Sanity check on PPO vs HDHP
Sanity check on PPO vs HDHP
I have the option enroll my family (three of us) in a PPO or HDHP through my company. My company provides a set amount of money towards the deductible, which means that I will pay a total of $671.28/year for the PPO and receive $1032.72/year for the HDHP (since the premium for the HDHP is less than the money they give us, I will recieve the difference in my paycheck).
Every way I look at it, the HDHP is clearly the superior option. It seems too good to be true, so I have a really hard time believing that I calculated everything properly. I'm hoping others can double-check my assumptions and make sure I'm making the right decision for my family.
The annual family deductible for the PPO is $1200 and the HDHP is $3000. The family out of pocket maximum for the PPO is $3450 and the HDHP is $6000. However, the employer contributes $1000 to the HSA. I plan on contributing the remaining $6100 myself to the HSA.
My family has relatively high medical expenses we expect for next year (i.e., approximately five sick-child visits, four specialist visits, one outpatient surgery, etc.). My understanding is that HDHPs are generally targeted towards healthy people with low medical expenses. However, I cannot conceive of a scenario where one would select the PPO over the HDHP. For example, assuming the worst possible outcome (e.g., major medical expenses) where I hit the out of pocket maximum, the HDHP is $154 cheaper:
PPO: $671.28 premium + $3450 out of pocket maximum = $4121.28
HDHP: -$1032.72 premium + $6000 out of pocket maximum - $1000 employer HSA contribution = $3967.28
Assuming my expenses are similar to this year (e.g., total of $10,000 billed, resulting in $2840 out of pocket for the family), my PPO out of pocket would be $2960 ( (10000-1200)*0.2 + 1200) and HDHP out of pocket would be $3600 ((10000-3000)*0.2 + 3000). The HDHP is $2064 cheaper:
PPO: $671.28 premium + $2960 out of pocket = 3631.28
HDHP: -$1032.72 premium + $3600 out of pocket - $1000 employer HSA contribution = $1567.28
I'm also planning on getting a vasectomy, which is covered on the PPO at 100% (deductible waived) and 80% on the HDHP (deductible applies). Since there's no question I will hit the family deductible, I've been able to estimate that this will add an extra $539.60 to my total cost if I choose the HDHP (i.e., 20% coinsurance under HDHP, free under PPO). So, that brings my $1567.28 to $2106.88. Still much cheaper than the PPO. I may actually be underestimating the out of pocket cost since the PPO has a copay for office visits whereas the HDHP is coinsurance (e.g., I may have to pay as much as $200 for a specialist office visit). This part is very difficult to calculate. However, when you compare my "expected" scenario for the PPO with the worst case scenario for the HDHP (e.g., because specialist coinsurance pushes my out of pocket all the way to the maximum), I would paying only $336.28 more on the HDHP.
This analysis, of course, does not factor in any tax benefits of the HSA. Since I won't have to pay federal, state or social security taxes, that saves ~40% (24% federal, 10% Oregon). In other words, it costs me only $3660 to save $6100.
Is there any reason I should not switch to the HDHP?
Every way I look at it, the HDHP is clearly the superior option. It seems too good to be true, so I have a really hard time believing that I calculated everything properly. I'm hoping others can double-check my assumptions and make sure I'm making the right decision for my family.
The annual family deductible for the PPO is $1200 and the HDHP is $3000. The family out of pocket maximum for the PPO is $3450 and the HDHP is $6000. However, the employer contributes $1000 to the HSA. I plan on contributing the remaining $6100 myself to the HSA.
My family has relatively high medical expenses we expect for next year (i.e., approximately five sick-child visits, four specialist visits, one outpatient surgery, etc.). My understanding is that HDHPs are generally targeted towards healthy people with low medical expenses. However, I cannot conceive of a scenario where one would select the PPO over the HDHP. For example, assuming the worst possible outcome (e.g., major medical expenses) where I hit the out of pocket maximum, the HDHP is $154 cheaper:
PPO: $671.28 premium + $3450 out of pocket maximum = $4121.28
HDHP: -$1032.72 premium + $6000 out of pocket maximum - $1000 employer HSA contribution = $3967.28
Assuming my expenses are similar to this year (e.g., total of $10,000 billed, resulting in $2840 out of pocket for the family), my PPO out of pocket would be $2960 ( (10000-1200)*0.2 + 1200) and HDHP out of pocket would be $3600 ((10000-3000)*0.2 + 3000). The HDHP is $2064 cheaper:
PPO: $671.28 premium + $2960 out of pocket = 3631.28
HDHP: -$1032.72 premium + $3600 out of pocket - $1000 employer HSA contribution = $1567.28
I'm also planning on getting a vasectomy, which is covered on the PPO at 100% (deductible waived) and 80% on the HDHP (deductible applies). Since there's no question I will hit the family deductible, I've been able to estimate that this will add an extra $539.60 to my total cost if I choose the HDHP (i.e., 20% coinsurance under HDHP, free under PPO). So, that brings my $1567.28 to $2106.88. Still much cheaper than the PPO. I may actually be underestimating the out of pocket cost since the PPO has a copay for office visits whereas the HDHP is coinsurance (e.g., I may have to pay as much as $200 for a specialist office visit). This part is very difficult to calculate. However, when you compare my "expected" scenario for the PPO with the worst case scenario for the HDHP (e.g., because specialist coinsurance pushes my out of pocket all the way to the maximum), I would paying only $336.28 more on the HDHP.
This analysis, of course, does not factor in any tax benefits of the HSA. Since I won't have to pay federal, state or social security taxes, that saves ~40% (24% federal, 10% Oregon). In other words, it costs me only $3660 to save $6100.
Is there any reason I should not switch to the HDHP?
Re: Sanity check on PPO vs HDHP
Might be worth putting your numbers into a couple of comparison tools, e.g., Health Savings Account (HSA) vs. Traditional Health Plan and the 'HDHP Analysis' tab of the personal finance toolbox spreadsheet.
Your analysis may be better than those generic ones, but at least you'll get to see one or two additional perspectives.
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Re: Sanity check on PPO vs HDHP
From my experience, with the company's contributions and subsidies, HDHP tends to be the superior option most of the times.
1) For healthier people who don't use much coverage (PPO deductible + PPO v. HDHP premium differences+subsidies), you pay a lower premium and since you don't use much coverage, HDHP is better.
2) In extreme situations when you meet your HDHP's Out-of-Pocket maximum, the only things in play are the HDHP's premium + company's subsidies - out of pocket maximum differences between the 2 plans. If there are significance premium differences and substantial subsidies, HDHP tends to come out ahead in this scenario too.
3) Only when a person spends more than the PPO deductible + PPO v. HDHP premium differences + HDHP subsidies, but less than the Out-of-Pocket maximum that the PPO may make sense. If the premium differences and subsidies are large, the window for 3 becomes narrower.
Without being able to control the healthcare utilization, the only certain things I can look at is premiums, and worst case scenario OOP Max. Comparing it that way, your PPO max is 3,450+$671.28 = $4,121.28 vs. HDHP = $6,000 - $1,000 HSA - $1,032.72 subsidies = $3967.28, a $154 difference like you said.
I would pick HDHP most of the times.
1) For healthier people who don't use much coverage (PPO deductible + PPO v. HDHP premium differences+subsidies), you pay a lower premium and since you don't use much coverage, HDHP is better.
2) In extreme situations when you meet your HDHP's Out-of-Pocket maximum, the only things in play are the HDHP's premium + company's subsidies - out of pocket maximum differences between the 2 plans. If there are significance premium differences and substantial subsidies, HDHP tends to come out ahead in this scenario too.
3) Only when a person spends more than the PPO deductible + PPO v. HDHP premium differences + HDHP subsidies, but less than the Out-of-Pocket maximum that the PPO may make sense. If the premium differences and subsidies are large, the window for 3 becomes narrower.
Without being able to control the healthcare utilization, the only certain things I can look at is premiums, and worst case scenario OOP Max. Comparing it that way, your PPO max is 3,450+$671.28 = $4,121.28 vs. HDHP = $6,000 - $1,000 HSA - $1,032.72 subsidies = $3967.28, a $154 difference like you said.
I would pick HDHP most of the times.
Last edited by gazelle1991 on Wed Oct 23, 2019 10:09 am, edited 1 time in total.
Re: Sanity check on PPO vs HDHP
My situation is not really the same (no HDCP), but I do have 2-PPO and 2-HMO choices. For me it all boils down to copay amounts, Office/Urgent Care. All of my choices have pretty low deductibles and out-of-pock-maximums compared to other plans I've seen, so the worst case scenario really isn't "bad" with any of them.
My biggest expense is by far the *seemingly* weekly office and urgent care visit copays between my 2-kids and spouse. So when I choose I try and look back at those costs for prior years and determine if the copay difference eats up any premium difference. Usually, even with all those visits, it would take some big emergencies or procedures to make up the premium difference. And the difference in coverages at the high end wouldn't be enough to break me. However, I've never had to look into a HDHP, but my numerous office visits *might* eat up any potential savings advantage at this point in my life, and the stress of figuring out how to incorporate an HSA into my investment plan would just result in more visits to a doctor and in turn higher healthcare costs.
My biggest expense is by far the *seemingly* weekly office and urgent care visit copays between my 2-kids and spouse. So when I choose I try and look back at those costs for prior years and determine if the copay difference eats up any premium difference. Usually, even with all those visits, it would take some big emergencies or procedures to make up the premium difference. And the difference in coverages at the high end wouldn't be enough to break me. However, I've never had to look into a HDHP, but my numerous office visits *might* eat up any potential savings advantage at this point in my life, and the stress of figuring out how to incorporate an HSA into my investment plan would just result in more visits to a doctor and in turn higher healthcare costs.
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Re: Sanity check on PPO vs HDHP
The position you're in is not uncommon, I have a similar situation: the HDHP/HSA option is better than the PPO option in most if not every scenarios because of employer contributions and the tax benefit of contributing to an HSA.
If you search the forums for past HDHP/HSA vs. PPO threads, you'll see that many employers are moving towards this model.
Re: Sanity check on PPO vs HDHP
They agree with my calculations. Thanks for pointing them out. It's good to know I didn't make a mistake in my math.FiveK wrote: ↑Tue Oct 22, 2019 1:45 pmMight be worth putting your numbers into a couple of comparison tools, e.g., Health Savings Account (HSA) vs. Traditional Health Plan and the 'HDHP Analysis' tab of the personal finance toolbox spreadsheet.
Your analysis may be better than those generic ones, but at least you'll get to see one or two additional perspectives.
Re: Sanity check on PPO vs HDHP
The worst case for the HDHP is usually if you hit the deductible exactly. Once you get past the deductible, the HDHP usually has better coverage than the conventional plan (particularly if you wouldn't have met the conventional plan deductible), and the additional payments up to the deductible become irrelevant if you hit the out-of-pocket limit. Therefore, if the HDHP comes out ahead when you hit the deductible exactly, as in your situation, it's almost surely the better plan.
Check that both plans have the same network, or that you are OK with the HDHP's network if they are different.
Check that both plans have the same network, or that you are OK with the HDHP's network if they are different.
Re: Sanity check on PPO vs HDHP
Check that both plans cover the same networks. Often PPO's have more specialized care that would be covered vs HDHP you may not have as many options, or have a higher out of network maximum.
Assuming you don't have any specialized needs though, your math appears correct that at any expense level you come out ahead with the HDHP.
Assuming you don't have any specialized needs though, your math appears correct that at any expense level you come out ahead with the HDHP.
Re: Sanity check on PPO vs HDHP
unless your kid has a chronic condition, five sick visits in one year seems like a lot to this parent. And don't forget with HD plan, you still benefit from any in network discounts.
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Re: Sanity check on PPO vs HDHP
In my experience PPO plans have exactly the same networks as HDHP plans.gch wrote: ↑Tue Oct 22, 2019 9:50 pm Check that both plans cover the same networks. Often PPO's have more specialized care that would be covered vs HDHP you may not have as many options, or have a higher out of network maximum.
Assuming you don't have any specialized needs though, your math appears correct that at any expense level you come out ahead with the HDHP.
If they were different, the incentive for the employer would work the other way. They pay more for the PPO so they would be less likely to cover the expensive specialty care.
Re: Sanity check on PPO vs HDHP
The network is identical for the PPO and HDHP (they are offered through the same provider and I called to confirm). They even confirmed that the doctor must bill the same amount regardless of whether they bill the PPO or HDHP. I also got the impression (but they weren't able to guarantee) that the discount/allowed amount would be identical regardless of whether I went through the PPO or the HDHP. So, that means the only difference between the two are the deductible, out of pocket maximum and coinsurances.HEDGEFUNDIE wrote: ↑Tue Oct 22, 2019 10:12 pm In my experience PPO plans have exactly the same networks as HDHP plans.
Re: Sanity check on PPO vs HDHP
I may have overestimated. I tend to favor calculations on the worse side and prefer to be pleasantly surprised at the end of the year.
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Re: Sanity check on PPO vs HDHP
Here's another comparison tool.
https://docs.google.com/spreadsheet/ccc ... nBUNnNUQWc
I downloaded it 4 years ago but don't remember how I found it. Maybe it was on this forum.
The sample data in the spreadsheet has a graph showing exactly what grabiner said about the worst case for HDHP. When I ran our numbers, the red graph (HDHP) was completely below the blue graph (LDHP).
We switched to HDHP and never looked back. Interestingly, after years of perfect health, my own health care has become extremely expensive. I now max out my HDHP deductible in January. Throw in an unusual year and we max out the family deductible in May. We just budget for max family and don't worry about it.
https://docs.google.com/spreadsheet/ccc ... nBUNnNUQWc
I downloaded it 4 years ago but don't remember how I found it. Maybe it was on this forum.
The sample data in the spreadsheet has a graph showing exactly what grabiner said about the worst case for HDHP. When I ran our numbers, the red graph (HDHP) was completely below the blue graph (LDHP).
We switched to HDHP and never looked back. Interestingly, after years of perfect health, my own health care has become extremely expensive. I now max out my HDHP deductible in January. Throw in an unusual year and we max out the family deductible in May. We just budget for max family and don't worry about it.
Re: Sanity check on PPO vs HDHP
+1. If you're surprised why people continue to choose the PPOs, the missing information is that many people would rather pay a higher premium (out of sight out of mind as a payroll deduction) to get a low fixed copay at the time of service. This is especially true for those who have trouble keeping enough cash on hand to cover deductibles. Another cost of poverty and/or financial illiteracy.gazelle1991 wrote: ↑Tue Oct 22, 2019 2:17 pm From my experience, with the company's contributions and subsidies, HDHP tends to be the superior option most of the times.
1) For healthier people who don't use much coverage (PPO deductible + PPO v. HDHP premium differences+subsidies), you pay a lower premium and since you don't use much coverage, HDHP is better.
2) In extreme situations when you meet your HDHP's Out-of-Pocket maximum, the only things in play are the HDHP's premium + company's subsidies - out of pocket maximum differences between the 2 plans. If there is significance premium differences and substantial subsidies, HDHP tends to come out ahead in this scenario too.
3) Only when a person spends more than the PPO deductible + PPO v. HDHP premium differences + HDHP subsidies, but less than the Out-of-Pocket maximum that the PPO may makes sense. If the premium differences and subsidies are large, the window for 3 becomes narrower.
Without being able to control the healthcare utilization, the only certain things I can look at is premiums, and worst case scenario OOP Max. Comparing it that way, your PPO max is 3,450+$671.28 = $4,121.28 vs. HDHP = $6,000 - $1,000 HSA - $1,032.72 subsidies = $3967.28, a $154 difference like you said.
I would pick HDHP most of the time.
For most Bogleheads the HDHP will be the right choice in large part because we know how to budget for lumpy expenses.
Also, in the environment described, younger healthier people who don't think they'll use the insurance at all are more likely to choose the HDHP than those with kids or chronic conditions (even if the HDHP might be cheaper for all of them). This might contribute to keeping the HDHP pool costs lower.
Re: Sanity check on PPO vs HDHP
Don't know your personal circumstances but that is elective surgery, have you considered having it done this year so it is covered under your current insurance?
Re: Sanity check on PPO vs HDHP
That would be ideal and I will try, but there are sometimes long waits for specialist appointments at my hospital. In the process of getting a referral now.
Re: Sanity check on PPO vs HDHP
This makes a lot of sense. I was surprised at the significant cost difference. It makes sense that insurers are evaluating who signs up for a particular plan, not the average across all plans.Tamarind wrote: ↑Wed Oct 23, 2019 5:25 am +1. If you're surprised why people continue to choose the PPOs, the missing information is that many people would rather pay a higher premium (out of sight out of mind as a payroll deduction) to get a low fixed copay at the time of service. This is especially true for those who have trouble keeping enough cash on hand to cover deductibles. Another cost of poverty and/or financial illiteracy.
For most Bogleheads the HDHP will be the right choice in large part because we know how to budget for lumpy expenses.
Also, in the environment described, younger healthier people who don't think they'll use the insurance at all are more likely to choose the HDHP than those with kids or chronic conditions (even if the HDHP might be cheaper for all of them). This might contribute to keeping the HDHP pool costs lower.
Re: Sanity check on PPO vs HDHP
This spreadsheet appears to be a fantastic comparison tool. Is anyone, more familiar than I with insurance, able to verify its accuracy? Based on the results I think I'm going to pull the trigger and switch plans this year. Once I leave my current LDHP PPO for the HDHP I can't go back. I want to make sure I'm not using a faulty comparison tool in my decision making.Ken Reckers wrote: ↑Tue Oct 22, 2019 11:07 pm Here's another comparison tool.
https://docs.google.com/spreadsheet/ccc ... nBUNnNUQWc
I'm also curious to hear if anyone has any other things that should be considered before making such a switch? Do young kids make a difference?
Re: Sanity check on PPO vs HDHP
Appears to give results identical to the 'HDHP Analysis' tab of the personal finance toolbox spreadsheet mentioned earlier (other than reversed line colors):csmath wrote: ↑Wed Oct 23, 2019 10:51 pmThis spreadsheet appears to be a fantastic comparison tool. Is anyone, more familiar than I with insurance, able to verify its accuracy?Ken Reckers wrote: ↑Tue Oct 22, 2019 11:07 pm Here's another comparison tool.
https://docs.google.com/spreadsheet/ccc ... nBUNnNUQWc
Both are either accurate or inaccurate, but at least "both clocks show the same time."
Re: Sanity check on PPO vs HDHP
How do prescription drugs factor into both plans?
Re: Sanity check on PPO vs HDHP
This. A Preferred Provider net work Can be a HDHP. Plan. PPO defines the in network providers and HDHP defines the cost bearing between you and the health plan.jgalt133 wrote: ↑Tue Oct 22, 2019 10:22 pmThe network is identical for the PPO and HDHP (they are offered through the same provider and I called to confirm). They even confirmed that the doctor must bill the same amount regardless of whether they bill the PPO or HDHP. I also got the impression (but they weren't able to guarantee) that the discount/allowed amount would be identical regardless of whether I went through the PPO or the HDHP. So, that means the only difference between the two are the deductible, out of pocket maximum and coinsurances.HEDGEFUNDIE wrote: ↑Tue Oct 22, 2019 10:12 pm In my experience PPO plans have exactly the same networks as HDHP plans.
Re: Sanity check on PPO vs HDHP
If you're nervous, I think it can be instructive to consider a worst case scenario. Under this scenario, the PPO waives the deductible for office visits (meaning you always have a $25 copay), whereas under the HDHP, you are responsible for the full cost of the office visit until you hit the deductible. After that, it's 20%.csmath wrote: ↑Wed Oct 23, 2019 10:51 pmThis spreadsheet appears to be a fantastic comparison tool. Is anyone, more familiar than I with insurance, able to verify its accuracy? Based on the results I think I'm going to pull the trigger and switch plans this year. Once I leave my current LDHP PPO for the HDHP I can't go back. I want to make sure I'm not using a faulty comparison tool in my decision making.Ken Reckers wrote: ↑Tue Oct 22, 2019 11:07 pm Here's another comparison tool.
https://docs.google.com/spreadsheet/ccc ... nBUNnNUQWc
I'm also curious to hear if anyone has any other things that should be considered before making such a switch? Do young kids make a difference?
So, assuming a $3000 deductible for the HDHP and 10 office visits that are billed at $300 each, you'd pay $3000 out of pocket under the HDHP and only $250 out of pocket for the PPO. Then, you need to factor in any potential differences between the premiums and employer contributions to the HSA. In my case:
$3000 out of pocket - $1000 HSA contribution - $1704 premium difference = $296 more for the HDHP. However, this is a worst case scenario and also very unlikely (if you have 10 office visits, you will likely incur other expenses that apply to the deductible for the PPO and, therefore, shift the balance back in favor of the HDHP). Plus, I'm not even factoring in the additional tax savings.
Re: Sanity check on PPO vs HDHP
You have a good plan then as many of the HSA Plans have a separate Out-of-Pocket Maximum for Pharmacy (prescription drugs) which dramatically increases one's exposure in a worst-case scenario. An example would be a plan which has a $5,000 family deductible for Medical and Pharmacy expenses that, once met, covers all Medical at 100% but prescription drugs would be subject to a higher Out-of-Pocket Maximum (say $12,000 for an additional $7,000 potential spend in a worst-case situation).
Re: Sanity check on PPO vs HDHP
For the available HDHP plan, 100% is covered after meeting the deductible.jgalt133 wrote: ↑Thu Oct 24, 2019 10:56 am If you're nervous, I think it can be instructive to consider a worst case scenario. Under this scenario, the PPO waives the deductible for office visits (meaning you always have a $25 copay), whereas under the HDHP, you are responsible for the full cost of the office visit until you hit the deductible. After that, it's 20%.
I'm going through my records to get an idea of what I would have paid under the HDHP for the last several years to see what my "full costs" would have been. I'll have a better idea where I stand then.
Re: Sanity check on PPO vs HDHP
Are you sure it's 100% after deductible or after out of pocket maximum?csmath wrote: ↑Thu Oct 24, 2019 8:43 pmFor the available HDHP plan, 100% is covered after meeting the deductible.jgalt133 wrote: ↑Thu Oct 24, 2019 10:56 am If you're nervous, I think it can be instructive to consider a worst case scenario. Under this scenario, the PPO waives the deductible for office visits (meaning you always have a $25 copay), whereas under the HDHP, you are responsible for the full cost of the office visit until you hit the deductible. After that, it's 20%.
I'm going through my records to get an idea of what I would have paid under the HDHP for the last several years to see what my "full costs" would have been. I'll have a better idea where I stand then.
Re: Sanity check on PPO vs HDHP
jgalt133 wrote: ↑Thu Oct 24, 2019 9:44 pmAre you sure it's 100% after deductible or after out of pocket maximum?csmath wrote: ↑Thu Oct 24, 2019 8:43 pmFor the available HDHP plan, 100% is covered after meeting the deductible.jgalt133 wrote: ↑Thu Oct 24, 2019 10:56 am If you're nervous, I think it can be instructive to consider a worst case scenario. Under this scenario, the PPO waives the deductible for office visits (meaning you always have a $25 copay), whereas under the HDHP, you are responsible for the full cost of the office visit until you hit the deductible. After that, it's 20%.
I'm going through my records to get an idea of what I would have paid under the HDHP for the last several years to see what my "full costs" would have been. I'll have a better idea where I stand then.
Looks like it to me.
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Re: Sanity check on PPO vs HDHP
We hit the worst-case scenario last year. After years of very few medical visits, we wound up with two surgeries, a broken foot, and a mysterious prolonged fever that required a million tests. Hit that 12K out of pocket plus. It was our first year with a high deductible plan and our last, maybe when our kids are out of the house but I felt cursed.
I realize that this is not the standard experience but it was enough for us
I realize that this is not the standard experience but it was enough for us
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Re: Sanity check on PPO vs HDHP
Some other things to consider based on experience:
- verify that you don't have a coinsurance after the deductible has been met, which can increase your cost until your out-of-pocket maximum has been met
- check that the PPO and HDHP networks are exactly the same, that your local hospital and physicians are covered as well as all their labs
- some providers will choose only the in-network services for a network-only PPO, if the HDHP allows out-of-network coverage they may favor one that is not in network even for preventive medicine; be aware that providers may go outside the network without your a priori knowledge
- check that billing is the same for the HDHP, you may spend hours untangling bills if the HDHP sends them directly to you instead of the PPO
Re: Sanity check on PPO vs HDHP
You would probably have hit the out-of-pocket max with a conventional plan as well; the co-pays on those surgeries, doctor visits, tests, and rehabs would have added up (as they did once you met the HDHP deductible).Isabelle77 wrote: ↑Fri Oct 25, 2019 10:38 am We hit the worst-case scenario last year. After years of very few medical visits, we wound up with two surgeries, a broken foot, and a mysterious prolonged fever that required a million tests. Hit that 12K out of pocket plus. It was our first year with a high deductible plan and our last, maybe when our kids are out of the house but I felt cursed.
This actually tends to be a good situation for the HDHP; while you meet the out-of-pocket max either way, you get a bigger tax savings with the HSA (unless your medical bills are so high that you get a big itemized deduction).
Re: Sanity check on PPO vs HDHP
The HDHP my company offers beats the PPO at the no-spending, max deductible, and max out-of-pocket points. Due to the HSA subsidy they provide, this year so far I *made* money on my health plan.
Re: Sanity check on PPO vs HDHP
Agreed. I'd look at what the alternative to the HDHP offered in terms of out of pocket. Often once you factor in the difference in premium, HSA employer contribution and the tax savings from your own contribution you may have come out ahead regardless.grabiner wrote: ↑Fri Oct 25, 2019 8:54 pmYou would probably have hit the out-of-pocket max with a conventional plan as well; the co-pays on those surgeries, doctor visits, tests, and rehabs would have added up (as they did once you met the HDHP deductible).Isabelle77 wrote: ↑Fri Oct 25, 2019 10:38 am We hit the worst-case scenario last year. After years of very few medical visits, we wound up with two surgeries, a broken foot, and a mysterious prolonged fever that required a million tests. Hit that 12K out of pocket plus. It was our first year with a high deductible plan and our last, maybe when our kids are out of the house but I felt cursed.
This actually tends to be a good situation for the HDHP; while you meet the out-of-pocket max either way, you get a bigger tax savings with the HSA (unless your medical bills are so high that you get a big itemized deduction).