Open Enrollment help!!

[lakelife]

Hey everyone, would love some advice on open choosing between hdhp's. Wife works for a healthcare startup and I am self employed so we have 2 options at her work.

 

Option 1 HDHP 3,000 single/6,000 family. OoP Max 6,350/12700.

Premiums are $185 a month  or $2,220 for the year

Option 2 HDHP 5,000 single/10,000 family OoP is same 6,350/12700.

Premiums are $78 a month or $948 for the year

 

Everything else is the exact same. So basically it comes down premiums compared to the deductibles. Kicker is my wife needs to have her meniscus scoped in January and a cyst removed from it. Looking at about 5,000. Based off this I think we should do option 1 but wanted some back up!

 

Thanks

[RogueDadMD]

Well if you end up with 0 expenses for the year after the surgery then you're still better off with option 2.  If you think you will have ongoing expenses and go well past the $6k deductible for option 1 then it's an easy decision to go that direction.  If you have kids then would probably also go option 1 because your chances of utilizing the system go up.

Either way make sure you're maxing out the HSA.

[lakelife]

PEMDoc wrote:

Well if you end up with 0 expenses for the year after the surgery then you’re still better off with option 2.  If you think you will have ongoing expenses and go well past the $6k deductible for option 1 then it’s an easy decision to go that direction.  If you have kids then would probably also go option 1 because your chances of utilizing the system go up.

Either way make sure you’re maxing out the HSA.

Click to expand...

I dont quite get the first part. Could you expand on that...cause if her surgery ends up being around 5k thats 2k over her individual deductible which is more than the difference in premiums.

[The White Coat Investor]

lakelife wrote:

Hey everyone, would love some advice on open choosing between hdhp’s. Wife works for a healthcare startup and I am self employed so we have 2 options at her work.

 

Option 1 HDHP 3,000 single/6,000 family. OoP Max 6,350/12700.

Premiums are $185 a month  or $2,220 for the year

Option 2 HDHP 5,000 single/10,000 family OoP is same 6,350/12700.

Premiums are $78 a month or $948 for the year

 

Everything else is the exact same. So basically it comes down premiums compared to the deductibles. Kicker is my wife needs to have her meniscus scoped in January and a cyst removed from it. Looking at about 5,000. Based off this I think we should do option 1 but wanted some back up!

 

Thanks

Click to expand...

Both of those sound awesome. Would you like to hear about mine- $1200 a month for a $6,000/12,000 deductible.

Personally, I'd probably go option 2 for my life (no significant expected health care expenses this year), but option 1 is great too. Since you're going to use your health insurance this year and probably hit the deductible, I'd probably go with option 1 if I were you.

[RogueDadMD]

lakelife wrote:

PEMDoc wrote:

Well if you end up with 0 expenses for the year after the surgery then you’re still better off with option 2.  If you think you will have ongoing expenses and go well past the $6k deductible for option 1 then it’s an easy decision to go that direction.  If you have kids then would probably also go option 1 because your chances of utilizing the system go up.

Either way make sure you’re maxing out the HSA.

Click to expand…

I dont quite get the first part. Could you expand on that…cause if her surgery ends up being around 5k thats 2k over her individual deductible which is more than the difference in premiums.

Click to expand...

Perhaps I am misunderstanding, but when you said you are self-employed I assumed you would want to be on her health insurance plan as it's likely more economical than you buying your own individual policy on an open market place.

If you are on a family plan then the 5k surgery won't meet your deductible with either option.  So then it's a matter of how much additional healthcare do you KNOW you will use (chronic meds/disease management, therapy, whatever).  Can't plan for a car accident requiring an ICU stay, but you can anticipate some things.