Are "better" plans simply not worth it if I hit my Out of Pocket max?

I feel like this must be incorrect but after doing the math, it seems like if I'm going to hit the Out of Pocket Max (actively use my insurance throughout the year), then the higher premium plan options I have just aren't worth it.

"Good" plan: Biweekly cost: $104 | OOPM: $3,100 | Yearly Deductible: $500 Plan pays 90% after deductible on basically everything until OOPM hit, then 100%

"Bad" plan: Biweekly cost: $20 | OOPM: $5,000 | Yearly Deductible: $4,000 Plan also pays 90% after deductible on basically everything until OOPM hit, then 100%. Plans can be changed every year during an open enrollment and thus biweekly costs are locked in for one year at a time.

So the good plan will cost, at most, 104 * 26 + 3100 = $5,804 The "Bad" plan will cost, at most, 20 * 26 + 5000 = $5,520

So it seems like the "good" plan is only worth it if my medical expenses are greater than (84*26) = $2,184 but less than $3,500, because only within that window do the biweekly costs + deductible offset.

Or I misunderstanding something here, or is the "bad" plan simply better except for the small window of cost calculated above? Feel free to ask questions to better help answer this.

submitted by /u/stickytoe
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See also  No options?