Need some outside perspective on HDP vs PPO plan with newborn on the way

[mindforchristmomof3]

Hi Everyone,

My wife and I are expecting our first child in July 2024. My company is updating their insurance plans this year and I realized that when we do have our child the PPO (which I'm currently enrolled in) has a large jump in premiums. Prenatal visits are 100% covered in both plans I'm considering. I haven't been on an HSA in almost 10 years and am strongly considering switching back but I wasn't sure if I'm missing something with the new plan changes listed below. At first glance, the HDP appears to come out higher total out of pocket, but I think what is throwing me off is that I'm adding the max contribution to an HSA ($7400) as an added cost as opposed to it offsetting the $8k OOP. Hoping anyone can shed some light on experience especially with newborns and insurance!

Thank you!

Any '*' listed below means after deductible has been met.

+
A
B
C

1

PPO
HDP

2
Annual Premium with wife
$7,700
$4,290

3
Annual Premium with family
$10,300
$5,560

4
Deductible
$600/$1,100
$1600/$3,200

5
HSA Contributions
N/A
$900 employee/$7,400 employee (federal limit)

6
OOP
$5000/$10,000
$4,000/$8,000

7
Coinsurance
90%
90%

8
Preventative (pre-natal included)
0% deductible waived
0% deductible waived

9
Office Visits
$25\*/$40\*
10%\*

10
Telemedicine
$25\*/$40\*
10%\*

11
Diagnostic Lab
10\*
10%\*

12
Emergency Room
$150 copay\*
10%\*

13
Urgen Care Center
$45 copay\*
10%\*

14
Inpatient Hospital Service
10%\*
10%\*

15
Outpatient Surgery
$75 copay\*
10%\*

16
Mental Health
10%\*
10%\*

17
Home Health
10%\*
10%\*

18
Rehab
10%\*
10%\*

19




20
Prescription



21
Generic (30 day)
$7.50 copay
10%\*

^Table ^formatting ^brought ^to ^you ^by ^[ExcelToReddit](https://xl2reddit.github.io/)

Edit: Table formatting

 

[basketball4him]

@mindforchristmomof3 Premiums - Company HSA contrib + deductible

PPO: 10,300 - 0 + 1100 = $11,400

HDP: 5560 -900 + 3200 = $7,860

Premiums - Company HSA contrib + OOP max

PPO: 10,300 - 0 + 10,000 = $20,300

HDP: 5560 -900 + 8000 = $12,660

Now you'll presumably be socking a lot of your own money into the HSA, but that's your money to keep and pay the bills with, not an expense as such.

As long as you have enough cash on hand to cover that 3,200 deductible with your newborn you should be fine. You only pay 10% per thing after that and most normal visits for babies aren't that much -- well baby visits and shots are preventive and free, just like most routine prenatal care, and visits for normal childhood illnesses like ear infections and strep tend to be on the inexpensive side. Birth will be a big expense, for sure, and you'll almost definitely hit the deductible, so if any unforeseen medical thing happens, you'll be in the 10% coinsurance range until you hit the OOP max.