We're currently able to select a HMO or PPO plan, and are unsure on what would be the best option, given the fact that we're planning for a baby in the 1-2 years.

HMO:
– $0 deductible
– $1500 individual OOP Max
– $30 copay for PCP visits
– $30-$45 copay for specialist visits
– 'No charge' for inpatient hospital
– $100 copay for ER

PPO:
– $250 individual deductible
– $3750 individual OOP Max
– $25 copay for PCP visits
– $30 copay for specialist visits
– 10% after deductible for inpatient hospital
– $150 copay + 10% after deductible fir ER

Based on what I'm seeing, I think grabbing HMO is the answer, BUT I can't help but feel like it's too good to be true that the OOP Max is only $1500, with no charge for inpatient hospital.

Are we right in assuming that with our HMO plan, even in the case where we rush to the hospital for delivery, have an emergency c-section, and stay in the hospital for 1+ nights, we would only be paying $1500 max?

I'm a bit fuzzy on what category of care delivering a baby would qualify under. In the medical benefit guide, I only see the below categories:

Physician Services preventative telemdecine primary care specialist visits diagnostic lab/xray complex lab inpatient hospital outpatient surgery urgent care emergency room prescriptions

I'd assume delivering a baby falls under the 'inpatient hospital' category, but surely we can't expect to receive no charge for the delivery?

submitted by /u/slugthugz
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