Expecting a baby! PPO or HDHP?

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Hi,

Hoping to get a little guidance from this community as insurance can be confusing! Wife and I are expecting a baby next March and are trying to choose between two plans. One is a PPO, the other is an HDHP.

PPO –

  • $3,750 deductible
  • $10,000 out of pocket max
  • 20% coinsurance after deductible
  • copays for PCP ($35), specialists ($60)
  • 20% coinsurance x-rays and labs

HDHP –

  • $3,000 deductible (aggregate deductible)
  • $8,000 out of pocket max
  • 10% coinsurance after deductible
  • 10% coinsurance for PCP, specialists, X-rays and labs

Wife is 5 months pregnant. At first glance, it sounds to me that the HDHP plan is the way to go. Lower deductible and lower out of pocket. On top of that, when she goes into labor, I’ll only be on the hook for 10% (helpful in the event we’re under the out of pocket). The only possible high costs that I would not be factoring in is her bi-weekly visits from now until labor where we’d be paying for 10% of her OBGYN visits. But with the birth, I’m wondering if we’ll already be hitting the out of pocket max anyways?

The only benefit I see to the PPO is that her OBGYN visits would be covered under co-pay, but then again labs would still be billed at 20%. Any help is appreciated! No current plans to take advantage of the HSA that goes along with the HDHP.

Thanks!

submitted by /u/JabroniPepperoni
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Hi, Hoping to get a little guidance from this community as insurance can be confusing! Wife and I are expecting a baby next March and are trying to choose between two plans. One is a PPO, the other is an HDHP. PPO –
$3,750 deductible $10,000 out of pocket max 20% coinsurance after deductible copays for PCP ($35), specialists ($60) 20% coinsurance x-rays and labs
HDHP –
$3,000 deductible (aggregate deductible) $8,000 out of pocket max 10% coinsurance after deductible 10% coinsurance for PCP, specialists, X-rays and labs
Wife is 5 months pregnant. At first glance, it sounds to me that the HDHP plan is the way to go. Lower deductible and lower out of pocket. On top of that, when she goes into labor, I’ll only be on the hook for 10% (helpful in the event we’re under the out of pocket). The only possible high costs that I would not be factoring in is her bi-weekly visits from now until labor where we’d be paying for 10% of her OBGYN visits. But with the birth, I’m wondering if we’ll already be hitting the out of pocket max anyways? The only benefit I see to the PPO is that her OBGYN visits would be covered under co-pay, but then again labs would still be billed at 20%. Any help is appreciated! No current plans to take advantage of the HSA that goes along with the HDHP. Thanks!
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