HDHP vs PPO for impending childbirth
Like everyone else right now, trying to decide between 2 plans for open enrollment. I’m expecting a baby and due the 1st week of January, so it’s really a toss up if I’ll give birth in 2023 or 2024. Currently on the PPO plan, but I’m evaluating whether I should choose the HDHP for 2024.
HDHP
Annual premiums for family – $4009
Company HSA contribution – $2000
Individual/family deductible – $4000 (family deductible must be met before coinsurance)
Family OOP max – $12900
Family OOP Rx max – Included in medical deductible
No copay for in-network office/specialist/mental health/PT/etc. after deductible met, which would happen w/ childbirth
PPO
Annual premiums – $5945
Individual/family deductible – $500/$1250
Family OOP max – $9650
Family OOP Rx max – $2000
$20 copay for office/mental health/specialist/etc. after deductible met, which would happen w/ childbirth
The insurance company said an event like childbirth will meet the deductible for both plans, so under the HDHP I’d pay $4000 OOP vs $500 OOP under the PPO. Taking into account the company HSA contribution of $2000 and lower premiums I think the math still works out for the HDHP being slightly ahead.
The main uncertainty is, if I give birth in 2023 (under my current PPO plan), I likely would not meet the $4000 HDHP deductible as easily in 2024 (assuming everyone is relatively healthy). And even if I did blow through my deductible, I think the HDHP still comes out slightly ahead? How does the math change if I use an FSA to cover copays/deductible under the PPO?
