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HSA vs PPO in Year of Birth

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  • HSA vs PPO in Year of Birth

    OK, I have seen a lot of posts on this issue. From what I have investigated it seems that the birth of a child is a qualifying event that allows for a change in coverage that is retroactive to the date of birth. Thus, isn’t the discussion of HSA versus PPO really a question of whether or not the decision is optimal at the time of birth, given prior expenditures that year?

    Furthermore, I think the grace period for this election is 60 days. Wouldn’t this allow you to look at the EOB and then make an optimal decision?

  • #2
    Isn't all the stuff prior to a birth really expensive too? It is for us, so I actually think the question is not at the time of birth, but at the time of conception (which probably isn't a qualifying event)

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    • #3
      Depending on complications it can be very costly. We had twins and even though it was as routine as twins can be there is so many ultrasounds and they are a lot!

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      • #4
        Routine checks are covered under the ACA I thought. Sure, an U/S is going to cost you. But the odds of needing multiple are low. The biggest cost is at time of birth and in the 1-2 days to follow. The rules, as I understand them, allow you to game the system a little. Though I’m sure if you change plans deductibles reset.

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        • #5
          Originally posted by ENT Doc View Post
          Routine checks are covered under the ACA I thought. Sure, an U/S is going to cost you. But the odds of needing multiple are low. The biggest cost is at time of birth and in the 1-2 days to follow. The rules, as I understand them, allow you to game the system a little. Though I’m sure if you change plans deductibles reset.
          Yes most likely you will be just fine since most often things are normal.

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          • #6
            You have 30 days from the date of the event to inform your employer you want to make a plan change. The deductible should not reset if you change plans.

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            • #7
              Originally posted by tylerjw12 View Post
              You have 30 days from the date of the event to inform your employer you want to make a plan change. The deductible should not reset if you change plans.
              You have 30 days to put the child on the insurance so they can be covered after 30 days (automatic for first 30) but the special enrollment period is 60 days apparently:

              https://www.ehealthinsurance.com/res...newborn-babies

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              • #8
                Originally posted by ENT Doc View Post

                You have 30 days to put the child on the insurance so they can be covered after 30 days (automatic for first 30) but the special enrollment period is 60 days apparently:

                https://www.ehealthinsurance.com/res...newborn-babies
                I believe this is for exchange plans only. Employer plans abide by different rules.

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                • #9
                  Originally posted by tylerjw12 View Post

                  I believe this is for exchange plans only. Employer plans abide by different rules.
                  Interesting. Will have to look into this.

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                  • #10
                    If we do plan to have kids and have frequent medical visits (3-4 times a year), is it better to have a PPO (or low dectubile plan) vs HSA?

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                    • #11
                      Originally posted by chocolatebear11 View Post
                      If we do plan to have kids and have frequent medical visits (3-4 times a year), is it better to have a PPO (or low dectubile plan) vs HSA?
                      It depends. Well visits and some basic check ups are covered under the ACA without deductible. Also depends on the underlying health needs. The basic question here is whether or not to select a certain plan in the year you know you are going to be having a child. After that event, it’s highly personal and depends on the financial factors (premium comparison, HSA contribution by employer, tax deduction benefits, and present value of the HSA vs taxable from a tax free growth/withdrawal perspective).

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