I've seen a few questions about health insurance open enrollment, so I thought I'd add my own situation. We have 3 options: HSA 1, HSA 2, or PPO. All are with the same company, so the network and discounts are the same. Preventative care is covered 100% with all.
This is the key: we are expecting a baby towards the beginning of the year.
Here are the breakdowns:
HSA 1:
4000 deductible*
8000 max
20% coinsurance
1500 company contribution
1956 premium
HSA 2:
3000 deductible*
5000 max
10% coinsurance
1000 company contribution
4803 premium
*NOTE: The deductible can be satisfied by one family member or a combination of family members.
PPO:
1400 deductible**
10000 max
10% coinsurance***
5838 premium
**NOTE: Two people must meet their own $700 deductible for the $1400 deductible family deductible to be covered (it can't just come from one person)
***NOTE: Doctor visits are covered 100% after $25 copay. Specialist visits are covered 100% after $40 copay. Emergency room/physician fee covered 100% after $150 copay. Urgent care facility covered 100% after $40 copay.
It seems to me that HSA 1 comes out to be the best, but am I missing something?
Say it is a $10,000 bill for our insurance for an uncomplicated birth (not sure what it would really be).
HSA 1: 4000+(10000-4000)*.2+1956-1500= $5656
HSA 2: 3000+(10000-3000)*.1+4803-1000= $7503
PPO: 1400+(10000-1400)*.1+5838= $8098
I realize this is a little simplified due to the rules for meeting deductibles, etc. I know the HSAs would leave us with a higher hospital bill, but I've been told that hospitals let you make payments interest free.
It seems the only situation where the PPO might be better is if we find ourselves going to the doctor/emergency room/urgent care often. Normally, we don't really use any of these but who knows how healthy our kid will be. Is the higher premium worth it for the small copayments in case of emergency?
What are your thoughts? Thanks.