Having a baby. What’s better: lower deductible or lower out of pocket max?

Hi everyone,

We are having baby number two, a planned C Section on 11/15/2024.

For the first time ever, I have a choice in health insurance plans at my company! The new plan will take effect 11/01/2024.

Important to note: Even though the plan starts 11/1, the deductible and out of pocket max do not reset until 1/1. We currently have hit our $2,000 deductible ($2,500 of the out of pocket max). This will be carried over to any new plan we choose.

These are the details:

Current Plan:

-Deductible $2,000/4,000

OOP Max: $6,500/$13,000

20% coinsurance after deductible

Copay for PCP/Spec/Rx

Total annual cost in premiums: $6,696.54

Not eligible for HSA

We can keep this, or switch to:

Deductible $5,000/10,000

OOP Max: $5,500/$11,000

No coinsurance after deductible

PCP/Spec/Rx subject to deductible

Total annual cost in premiums: $2,406.18

Eligible for HSA

Company will contribute $600 annually to HSA

We plan on hitting my wife’s OOP max with the C-Section. What we’re unsure of is what the new baby’s bill will be (hospital hasn’t been helpful in providing a consistent number).

Long term, we like the new plan a lot more. We plan ahead financially, and I’d prefer to have an HSA to contribute to instead of higher premiums. My concern is if we take this new plan right before the birth, are we shooting ourselves in the foot with the higher deductible – or do you think it will likely balance out since there is no coinsurance and a lower out-of-pocket max?

Thanks in advance for any help!

submitted by /u/Smooth-Mouse9517
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