Double Check My Math For Me?
Hello Everyone,
I currently cover myself and my wife on my health insurance through my employer, and we are expecting our first child in April of 2025. We have the PPO plan offered by my company as I have a few health issues and almost always reach the OOPM, but my wife doesn’t get sick very often and usually only sees her doctors once a year and a few maintenance prescriptions.
However, knowing we will have the expense of the delivery, I’m wondering if it would be better to sign up for the HDHP option and put the difference we’d pay between the PPO and the HDHP into fully funding a HSA account.
The bi-weekly cost of the PPO would be $291 with a $1500 family deductible and a family OOPM of $8,000 but broken up with $4,000 individual OOPM’s not to exceed the $8k. With this plan, my wife would hit her OOPM of $4k with the delivery, and then myself and the baby would be left to make up the other $4k.
The bi-weekly cost of the HDHP would be $167 and would have a family deductible of $3400 and then a true family OOPM of $8k. Again, we would hit the OOPM with my wife’s delivery so our max OOPM stay’s the same, but our premiums are far lower.
Am I missing anything? The PPO has co-pays whereas the HDHP has 20% co-insurance but none of that really matters because we are guaranteed to hit the OOPM either way. My company also provides $1k towards the HSA account whereas they do not provide any subsidy for a FSA on the PPO plan.
My math says we would spend $7,556 in premiums plus $8k OOP for a total of $15,556 for the PPO plan while we’d spend $4342 in premiums and then $7k OOP since my employer would pay $1k towards the HSA account on the HDHP. In effect, we’d save a little over $4k on the HDHP option for the year. Please help me confirm my math is correct or if I missed anything. The plans are the same other than that, both BCBS Anthem plans and are the same network with coverage within any Blue Cross network nationwide.
