Please help me understand plan costs

[drick]

I have two plans offered to me, and it seems the one with lower premiums will also have a lower cost overall. Can that be right? Please help me compare these two. Both are PPOs...

A: $26,234 per year, $0 deductible, $8,750 family out of pocket max

B: $14,092 per year, $5,000 family deductible, $7,150 family out of pocket max, HSA option

If I understand correctly, with B, I'm guaranteed to pay $14,092, plus up to $5k of costs as they're incurred, plus 20% after that until I pay another $2,150 (thus hitting my $7,150 OOP max). So worst case, I'm out $14,092 + $7,150 = $21,242 for the year.

With A, I'm paying more than that, just for the premiums. Not to mention, B allows me to put cash into a HSA and miss some taxes there.

Am I missing something here? We're a family of 5, with good health, and no prescriptions other than an occasional antibiotic for the kids.

Thanks!

 

[samuelc]

@drick It seems pretty common for the HDHP with HSA plan to be mathematically way better than the regular PPO alternative. Same thing at my job, and I can't figure out why anyone would choose the PPO, other than it's what they're used to.

With that said, your premiums are REALLY HIGH. Have you done the affordability calculation to see if you qualify for something better through the exchange?

 

[drick]

@samuelc I think I did this before, but seems like I didn't qualify for any lower priced plans due to income. But now that the cost of this plan went up $3k since last year, I'll check again. Thanks.

But to your other point - I can't figure out what I'm missing, if I'm understanding costs correctly. BOTH are PPOs, and the cheaper one allow an HSA, for further savings.

 

[meliorakos]

@drick Your premiums are insane. Did you try the marketplace?