HDHP vs. PPO Break-Even Calculator · #105 · AL-112

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HDHP vs. PPO Break-Even Calculator

Model the total annual cost of an HDHP+HSA vs. a PPO at any spending level, accounting for the HSA tax shield. Find the exact spend where HDHP flips cheaper.

Plan Details

Coverage Type

HDHP + HSA

Monthly Premium ($)

Deductible ($)

OOP Max ($)

Coinsurance (%)

PPO

Monthly Premium ($)

Deductible ($)

OOP Max ($)

Coinsurance (%)

HSA & Usage

Employer HSA Contribution ($/yr)

Your company contributes this to your HSA annually (common: $500–$1,500).

Your Additional HSA Contribution ($/yr)

2026 individual limit: $4,400 total (incl. employer); family: $8,750. Age 55+: add $1,000.

Marginal Tax Rate (%)

Federal + state marginal rate. Used to compute HSA tax shield.

Expected Annual Medical Spend ($)

Your best guess: Low ≈ $1,500 · Moderate ≈ $5,000 · High ≈ $12,000+

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Break-Even Medical Spend

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HDHP Total @ Expected Spend

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PPO Total @ Expected Spend

Annual Total Cost Curve ($0–$20k Medical Spend)

HDHP+HSA

PPO

Break-Even

Cost at Key Spend Levels

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