Basics | BS-CA PPO 500 CA - Enrolled plan | BS-CA HDHP 2500/2600 CA - Eligible plan |
Overview | The plan pays 90% of in-network eligible charges and 70% of out-of-network eligible charges for most covered expenses. You will pay a copay for certain expenses. | The plan pays 90% of in-network eligible charges and 70% of out-of-network eligible charges for most covered expenses. You will pay a copay for certain expenses. |
Coinsurance | In-network: Plan pays 90% Out-of-network: Plan pays 70% | In-network: Plan pays 90% Out-of-network: Plan pays 70% |
Office copay | In-network: $25 Out-of-network: No copay | No copay in-network or out-of-network |
Deductible | There is a combined network deductible. Individual: $500 Family: $1,000 | In-network: Individual: $2,600 Family: $5,200 Out-of-network: Individual: $2,600 Family: $5,200 |
Out-of-pocket maximum | In-network: Individual: $3,500 Family: $7,000 Out-of-network: Individual: $6,500 Family: $13,000 | There is a combined network out-of-pocket limit. Individual: $5,000 Family: $10,000 |
The PPO is $4800 more per year. Worst case you max out your in-network deductible and spend $400 more, which you'll have already partially made up with no copays. I think it's a clear winner.
It sounds like "$200/month" is paid by insurance, in which case you'll looking at $2400 towards your (out-of-network) deductible, or $1400 more than the PPO ($1k deductible -> $5200 deductible) so you're still better off by about $3400 by switching to the HDCP.