[USER]

It’s time for my husband to renew our health insurance through his employer.

Our options are a PPO with a $750 individual deductible/$2,250 family deductible and $5,250/$10,500 out of pocket max which would cost $660 per month.

The other option is a high deductible PPO that has a $5,500/$11,000 deductible and $6,650/$13,300 OOPM which would cost $530 per month.

We are high earners so we try to take advantage of any opportunity to reduce our taxable income and the high deductible plan would give us the option to contribute the full $8,300 to a HSA.

Health insurance confuses the crap out of us. What would be the best cost effective option for us?

Can anyone provide any insight? Thank you in advance

[Danielle]

If you’re comfortable in excel (or you could do it on paper), when I had the option of an HDHP, I would lay out 3 scenarios for each plan and get a feel for how we’d likely shake out for the year.

One was just routine (our normal visits and normal meds, plus a couple sick visits for the kids), high was something with ER, surgery and a few specialist appts, and medium I’d tinker around with assumptions on visits/meds/etc.

I’d compare the total all in cost of premiums and OOP costs.

At the time, the HDHP was a clear winner for me so I didn’t need to get complicated on the tax advantages of the HSA because it already won.

[Pam]

For the first one, what’s the contribution after you hit deductible? Also – Check each policies’ coverage of prenatal appts, plus how they handle extra appts that go beyond standard prenatal.

If you think there’s any likelihood of being a high risk pregnancy with extra ultrasounds, perinatologist appt, etc, you should understand how those are handled.

My guess is that will steer you to the lower deductible one.

Saving on taxes isn’t worth it if you wind up spending way more on the deductible or OOPM.

They often are not part of a normal prenatal cost, so all the extra visits add up quick.

For reference, my pregnancies cost 2 out of pocket maxes each.

(2 pregnancies; each spanning two calendar years bc they are mid-year birthdays
= 4 family out of pocket maxes.) meanwhile my friend on the HMO, for a normal pregnancy it’s $400 TOTAL.

But if she has complications and needs all the extra tests, her costs skyrocket too.

[Jennifer]

I had a baby under a HDHP plan and even with an extra ultrasound, I paid just over $400 OOP over my entire pregnancy thanks to testing I had on January 2nd.

No complications though.

When I was making the decision, I put it into the health insurance wizard and only a catastrophic event would have made a difference.

I also increased my short term disability payout to 80%.

[Diane]

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