Sanity/Math Check HDHP/HSA vs Copay (I have detailed numbers)
*edit apparently my formatting gets wiped when posting… in my preview I have the text in columns… sorry*
No matter how I run the numbers the HDHP+HSA combo seems to beat the Copay plan out. I just wanted a sanity check in case I was overlooking something major. Whether I look at worst case/max usage scenario vs no usage vs moderate usage the HDHP seems to be the winner. Thoughts?
I find it hard to believe the Copay plan is worse for ALL scenarios…
Currently just me and spouse mostly heathy. But we are trying for baby and have tried IUI and will likely be doing IVF (which is covered by both types of plans). For 2023 I was under the Copay plan and it has covered around 2500$ worth of treatment for 2 rounds of IUI (I joined the company late in the year so I went with the copay plan since I was only paying for a few months of Premiums as opposed to 12 months).
Google Drive link for spreadsheet
https://docs.google.com/spreadsheets/d/1L2Vnlidi9gaNuGKKQ-xnxRvCxlc6VRue/edit?usp=sharing&ouid=106521871182708779755&rtpof=true&sd=true
HDHP / HSA CO PAY
Monthly Premium 280 720
Employer Contribution 187 0
Deduct Individual 3000 200
Deduct Family 6000 600
OOP Max Individual 5000 3000
OOP Max Family 10000 6000
Annual Premium Cost -3360 -8640
Employer HSA Contrib 2250
Worse Case Scenario (assuming I stay in network)
HDHP Copay
OOP Max family cost -10000 -6000
WCS + Annual Premium -13360 -14640
0 Usage scenario HDHP CoPay
OOP Costs 0 0
Ann. Premium + Employer Cont. -1110 -8640
Middle Ground Usage HDHP CoPay
Specialist 300 x6 1800 150
labwork 100 x2 200 50
Imagery 350 x2 700 200
Urgent Care 300 x1 300 75
Pharmacy 300 300 50
Chiro x12 100 1200 300Numbers based of previous years approx costs
OOP / Copay -4500 -825
OOP/Copay + annual premiumminus employer contribution -5610 -9465
I didn't factor in potential tax savings from HSA contributions since it would skew more toward the HSA plan anyways… so it would add alot of numbers without changing the overall picture too much. And yes the co pay plans allow for FSA accounts so it kinda cancels out the HSA tax break vs FSA take break somewhat… But the impact doesnt change the big picture I dont think.
Thank you in advance. 🙂
submitted by /u/perrier22
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