[USER]

It’s open enrollment and I would appreciate help thinking through this. Below are my plan options for coverage for myself, husband, and 2 children.

This year is the first year I funded an HSA.

I will most likely have a c-section next year in April, which will activate deductibles for me and the child (at minimum).

Currently, there are no other medical or health needs in my family.

I feel my the High Deductible plan with HSA is still the best option, but since I know I will be accessing expensive medical services, should I opt for a PPO plan instead?

My employer does fund $1000 towards an HSA.

Any thoughts are appreciated.

[Sean]

I’d plan for family out of pocket max as a worst case scenario.
Cdhp would be 9606 minus $1000 in free money and you can contribute $7550 additional to an hsa, so if I guess 22% bracket then that’s a tax savings of $1661.
Total: $6945

Premium PPO: 4376 + 4000 out of pocket max total:$8376
So it appears the cdhp will easily come out ahead.

In the worst case scenario, although I’d imagine it’s a likely scenario with a known c-section.

If you will have access to an fsa then it’s closer but still appears the cdhp comes out ahead.

I can’t see a scenario where the base ppo would be close.

[Marie]

My employer offers additional insurance for just a few $ a month that is paid out immediately for major medical event and covers my $5k deductible.

Not sure if a c section would be a covered but it might be worth looking into.

[Danny]

Look into if your insurance offers supplemental health plan. usually $10/mo and they’ll pay you for pregnancy hospital stay.

[Dayna]

I planned on getting pregnant this year and ultimately opted for the premium PPO my company offered, more so for peace of mind and so that I wouldn’t have to constantly be running the numbers based on the care I was receiving.

It’s meant that I’ve been able to have additional appointments that I may have opted to skip if I was on the HDHP plan

[Julie]

The difference between annual costs and deductibles is nearly the same between the high deductible plan and base PPO with basically the same coverage.

The only things that would draw me towards the base PPO is the set copay for primary care and specialist visits and the $2500 family deductible, which you’ll hit quickly having a baby.

[Author]

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