket maximum — plus what you expect to spend on medical care next year, and this free health plan comparison calculator will show you which plan costs less overall, where the break-even point is, and how the costs compare across spending scenarios. Runs entirely in your browser; nothing is uploaded.

Plan A

Plan name

Monthly premium ($)

Annual deductible ($)

Coinsurance you pay after deductible (%)

Annual out-of-pocket maximum ($)

Employer HSA contribution ($/year)

Plan B

Plan name

Monthly premium ($)

Annual deductible ($)

Coinsurance you pay after deductible (%)

Annual out-of-pocket maximum ($)

Employer HSA contribution ($/year)

Expected annual medical expenses ($) — what you think you'll spend on care next year

Frequently Asked Questions

What is the difference between an HDHP and a PPO?

An HDHP (High-Deductible Health Plan) has lower monthly premiums but a higher deductible — you pay more out of pocket before insurance kicks in. HDHPs are usually paired with an HSA (Health Savings Account). A PPO (Preferred Provider Organization) has higher premiums but a lower deductible and more flexibility to see specialists without referrals. Neither is universally better — it depends on your expected medical spending, which is exactly what this calculator compares.

What is an out-of-pocket maximum?

It's the most you'll pay for covered services in a plan year, including your deductible, copays and coinsurance — but not your premiums. Once you hit it, the plan pays 100% of covered costs for the rest of the year. A lower out-of-pocket maximum protects you in a worst-case (high medical bills) year.

What does coinsurance mean?

After you've met your deductible, coinsurance is the percentage of covered costs you still pay. "20% coinsurance" means you pay 20% and the plan pays 80% of each covered bill, until you reach your out-of-pocket maximum.

What is the HSA triple tax advantage?

With an HDHP-qualified HSA: (1) contributions are tax-deductible (or pre-tax through payroll), (2) growth is tax-free, and (3) withdrawals for qualified medical expenses are tax-free. Some employers also seed your HSA with a yearly contribution — enter it above and this calculator subtracts it from that plan's total cost.

When should I pick the HDHP over the PPO?

As a rough rule, HDHPs tend to win for very healthy people (low expected spending — low premiums dominate) and sometimes for very high spenders (both plans hit their out-of-pocket maxes, so the cheaper premium wins). PPOs often win in the middle range. The break-even analysis above shows exactly where the crossover happens for your two plans.

Is this financial advice?

No. This is a simplified estimate for comparison purposes only — it doesn't model copays, prescription tiers, out-of-network charges, dental/vision riders, or tax effects. Always confirm details in your employer's official plan documents (Summary of Benefits and Coverage) before enrolling.