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HMO vs Higher Deductible

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  • HMO vs Higher Deductible

    Employer is changing up Healthcare. Up until now I have had had HMO with FSA.

    PLAN A High Deductible Employee + Family
    • $2050 less than plan b
    • $3300 deductible then 90% co insurance
    • No office co pays all 90% co insurance after deductible
    • Essentially 90% co insurance across the board
    • preventative free
    • Has HSA ($600 employer contributions)
    • out of pocket max $6600

    Plan B HMO Employee + Family
    • $2050 More than plan A
    • $1000 Deductible then 80% co insurance
    • $15 PCP and $40 specialist co pays
    • After co pays and deductible Essentially 80% co insurance
    • FSA (no contribution by employer)
    • out of pocket max $5000

    The plan network and coverage is essentially the same beyond what is outlined above. I have read through the benefits of HSA and other forum posts.

    Background info:
    Mid 30s No chronic conditions
    maxing out all 403b,457,rothIRAs
    Married anticipate starting family in 2021
    could afford to max out HSA

    It seems like for fairly equal costs I could get a plan with an HSA. Having not gone through birth of a child and costs of kids does the HSA plan make sense?

  • #2
    You don’t know if you’ll be having a child in 2021. But even if you did I would go HSA for the following reasons:

    You’re starting off $2,050 in the positive
    Your employer contributes $600 to HSA
    Your likely healthcare needs
    $6500 tax deduction ($7100-$600)

    Plus, if you do have a child, per a recent post of mine, this qualifies as a special event where you can enroll in an alternative plan that is retroactive to the date of birth. Would need to check if any previously paid deductible rolls over to the new plan.

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