rockysworld OP t1_iui5mmz wrote on October 31, 2022 at 2:50 PM

Reply to comment by gsasquatch in Having a baby - question about health insurance by rockysworld

The high deductible is $1740 a year, the PPO is 2100. Coinsurance for both is 80/20.

Last kid was c section, I literally just paid copays, we were under my insurance at a different job that had really good insurance and didn't have to go through this.

HSA is available through her employer with employer contribution of up to $750

gsasquatch t1_iui8cym wrote on October 31, 2022 at 3:09 PM

Does the HSA work with the PPO? I'd doubt it. Paying an extra $140 ($360 premium-$500 deductible) to get $750 is a no brainer.

Plus, the HSA can be treated as a tax-free retirement account as it is funded with pre-tax money, and grows tax free like a 401k. It can be used as an emergency fund, if you just pay the bills, and not submit them until such time as you need the money, even years down the line. There is something to be said for maxing that out at the $7300 per year, which only reduces your paycheck like $5000 per year.

In light of the c-section, where 20% of $50k is $10k, so you'll hit the out of pocket max on either. The lower max, means the high deductible plan is going to be $1340 cheaper.

I'm having a hard time finding a scenario where the PPO is the better way to go.

I'm on the ACA now, my premiums are going to be $1480/month for 5 with $7500/$15000. To me, your plan looks really good, very generous. Your employer would seem to be contributing 80% or more of your premium. The high deductible plan in that case would be that much cheaper for them, making the $750 HSA contribution for them worth while to push you toward the high deductible.