New job – help me decide between plans
I have a new job with a state government and am looking for help deciding on healthcare plan options. I understand all the terms, have gamed out different scenarios, and nearly all scenarios seem to point to the HDHP. I have a family of 4 with kids. Am I missing something?
Details:
Family of 4. Parents in their mid-late 30s, with two kids under 3. All generally healthy, with no chronic or other major health problems. Possible upcoming surgery for one of us in the next couple years
We are deciding between a HDHP with HSA (+$750 annual match by employer) and a more traditional plan.
Both plans are on the same Anthem BCBS network
After deductible, for most costs, the HDHP usually covers 80% of costs (surgery, urgent care, etc etc), while the traditional plan covers 90%.
The traditional plan has some categories that are not subject to the deductible and have a copay instead. The ones that we could possibly use are PCP visits and specialist visits. Maternity care is also under here, but are not planning on having another baby. The HDHP has no categories like this. Other than the scenario described below, this is the one case where it seems like the HDHP could suffer, if using more than a few such visits. Am I right?
If we chose the HDHP, the plan is to still contribute the same amount monthly as we would in the traditional plan by paying into the HSA, and then some. The annual HSA contribution max is $7,000, and we’d plan to max it.
Math breakdown (annually)
Premium: HDHP $3,533, traditional plan $7,500
Deductible: HDHP $5,000*, traditional plan $1,000 individual / $3,000 family
Max out of pocket (OOP): HDHP $9,000*, traditional plan $2,250 individual / $4,500 family
HSA: Employer matches $750 annually for HDHP. No HSA for traditional plan
*the HDHP does not have a separate deductible or OOP max for individuals vs families
Math assumes all care is done in network; the out of network maximums are much higher
All annual costs for HDHP are reduced by $750 to account for the employer match
I’m copying the scenarios below that I gamed out. The left reflects scenarios where family members are all using healthcare, where the family deductible kicks in. The right reflects the worst case scenario for the HDHP I could think of, where only 1 family member is using a lot of healthcare and the others are not, thus hitting the low OOP max for the individual under the traditional plan, but where the $9k OOP max still applies for the HDHP. I don’t see this as realistic (or is it?). I was just trying to break the HDHP
Edit: picture not showing. Here’s a link: https://imgur.com/a/l5XmRgR
It seems like in most scenarios or in most years, the HDHP will win out. And factoring in the many benefits of the attached HSAs, that’s even more reason to go for the HDHP. But I’ve read over and over that if you have kids, a traditional plan is better. Am I missing something?
