Author Topic: HDCP vs. PPO  (Read 1111 times)

Clarinetah

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HDCP vs. PPO
« on: November 05, 2019, 09:27:09 PM »
It is open enrollment time, I have tried a few different online calculators and am getting different results. Mostly I am just bad at math...

PPO:
Deductible: $1,200
Coinsurance: 80% plan pays after deductible
OOP Max: $2,500
Annual Premium: $2,250

HDCP:
Deductible and OOP Max: $4,000
Coinsurance: 100% plan pays after deductible
Annual Premium: $1,200

No employer HSA contributions, but I would contribute the max amount into a Vanguard target date fund matching retirement year.

I have one year expenses in an emergency fund, and my past medical spending has ranged from $600 - $83,000 per year (surgery/hospital stay). This year I am anticipating $2,000- $4,000 per year, but who knows.

Some of the online calculators are showing there is no situation in which the PPO makes more sense, others are showing PPO winning by different margins. Is there any amount of medical spending in which switching to HDCP would be the wrong answer?
« Last Edit: November 06, 2019, 08:50:34 PM by Clarinetah »

MDM

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Re: HDCP vs. PPO
« Reply #1 on: November 06, 2019, 12:40:14 AM »
Have you tried either Health Savings Account (HSA) vs. Traditional Health Plan or the 'HDHP Analysis' tab of the case study spreadsheet?

At a quick glance using the latter tool (and guessing on some things not in the OP), "it depends..." on things such as HSA vs. FSA contributions, gross medical costs, and marginal tax rates.

Blonde Lawyer

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Re: HDCP vs. PPO
« Reply #2 on: November 06, 2019, 09:03:52 AM »
I think you mean insurance pays 80% or 100% on the co-insurance line.  Not what you will owe.  So your co-insurance would be 20% and 0% respectively, right?

Clarinetah

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Re: HDCP vs. PPO
« Reply #3 on: November 06, 2019, 08:50:49 PM »
I think you mean insurance pays 80% or 100% on the co-insurance line.  Not what you will owe.  So your co-insurance would be 20% and 0% respectively, right?

Clarified in original posting.