Hey y'all, so I (24 Male, single) recently just accepted a full-time offer from the company i was interning with and needed help deciding what medical plan to go with.

    The employer pays 100% of the premium for the HDHP, and the PPO would cost $13.20 weekly for a single person. They also contribute $750 each year to an HSA. I would also like to note that I am relatively healthy and have no health issues.

    Here are the details:

    Deductibles
    PPO
    In-network individual: $1,500
    In-network family: $3,000
    Out-of-network individual: $3,000
    Out-of-network family: $6,000
    HDHP
    In-network individual: $3,400
    In-network family: $6,800
    Out-of-network individual: $6,800
    Out-of-network family: $13,600

    Out-of-pocket maximums
    PPO
    In-network individual: $4,000
    In-network family: $8,000
    Out-of-network individual: $8,000
    Out-of-network family: $16,000
    HDHP
    In-network individual: $5,000
    In-network family: $10,000
    Out-of-network individual: $10,000
    Out-of-network family: $20,000

    Coinsurance
    PPO
    In-network: 80% plan pays
    Out-of-network: 60% plan pays
    HDHP
    In-network: 100% plan pays
    Out-of-network: 70% plan pays

    Office visits
    PPO in-network
    Primary care: $25 copay
    Specialist: $50 copay
    Urgent care: $50 copay
    ER: $250 copay
    HDHP in-network
    Primary care: Deductible, then $25
    Specialist: Deductible, then $50
    Urgent care: Deductible, then $50
    ER: Deductible, then $250

    Prescriptions
    For the PPO, prescriptions are copays before deductible:
    30-day generics: $10
    30-day formulary: $35
    30-day non-formulary: $60
    30-day specialty: $60
    90-day generics: $25
    90-day formulary: $87.50
    90-day non-formulary: $150
    90-day specialty: Not covered
    For the HDHP, prescriptions are generally:
    Deductible first, then the same copays
    Out-of-network prescriptions are not covered

    Need help deciding: HDHP or PPO
    byu/Affectionate-Test548 inpersonalfinance



    Posted by Affectionate-Test548

    2 Comments

    1. > I would also like to note that I am relatively healthy and have no health issues.

      Then with $0 expected healthcare expenses (or close to it), you would generally be better off with the HDHP.

      > They also contribute $750 each year to an HSA.

      Since you’d have access to an HSA, you should prioritize making HSA contributions in addition.

      Priority of HSA is on the high side.

      * https://www.reddit.com/r/personalfinance/wiki/commontopics

    2. turtle_hurtle on

      If you’re 24 and healthy, HDHP sounds perfect for you. If you can, max out your HSA for the year. (You are limited on how much you contribute based on how many months you’re eligible and how much your employer puts in.)

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