Choosing between embedded vs aggregate OOPM for pregnancy year? How much after birth care is billed to the new baby?
My wife and I are already on one “employee+spouse” plan and going to try for our first baby next year. This is open enrollment season, and my employer offers 2 HDHPs, a “Bronze” one with an embedded deductible/oopm and a “Bronze Plus” one with an aggregate family deductible/oopm.
Bronze: – premiums: $203/month (+$97/month to add baby) – embedded deductible: $4900 individual / $9800 family – embedded OOPM: $6400 individual / $12800 family
Bronze Plus: – premiums: $430/month (+$155/month to add baby) – aggregate deductible: $3500 family – aggregate OOPM: $9200 family
Originally I had been thinking all pregnancy costs would go towards my wife, and given Bronze’s lower $6400 individual OOPM it would be the best option, right?
However! I just realized, of course, after birth the newborn gets his/her own deductible 😅. If a lot of care gets billed to them after birth instead of the mom, then the Bronze’s $12800 family OOPM would be worse than the Bronze Plus’ $9200 aggregate OOPM. $3600 – $2736 additional premiums = $864 worse.
How likely is it for the baby to be billed for part of the labor/delivery/etc?
The difference between the plans is slight, and we are not pregnant yet, maybe birth doesn’t happen next year…maybe I should gamble on Bronze anyway and save the premium difference?
submitted by /u/andrewbt
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