Want to make sure I'm understanding the fairly elementary logic of single vs family max deductible (let's exclude the $1,200 company funded under the HDHP in this case). E.g. If one family member has $10k worth of medical care you'd pay $250 under LDHP or $1,600 under HDHP. Meanwhile, if you had 4 family members each receiving $10k worth of medical care you'd pay up to the family max deductible ($500 LDHP, $3,200 HDHP). Is that correct?
1) If one family member needed $10k worth of medical care:
- LDLP: You'd have to cover the first $250 for your deductible, then the next $9,750 would be covered at 90% by your insurance, for a total out of pocket cost to you of $1,225.
- HDHP: You'd have to cover the first $1,600 for your deductible, the next $7,000 of the bill would be covered at 80% by your insurance and you'd hit your personal out of pocket max of $3,000. Your insurance would completely cover the final $1,400 of the bill 100% and cover the rest of your health care bills for the remainder of that plan year.
2) If four members needed $10k worth of medical care:
- LDHP: You'd cover the first $500 for your deductible, then the next $35,000 would be covered at 90% by your insurance, for a total out of pocket cost to you of $4,000. Your family's covered expenses for the remainder of the plan year would be paid 100% by your insurance because you reached your out of pocket max.
- HDHP: You'd cover the first $3,200 for your family deductible, then the next $14,000 would be covered at 80% by your insurance, for a total out of pocket cost to you of $6,000. The final $22,800 for this event and your family's covered expenses for the remainder of the plan year would be paid 100% by your insurance because you reached your out of pocket max.
Note that in both cases, when considering the $1,200 given to your by your employer and the $1,000 difference in premiums, your total out of pocket costs are lower with the HDHP. Your HDHP offering also makes you eligible to stash $6,450 tax-free in an HSA, which you can either use to pay for medical expenses or not use and watch it grow.