Need help selecting a plan!

[wendy1948]

Greetings,

I am starting a new job in Indiana and I have to select the health insurance plan for my wife and me. We are early 30s and healthy. I never understood health insurance.

I just would like a little advice. Below are the details.

Plan A is HSA Qualified Health Plan, $121.39 eighteen times a year, with Employer HSA Contribution of $660.06

Plan B is PPO Health Plan 2023, $208.42 eighteen times a year

Individual Deductible

A:$2,500 B: $1,300

Family Deductible

A: $5,000 B: $3,900

Individual Out of Pocket Max (OOP Max)

A: $4,750 B: $4,050

Family Out of Pocket Max (OOP Max)

A: $7,150 (Individual)/$8,250 (Family) B:$9,750

Doctor's Office Visit

A: 20% Coinsurance B: 20% Coinsurance

Inpatient

A: 20% Coinsurance B: 20% Coinsurance

Outpatient

A: 20% Coinsurance B: 20% Coinsurance

Emergency Room Visit

A: $200 Copay/Visit then 20% Coinsurance B: $200 Copay/Visit then 20% Coinsurance

Prescription Drugs

A: Tier 1: 20% Coinsurance, Tier 2: 40% Coinsurance, Tier 3: 50% Coinsurance, Specialty: $110

B: Tier 1: 20% Coinsurance, Tier 2: 40% Coinsurance, Tier 3: 50% Coinsurance, Specialty: $110

Mail Order Prescription Medications

A; Tier 1: 20% Coinsurance, Tier 2: 40% Coinsurance, Tier 3: 50% Coinsurance, Specialty: $110

B: Tier 1: 20% Coinsurance, Tier 2: 40% Coinsurance, Tier 3: 50% Coinsurance, Specialty: $110

 

[christeveanity]

@wendy1948 Why a premium 18 times a year??? Did you mean to say 12 (monthly) or 26 (biweekly) or 24 (bimonthly)?

Plan A: $121.39 x 18 times a year = $2,185.02 + $8,250 OOP max = $10,435.02 total possible annual cost (family deductible $5,000, employer HSA contribution $660.06)

Plan B: $208.42 x 18 times a year = $3,751.56 + $9,750 OOP max = $13,501.56 total possible annual cost (PPO, family deductible $3,900)

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Is Plan A a PPO also?

HSA plans can be good if you are younger, the employer contributes, and you contribute to the plan over many years. You can choose investments within your HSA plan. People will pay for current medical expenses out-of-pocket and let the money in the HSA account grow to be used in the future so that, by the time retirement rolls around, you will have this nice-sized HSA account to be used to pay medical bills in your 60s. (Save your receipts over the years.)

 

[wendy1948]

@christeveanity Thanks for responding. Plan A is a high deductible and Plan B is a PPO. It’s 18 times a year is because I am a professor and I only technically work 9 months. I can spread my pay 26 times but I don’t think I can spread the monthly insurance payment.

 

[resjudicata]

@wendy1948 high deductible health plans tend to be good choices if you either intend to use your health insurance very little or very much (such as meeting the OOP). The HSA contribution from your employer will more or less make up the difference in the OOP. In the end it then comes down to premiums, and since you would be paying significantly more under plan B, plan A ends up being the better option.

 

[wendy1948]

@resjudicata This is the direction we will most likely be headed. Thanks for your time and attention to this question!!