Remember that they are incentivized for you to choose the HDHP because it costs them less money. So do your own research for your own situation before believing anything your employer says!
Source: I used to temp for a company that makes employee open enrollment trainings with the explicit goal of pushing people towards HDHPs
Logic wise I don’t think I have much to add to anomalily… You do the math on expected expenses and see what comes out ahead. Worst case/emergency, IMO, should mostly be considered for survivability (can you pay it, even if it’s tight?) , unless you know you have a large expense coming up (surgery, childbirth), although if the cost difference is fairly small the extra risk coverage may be worth it.
But also: even if numbers work out, switching to a new plan type can just be scary. I had a PPO my whole cognizant life and I was scared to switch to Kaiser. For me it worked out great so far. But that is plan and needs specific so I’m not promising that outcome… Just acknowledging that the coverage numbers aren’t the whole story and many unknowns remain when you choose a plan and it’s scary.
In our scenario, the HDHP works out best for us monetarily in every situation - no medical care at all, hit the deductible, hit the out-of-pocket max. And while the HDHP has different tiers for in-network vs. out of network coverage, the network for the HDHP is better than any of the others, and it includes coverage for every state as long as the provider is in-network for Blue Cross. So for us it’s a no brainer.
I had to put all the options into a spreadsheet to sort out the various potential outcomes, but it was worth it, and I’ve reused it annually since.
This is a big reason why I am hesitant. I sat through one of these meetings a couple years ago and was like WHY are they pushing this so hard, what’s in it for them? It makes me suspicious!
That being said, my co-worker has HSA and loves it.
Yup, all the meds I take are on the HSA list - no copay, not subject to deductible.
Though, they’re all generic and run me around $15/month now. Every little bit helps though!
$226/month.
yes, $600 for individual.
I don’t know! It doesn’t say on Cigna’s site or in our enrollment materials. I feel like it should say this in blinking red text somewhere, why is this obscured? I need to ask this at our benefits meeting.
None of our plans include any out of network coverage whatsoever any more, though, including the PPO. So HMO vs PPO is mostly a matter of who accepts what, a lot of doctors don’t accept HMO of any kind here.
This is hard to figure out from Cigna’s website! All the other regular plans - PPO, HMO, have names. Like, my PPO is Orange 500. But I can’t seem to find the exact name of the HSA plan on their site, and it’s not in any of our enrollment stuff?? On my list of questions to ask at the upcoming benefits Q and A meeting.
My therapist did say that she doesn’t accept HMO whether it’s HSA or not.
I have never hit my deductible in my life, not even with this year’s blood pressure shenanigans.
Yeah, I have to sit down and figure this out. I did see that mental health care is subject to deductible, which is $2800, so I have to pay $150/session until I hit that. BUT my company puts $600 in and that’s a month’s worth of therapy right there.
This is the part that is completely incomprehensible to me. The tax implications and also having the savings account itself. I need to do more research. The thing is, I just don’t have that many out of pocket expenses, every year when I have to figure out open enrollment I do so with fear of The Big One in mind, whatever that might be (accident, cancer, heart attack, diagnosis of something else expensive). This makes it hard to forecast what I need. It’s a huge game of what-if and CYA-in-case-something-terrible-happens and I don’t like it! (Not that ANYONE enjoys this stuff, haha, and I realize that no one can know every medical event that might occur.)
How much is your current deductible? This is hard for me to conceive of as someone who hits her OOP max in February every year 
So… if you can save $226 per month in an HSA to use towards your deductible, that is $2,715 per year in your HSA + $600 from your employer = $3,315 per year. Don’t worry about the taxes calculations on that amount since paying for health insurance is also pre-tax
So… can you realistically cover the difference between your HDHP deductible and $3,315? Looks like your deductible is $2,800, so you would be better off with the HDHP as long as your providers are in-network.
Next question: can you cover/find the money between $3,315 and your OOP max (which is probably $7,050) - so $3,735 - in an emergency situation.
I’m leaning towards the HDHP with HSA in your situation since you’re mostly preparing for the big one - you can save what you would’ve paid for a premium in an HSA, which you can keep building up savings in case you do have an emergency/high cost situation. You get to keep it even if you leave your employer.
$800. I’ve only ever had preventive care until this year, and the BP-related tests were way cheaper than I expected. I still have like $400-something to go this year.
It looks like lump sum contributions are allowed in the HSA account, so I could take my medical savings subaccount that contains current deductible/OOP max and just throw that in there.
We have no out of network coverage at all even with the non-HSA PPO I have now, so if I end up inadvertently getting out of network care, I’m no more fuct having HSA than not.
I have to look up what the OOP max was, I don’t think it was as high as you are saying. I think maybe $6,000? Will check next time I’m on my work computer.
I know I’ve wasted a ton of money on PPOs over my adult life - but I was always worried about not being able to choose a doctor or accidentally getting out of network care that I was completely on the hook for. Now that I HAVE no options for out of network care, even the PPO is in network only, this is less of a problem.
Oh, if you remember the tales of my horrible gyno, that’s the other reason I stuck with the PPO, that’s the only plan she would take. But I don’t intend to see her again so that reason is out too.
Thanks for this very detailed info! It helped.
Eh, only a small portion of your adult life were HDHPs as advantageous as they are now due to the ACA. also, insurance is about insuring against risk. You can only know if you “wasted money” in hindsight and there’s no real knowing if something else could’ve gone differently. Don’t beat yourself up about it. These things suck at all times in america.
the main annoying part about this is you’ll have to take an above the line deduction if you contribute to your HSA directly, vs via payroll contributions.
For me this year I did the math between the hdhp and ppo plans and the oop Max along with premiums plus what my employer contributed made it significantly cheaper to have the hdhp plan. I had a baby this year so knew I was going to hit the oop Max no matter what. I thought it was super odd that the ppo plan would be more expensive in ALL scenarios.
All true, and in the past I was willing to pay more so that I had more choice of doctors; now that’s not available to me any more. I do still feel like it was the right decision to go with PPO, but when I mentally add up all that money for insurance I barely used… ughhhhh.
Dumb question, above-the-line deduction means that I have to pay taxes on the direct contribution?
No, you wouldn’t have to pay taxes on it (it’s a deduction) but you’d have to do it on your tax return (and remember to do so), as opposed to it being taken out of your paycheck without taxes.
Does the PPO give you more choice of doctors and better out of network coverage? Mine did until this year and I feel like that’s what I was paying for. It gave me more peace of mind. Oh well. 
Hey, I spent most of my 20s desperate to get health insurance but there was none available at any price prior to the ACA. So when I was sick, I got up at 3:30 in the morning to wait outside for one of the slots available at the free clinic. And unfortunately having to help organize a lot of fundraisers for friends who got in bike crashes. So rest assured having health insurance was not wasted! and peace of mind is worth something!
Also it’s exempt from FICA taxes, but only if it’s done as a payroll deduction, not if you contribute from savings.
Ah, got it. Does it work even if I don’t have enough deductions to be able to itemize?
It might be simpler to just do it as a payroll deduction, and then take that same amount out of my medical savings bucket and stick it in another bucket. That sounds convoluted, I realize, but it makes sense to my savings bucket-driven brain!
I am so grateful for you all here - I have learned way more on this thread than I did from spending a couple hours reading thru all my company’s open enrollment info.
From what I could tell(it’s always super hard) the hdhp actually gave you more options than the ppo
IT does; it’s an “above the Line” deduction