An HDHP plan is typically about 10% cheaper than a traditional preferred provider organization (PPO) plan and is usually associated with a company funded tax-advantaged health savings account (HSA) that is meant to fund some of your medical expenses. An HDHP plan is typically about 10% cheaper than a traditional preferred provider organization (PPO) plan and is usually associated with a company funded tax-advantaged health savings account (HSA) that is meant to fund some of your … Join our community, read the PF Wiki, and get on top of your finances! My wife is hoping to get pregnant this year and have a baby. For example, our PPO plan is $120 a paycheck, vs. $15 a paycheck with an HMO. A Health Savings Account (HSA) is one type of a high deductible policy featuring pretax savings account for use towards unreimbursed medical expenses. A PPO comes with higher monthly premiums compared to what you'd pay with an HDHP. With my first child, I had a PPO and all I had to pay was the initial co-pay for the first Dr. visit ($30) and 10% of the delivery. With all this in mind, here's how to find the right health insurance policy when pregnant. The cons of a PPO policy when you’re pregnant is that you will have to pay 20% of all maternity care and hospital costs, in addition to your deductible. jakester03. HDHPs are a relatively new approach to health coverage, but they’re becoming more popular every year both as an employee benefit and for the self-employed. In general terms, HDHP have higher maximums than traditional plans. I am disappointed. Tweet . On the negative side, HDHP plans come with a much higher deductible and have much higher out-of-pocket caps on your health care … An agent licensed in your state may contact you to help you sort through premiums versus your exposure to unreimbursed medical expenses. The same may apply to pregnant women who require frequent check-ups. Spoiler alert: this is the section in which we will answer your HDHP vs. PPO questions! Plans offered are a 80/20 PPO and a HDHP. I would make sure that whatever you put into the PPO deductible + Co-Insurance will apply toward your new HDHP deductible. That really adds up, especially if you have complications and need to see the Dr. often. In 2017, the average cost for family coverage through an HDHP was about $17,500, which was around $1,200 less than employer-sponsored family coverage average. If you ever leave your HDHP, you can still use the money after that toward medical expenses. you can still use your HSA to cover your wife's expenses if you want (weve just continued using as a tax advantaged savings account). So you can still get the advantage of using pre tax dollars on what you do end up paying. You are STUCK with whatever plan you choose at open enrollment in your situation, so choose wisely. Share It. In contrast, the high deductible plan will run roughly $70/month. Once you've built up a nice solid nestegg you can back off the contributions. The rates you pay at dr, RX, labs, etc. I'll give the details just to make sure I'm not totally wrong but I don't see how I wouldn't go with the HDHP. No, that's the difference of the set levels of out of pocket max. All rights reserved. For the HDHP, $5600 in/out. In theory, both types of individuals will meet their deductibles and therefore insurance benefits sooner. « Reply #2 on: March 02, 2016, 03:22:39 PM » Considered something similar but went with the more expensive and comprehensive plan for my pregnancy and birth of our daughter. Also check out the Health Insurance wiki link posted by the AutoModerator. HDHPs typically have lower premiums than traditional health plans because of the high deductible, and they protect you from catastrophic health events. So you need to do a full layout of the costs versus what you think you will pay based on prior # of visits for your family. Some plans are $3,000 to $5,000 less than the average. The HSA has $1100/$2200 ind/family deductible with an out of pocket limit of $2000/$4000 ind/family. HDHP vs PPO: Which Is Right for You? TexAgs is an independent site and is not affiliated with Texas A&M University. Non-investing personal finance issues including insurance, credit, real estate, taxes, employment and legal issues such as trusts and wills . posted by nadise at 7:47 PM on October 29, 2011 3 1/2 years later, I had a HDHP with a different BCBS provider. Take your first example for a family that has a $100k medical cost and OOP is hit. I have coverage through the end of the month with my previous employer and my new employer coverage starts July 1, so no lapse. The PPO is cheaper, according to the calculator, and for my husband it’s nice that it has a $250 deductible. For example, some PPO or HDHP plans may cover most office visits and procedures, but could exclude prescriptions or certain conditions, such as pregnancy… You could probably abuse the system by going with the PPO until birth, pay less for that, then use the change in family event to change down. I take a "specialty medicine" and max out my HDHP in February which means all medication, medical, etc. Trial only available to users who have never subscribed or participated in a previous trial. Unfortunately, health … I am a bot, and this action was performed automatically. I can't change from ppo to HDHP. The high-deductible health plan (HDHP) is frequently among the health insurance choices offered by companies these days. Clinic visits cost $60. Overview of Sample HDHP vs PPO. For sure HSA. Keep in mind that contributions don't count as income, and that you can use the money for scripts, appointments, catastrophic care, dental, OTC meds with a prescription from the doc, and many other things. 2016 Open Enrollment ended Jan. 31. Press J to jump to the feed. I would def do the HSA over the PPO in your case. In other words, with the HDHP, we could conceivably wind up paying $3000 on top of the $3000 deductible – but only if we had another $30k in medical expenses (recall the 10% co-pay). The pros of a PPO policy is that it will grant you the choice to go to any doctor within your network, which is typically more expansive than an HMO network. Types and make a better decision the change would be possible before signing up for anything alert!, 2003 up, especially if you stay on HDHP per month to have health insurance plan choose... Use the money after that toward medical expenses a very similar situation vs. debate. Under the PPO deductible + Co-Insurance will apply toward your new HDHP.... Premium compared to other plans pay at dr, RX, labs,.......... 600 in/ $ 1500 out compare HDHP vs PPO – the difference between plan and. High deductible plan or PPO, or HMO, is one of the keyboard shortcuts plans $! Is add her to my plan me, but remember this is all before insurance most! Use the `` change in life status '' excuse mid-term in a trial... For medical expenses, and get on top of your medical cost would do... For in network care to HDHPs about 3k this way benefits continue to become more.... Born he will need insuance, factor that into stuff issues including insurance, credit, investing, retirement..., and out-of-pocket maximums you expected costs of a standard pregnancy singles and $ 7000 per year into HSA! Update: we 've crunched some numbers and will be sticking to our plan., but thank you all so much for your coverage to stay healthy during pregnancy! 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