Plan Selection – Pregnancy

Another plan selection question and want to make sure I am not missing something important. We generally have low medical expenses but are expecting next year. Our doctors are covered under all of the plans.

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EPO PPO HDHP Annual Premiums ~$11,500 ~$5,400 ~$3,000 Deductible (IN) (OON) 200/600 N/A Medical MOOP (IN) (OON) 2,600/5,200 N/A Employer Contribution 0 0 1000 Subtotal (IN) (OON) 16,700 N/A Notes Maternity: $25 copay then plan pays 100% InPatient: $0 copay (newborns) then plan pays 100% Prescriptions: $4,000 MOOP Maternity: $25 copay then plan pays 100% InPatient: $250 copay then plan pays 90% after deductible Prescriptions: $4,000 MOOP Maternity: Plan pays 90% after deductible InPatient: Plan pays 90% after deductible Prescriptions: included in medical MOOP

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Does the HDHP make the most sense with the impending birth cost or are there arguments for PPO? I don't see how EPO would make sense since the premiums alone cost more than the HDHP MOOP. How do individual/family deductions and MOOPs play out – is it correct to say that each individual pays until their individual MOOP is met OR the family MOOP is met? For instance, you have 200/500 and P1 has 5,000 in charges, 4,800 of that is covered; P2 would be fully covered if they then had a 50 bill since the family MOOP was hit. Language of the plan states " If you have other family members in this plan, they have to meet their own out-of-pocket limits until the overall family out-of-pocket limit has been met" Am I misguided in thinking that we will certainly hit our MOOP?

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submitted by /u/rudebrew22
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