We are choosing between 2 health insurance options offered through my spouse's employer, standard copay-driven plan vs. HDHP + HSA plan. Conventional wisdom seems to be that a standard plan should beat the HDHP option, which is reflected in the price difference between the plans, and is what we've gone with in the past.
However, digging into the numbers more, I'm having a hard time seeing any scenarios where the standard plan wins financially, as long as we stay in-network. Even considering traditionally-expensive situations such as maternity care & childbirth, it looks to me like the HDHP comes out ahead.
Standard plan:
$3300 premiums / yr
$0 deductible
No employer HSA contribution
$2000 out of pocket max (in-network)
$15 copays (primary care or specialist, referrals not required)
$100 emergency room copay
100% coverage in-network after copays
HDHP + HSA:
$0 premiums / yr
$3000 deductible
$1500 employer HSA contribution
$10,000 out of pocket max (in-network)
no copays (full amount paid counts towards deductible)
100% coverage in-network after deductible
same prescription drug copays as standard plan after deductible
By my math, if we go w/ the HDHP, investing the $3300 saved premium plus the $1500 employer contribution gives us $4800 for services, which is already over the $3000 deductible and puts us into the fully-covered zone. Plus we could still contribute an additional $2200 to the HSA for tax savings. AND we save on the copays we'd be paying under the standard plan.
What am I missing here? Total cost (including employer subsidy) of the standard plan is ~$27k / yr, vs ~$21k / yr for the HDHP. Why does the standard plan cost so much more? Also, what's the significance of the $10,000 out of pocket max if services are covered at 100% after deductible? Is that just for tons of prescription medications? (of which we have none atm)
Any insights greatly appreciated!