It's annual enrollment time, and we are torn whether to stay with my PPO health plan or switch to the HDHP+HSA option. I have never used a HDHP so don’t feel like I understand it that well. The PPO has worked will for us , but we don’t get the HSA benefit.
Both plans are through United HealthCare . My husband and I will be on the plan. My husband is getting treated for sleep apnea . I rarely see a Dr besides preventative . We are late 40s/ early 50s
PPO option (United HealthCare Standard ):
Annual premium: $4560
In-network deductible: $0person, $0family
In-network max: $4000/person, $12000 family
$25primary care copay, $35urgent care and specialist copay
HDHP option ( UHC HDHP 2000):
Annual premium: $0
In-network deductible: $2000/person, $4000family
In-network max: $5000/person, $10000 family
Co pays - 10% after deductible.
Company pays $1200 to HSA
Any advice ?
Healthcare plan choice - switch to HDHP?
Re: Healthcare plan choice - switch to HDHP?
This seems like a no brainer to me, with no premiums, a deductible on par with the other plans premiums, similar OOP max and seed money to make up for any differences.
The only caveat would be if the new plan has a different network and excludes your current care team.
The only caveat would be if the new plan has a different network and excludes your current care team.
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Re: Healthcare plan choice - switch to HDHP?
I'd probably go w/ the HSA HDHP.
To be sure, I'd look at what the billed/allowed charges were last year for the sleep apnea, since that's what you will pay up to the deductible; then 10% up to the oop max. That's basically your fixed cost since added to the premium ($0) you are sure to pay roughly what the billed/approved charges are for the sleep apnea.
Additionally, taking the HSA, the company contribution basically makes up for the difference in OOP Maximum between plans. Then when you factor in premium savings, even more so.
To be sure, I'd look at what the billed/allowed charges were last year for the sleep apnea, since that's what you will pay up to the deductible; then 10% up to the oop max. That's basically your fixed cost since added to the premium ($0) you are sure to pay roughly what the billed/approved charges are for the sleep apnea.
Additionally, taking the HSA, the company contribution basically makes up for the difference in OOP Maximum between plans. Then when you factor in premium savings, even more so.
Re: Healthcare plan choice - switch to HDHP?
One more vote for the HDHP/HSA combo.sailaway wrote: ↑Wed Aug 17, 2022 3:03 pm This seems like a no brainer to me, with no premiums, a deductible on par with the other plans premiums, similar OOP max and seed money to make up for any differences.
The only caveat would be if the new plan has a different network and excludes your current care team.
One more caveat would be if OP exceeds the $4,500 expenses - then, the costs could potentially go up quicker with the HDHP than they would with the PPO (until the OOP max of course). But with only a 10% copay, maybe they wouldn't go up that quickly.
OP, make sure you contribute to the limit of the HSA (and let it grow, i.e., don't use it, if you can pay for your expenses out of pocket).
Re: Healthcare plan choice - switch to HDHP?
Agree - particularly verifying the network, including hospitals.sailaway wrote: ↑Wed Aug 17, 2022 3:03 pm This seems like a no brainer to me, with no premiums, a deductible on par with the other plans premiums, similar OOP max and seed money to make up for any differences.
The only caveat would be if the new plan has a different network and excludes your current care team.