Insurance Plan Help – Married Couple (early 30s) with a 7 month old baby in MN.
What would you go with? I’m currently on an HDHP/HSA plan with employer # 1. It has been the best choice for my healthy wife and I up until now, even through pregnancy this year. With the baby, we are now deciding between a PPO or HSA but also deciding between our two employers. 7 month old healthy baby. No baby #2 planned for this year. All numbers are In Network.
Employer 1 (2 options):
PPO:
Deductible: $2,000 single, $6,000 family
OOP MAX: $4,000 single, $12,000 family
Cost Share (in program doctor/non-program doctor): Primary Care Physician $20/$40, Primary
Care (dependent under 19) $0, Specialist $40/$80, Urgent Care $80, ER $250/20%, Coinsurance
20% after deductible.
Premium: $149 per pay period / $3,874 annual
HSA:
Deductible: $3,000 single , $6,000 family
OOP MAX: $6,000 single $12,000 family
Cost Share (in program doctor/non-program doctor): Primary Care Physician $0/$20 after
deductible, Primary Care (dependent under 19) $0 after deductible, Specialist $20/$40 after
deductible, Urgent Care $40 after deductible, ER $250 co-pay after deductible then 20%
coinsurance, Coinsurance 20% after deductible.
Premium: $78 per pay period / $2,028 annually.
Employer contributes $2,000 to the HSA and we would plan to max out the remainder.
Employer 2 (3 options):
Deductible PPO Plan:
Deductible: $1,000 single , $2,000 family
OOP MAX: $2,000 single $4,000 family
Coinsurance: 20%
Preventative Care: $0 for Well-child care, pre/postnatal care, routine cancer screening,
immunizations/vax.
Office visits: $25 co-pay for illness/injury, chiropractic, urgent care, physical occupational &
speech therapy.
Hospital Services: Emergency room 20% coinsurance (deductible does not apply), Inpatient
Hospitalization 20% after deductible, Outpatient facility charges 20% after deductible.
Premium: $299.51 per pay period / $7,787.26 annually OR Narrow Network: $250.85 per pay
period / $6,522.10 annually.
Co-Pay PPO Plan:
Deductible: $0 single , $0 family
OOP MAX: $2,500 single $5,000 family
Coinsurance: 10%
Preventative Care: $0 for Well-child care, pre/postnatal care, routine cancer screening,
immunizations/vax.
Office visits: $20 co-pay for illness/injury, chiropractic, physical occupational &
speech therapy. $25co-pay for urgent care.
Hospital Services: Emergency room $200 co-pay. Inpatient
Hospitalization 10%, Outpatient facility charges 10%.
Premium: $316.23 per pay period / $8,222.04 annually OR Narrow Network: $259.45 per pay
period / $6,745.70 annually.
HDHP with HSA:
Deductible: $2,800 single , $5,600 family
OOP MAX: $2,800 single $5,000 family
Coinsurance: 0%
Preventative Care: $0 for Well-child care, pre/postnatal care, routine cancer screening,
immunizations/vax.
Office visits: 0% after deductible for illness/injury, chiropractic, physical occupational &
speech therapy, urgent care
Hospital Services: 0% after deductible for Emergency room, Inpatient
Hospitalization, Outpatient facility charges
Premium: $253.18 per pay period / $6,582.68 annually OR Narrow Network: $213.99/$5,563
annually.
Employer contributes $750 to HSA, we would plan to contribute close to the max.
