I have three kids. Every fall, open enrollment lands on my desk with the same question. HDHP or PPO for the family?
I want to be honest up front. There is no answer that is right for everyone. The plan that wins depends on your family's numbers. But the math is simpler than the insurance forms make it look.
Start with the two premiums
Look at your paycheck deduction for each plan. That is the annual premium. PPO premiums are usually higher. The HDHP usually costs less per paycheck.
Write down the yearly difference. Say the HDHP saves you $2,400 a year in premiums. That is a hypothetical. Run your own number from your real paystub.
That premium savings is money in your pocket before you see a single doctor. Hold onto it. It matters in a minute.
Then look at the deductible gap
Here is where families get scared. The HDHP has a higher deductible. With three kids, somebody is always at the doctor.
For 2026, an HSA-qualifying family HDHP has a deductible of at least $3,400. Its out-of-pocket max cannot go above $17,000 for family coverage. For 2027, the minimum deductible rises to $3,500 and the out-of-pocket cap rises to $17,400.
That out-of-pocket max is your worst case. It is the most you pay in a truly bad year. The premium is what you pay in every year.
The HSA is the part people skip
The HDHP comes with an HSA. The PPO usually does not. This is the piece that flips the math.
In 2026 you can put $8,750 into a family HSA. In 2027 that rises to $9,000. That money goes in pre-tax, grows tax-free, and comes out tax-free for medical costs.
If your employer chips in, that counts toward your limit. It shows up on your W-2 in Box 12 with code W. It is generally not hit by employment taxes. So an employer contribution is close to free money.
Run a hypothetical year
Take a hypothetical family. The HDHP saves $2,400 in premiums. The employer drops $1,000 into the HSA.
Now imagine a rough year with $5,000 in medical bills. You pay those bills, but you pay them with HSA dollars you never paid tax on. The premium savings plus the employer money already covered $3,400 of the gap before your own cash showed up.
Run your own version. Plug your premiums, your deductible, and your expected bills into our HDHP vs PPO calculator. It does the comparison in about a minute.
When the PPO still wins
I am not here to sell you the HDHP. Sometimes the PPO is the better call.
If your family hits the deductible every single year with expensive, predictable care, the PPO's lower deductible can beat the premium savings. Kids with ongoing specialist visits or standing prescriptions change the math fast. Our post on HDHP plans and high medical bills walks through that case.
The point is to check. Do not pick the PPO out of fear because the deductible number looks big.
The one habit that pays off later
Whichever plan you choose, if you land on the HDHP, save every receipt. You do not have to reimburse yourself right away.
You can pay a doctor bill today, leave the money in the HSA to grow, and pay yourself back years later. The only rule is you need the receipt. We wrote about when to reimburse yourself if you want the long game.
That is the whole reason I built Tripl. Three kids means a shoebox of receipts, and I did not trust myself to keep them straight.
*This is educational content, not financial or tax advice. Consult a qualified professional before making decisions about your HSA.*