How desirable/necessary is OON coverage?

I'm currently stuck analyzing the multiple HDHP options of my employer vs the multiple health plan offerings (of various types) of my wife's employer. We live in the greater Boston area. We don't have any current medical conditions, but we're considering starting a family sometime in the next year or two.

Of all our health plan options, the EPO/HMO style plans look like they would be the least costly, overall, but I've always shied away from them on the assumption that inadvertent OON care is hard to avoid in an emergency, or in any kind of complex care like surgery or a pregnancy/birth. My basic assumption is that under those circumstances the savings would be illusory, and I'd wind up with some kind of enormous uncovered expense to deal with. So, in the past I've always opted for PPO or more generous HDHP plans than we're currently being offered. Now those are our most expensive-looking options, if I assume we're going to be consuming a fair bit of care in the near future.

In case you're curious, the HSAs we had from prior HDHPs have been spent down, so we don't have a pot of cash there to buffer us.

My basic question is in the title though: If we went with an EPO/HMO plan with no OON coverage, how likely is that to bite us?

I'm also open to hearing about your own experiences with such plans, to help me get a feeling for what to expect.

Thanks in advance!

submitted by /u/MgFi
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