Help us choose between PPO vs HDHP. Planning for pregnancy.

Hi all, I need your help in deciding which insurance to pick during the enrollment for 2022. We are currently on a HDHP with HSA plan. Wife and I would try for pregnancy next year, so should factor in OB/GYN visits. I have used the insurance calculator, but I’m having difficulty to come to a conclusion due to our specific needs. Our company has two HDHP – Value Saver and Premier. We are on Premier HDHP as it has somewhat low deductible and out of pocket max.

Premier HDHP with HSA – Monthly premium $165 – Employer contribution to HSA $400 – Combined medical and pharmacy family deductible $3350 – Out of pocket max family $5000 – Coinsurance 10% – Specialty pharmacy 50% ($100 min $250 max)

PPO – Monthly premium $194 – Medical family deductible $1275 – Medical Out of pocket max family $6000 – Pharmacy family deductible $300 – Pharmacy Out of pocket max family $4000 – Coinsurance 10% – Copay Specialist visit $50 – Copay PCP $30 – Specialty pharmacy 50% ($100 min $250 max)

I have a chronic condition and recently put on a medication and need specialty medication refill every month which costs around $4000. I have a coupon card which would cover almost everything and also counts towards the deductible. Also I use a CPAP which needs regular replacement of supplies every quarter. We are worried that it would be very expensive if we need to go to a doctor for medical needs in the month of Jan before I meet my deductible. For PPO, we have to meet $1275 for medical expenses and a separate deductible for pharmacy. If we go for HDHP we would most probably avoid deductible and have to pay coinsurance. If we go for PPO we cannot avoid not paying for deductible. Am I thinking right? How should I weigh my options here? Please help me guide here. Appreciate any help!

submitted by /u/brainelf
[link] [comments]Hi all, I need your help in deciding which insurance to pick during the enrollment for 2022. We are currently on a HDHP with HSA plan. Wife and I would try for pregnancy next year, so should factor in OB/GYN visits. I have used the insurance calculator, but I’m having difficulty to come to a conclusion due to our specific needs. Our company has two HDHP – Value Saver and Premier. We are on Premier HDHP as it has somewhat low deductible and out of pocket max. Premier HDHP with HSA – Monthly premium $165 – Employer contribution to HSA $400 – Combined medical and pharmacy family deductible $3350 – Out of pocket max family $5000 – Coinsurance 10% – Specialty pharmacy 50% ($100 min $250 max) PPO – Monthly premium $194 – Medical family deductible $1275 – Medical Out of pocket max family $6000 – Pharmacy family deductible $300 – Pharmacy Out of pocket max family $4000 – Coinsurance 10% – Copay Specialist visit $50 – Copay PCP $30 – Specialty pharmacy 50% ($100 min $250 max) I have a chronic condition and recently put on a medication and need specialty medication refill every month which costs around $4000. I have a coupon card which would cover almost everything and also counts towards the deductible. Also I use a CPAP which needs regular replacement of supplies every quarter. We are worried that it would be very expensive if we need to go to a doctor for medical needs in the month of Jan before I meet my deductible. For PPO, we have to meet $1275 for medical expenses and a separate deductible for pharmacy. If we go for HDHP we would most probably avoid deductible and have to pay coinsurance. If we go for PPO we cannot avoid not paying for deductible. Am I thinking right? How should I weigh my options here? Please help me guide here. Appreciate any help! submitted by /u/brainelf [link] [comments]Read Morer/HealthInsurance

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