I’ve had PPO plans for several years. My yearly costs are high and will likely continue to be. 36M, single, NY.
This year my company’s CDHP plan premiums are going up 9% and the PPO premiums are going up 29%. I’m wondering if that tilts the scales toward CDHP.
CDHP: $580 yearly premium. $2000 deductible, $4000 OOP maximum. Company seeds HSA $700 spread over 26 paychecks. I could contribute up to $2900 pretax money to the HSA to hit the IRS $3600 maximum.
PPO: $3000 yearly premium. $500 deductible, $2500 OOP maximum. Company funds a $500 HRA.
CDHP premiums are $2400 lower. Factoring HSA/HRA company seeds, my OOP would be $1300 higher with CDHP (3300 vs 2000).
I am administered an expensive drug via IV (Remicade) once every four weeks. I’ve had the PPO for several years- the first treatment hits the $500 deductible, which uses up the $500 HRA. After that the treatments and office visits chip away at the $2500 OOP. I usually hit that in the third quarter. I make use of the drug maker’s patient assistance program- that reduces my drug cost to $5, but because it’s an IV administered at an office my PPO OOP for each treatment is around $350.
If I were to choose CDHP I am allowed to change contributions during 2022. I would pull $500 from each of my first 5 paychecks to HSA, then drop to a number that gets me to the IRS maximum by year end. The Jan/Feb treatments, billed in Mar/Apr, would drain my early HSA contributions plus about $1000, but they’d hit deductible and OOP maximum. The rest of the year will be fully covered. The company HSA contributions throughout the rest of the year give 2023 a head start.
CDHP premiums $2400 less than PPO. CDHP OOP $1300 more than PPO, though a lot of that would have HSA tax advantages. I’m leaning CDHP. Is my thinking right here? Thanks for your input.
submitted by /u/AwixaManifest
[link] [comments]I’ve had PPO plans for several years. My yearly costs are high and will likely continue to be. 36M, single, NY. This year my company’s CDHP plan premiums are going up 9% and the PPO premiums are going up 29%. I’m wondering if that tilts the scales toward CDHP. CDHP: $580 yearly premium. $2000 deductible, $4000 OOP maximum. Company seeds HSA $700 spread over 26 paychecks. I could contribute up to $2900 pretax money to the HSA to hit the IRS $3600 maximum. PPO: $3000 yearly premium. $500 deductible, $2500 OOP maximum. Company funds a $500 HRA. CDHP premiums are $2400 lower. Factoring HSA/HRA company seeds, my OOP would be $1300 higher with CDHP (3300 vs 2000). I am administered an expensive drug via IV (Remicade) once every four weeks. I’ve had the PPO for several years- the first treatment hits the $500 deductible, which uses up the $500 HRA. After that the treatments and office visits chip away at the $2500 OOP. I usually hit that in the third quarter. I make use of the drug maker’s patient assistance program- that reduces my drug cost to $5, but because it’s an IV administered at an office my PPO OOP for each treatment is around $350. If I were to choose CDHP I am allowed to change contributions during 2022. I would pull $500 from each of my first 5 paychecks to HSA, then drop to a number that gets me to the IRS maximum by year end. The Jan/Feb treatments, billed in Mar/Apr, would drain my early HSA contributions plus about $1000, but they’d hit deductible and OOP maximum. The rest of the year will be fully covered. The company HSA contributions throughout the rest of the year give 2023 a head start. CDHP premiums $2400 less than PPO. CDHP OOP $1300 more than PPO, though a lot of that would have HSA tax advantages. I’m leaning CDHP. Is my thinking right here? Thanks for your input. submitted by /u/AwixaManifest [link] [comments]Read Morer/HealthInsurance