BCBS PPO vs HDP – can’t figure out why anyone would choose the PPO

Hi all,

WE’re trying to decide between a Blue Cross PPO and a High Deductible Plan (HDP). We’re a family of four, two adults in their 30s and two kids under 4. Plan details are below:

PPO

annual premiums: ~$9,500

deductible: $900 for BCO network, $1500 for normal in-network (key phrase: “if you have other family members on the plan, each family member must meet their own individual deductible until the total amount of the deductible expenses paid by all family members meets the overall family deductible.” WTF does this mean??)

Out-of-pocket max: $2,400 for BCO network, $4,000 for normal in-network

Separate prescription OOP: $6,000 (supposedly this plan comes with a prescription drug card “that covers prescriptions and does not rely on deductibles being met.”, except that only came from HR and is not in the plan description)

post-deductible co-insurance: 10% for BCO network, 30% for normal in-network

HDP:

annual premiums: $7,000

HSA contribution from employer: $400

deductible: $3,000 (in comparison, this one says “if you have other famliy members on the polics, the overall family deductible must be met before the plan begins to pay”)

OOP max: $6,000 in-network

prescriptions included in deductible/OOP max

post-deductible co-insurance: 20%

Right off the top, the HSA is $2400 ahead, which more than covers the OOP difference compared to the “normal in-network”, but if we stay entirely in the BCO network, the BCO PPA would be ahead by $1200. But if we have more than $1200 worth of prescriptions, then the HSA comes out ahead. I ran a couple scenarios about potential/known upcoming health care needs (dermatology/mole treatment, vasectomy, etc), and it’s hard to see a way that either of the PPO options are much, if any, better than the HDP. They only exception being if we stay entirely within the BCO network, which seems like it might be pretty limiting.

See also  An Arm and a Leg: A ‘Payday Loan’ From a Health Care Behemoth

What am I missing?

Thanks!