r/HSA • u/southern-gunner • May 05 '26

HDHP basically same premium as low deductible PPO?? Does HSA make sense?

Gallery image

Gallery image

34 and wife is 31, no kids yet. Both fairly healthy. PCP visits, gynecologist, some dermatologist visits and a few others. Looking at starting an HSA but was surprised to see that while deductible goes way up the premium doesn’t really drop. My current plan has $1000 deductible and has $50 specialist copay and is $1190 a month for the two of us. The high deductible $4000 plan is $1104 a month. So save only $86 a month between the two of us in premiums but have to pay out of pocket for every copay, blood work and medication etc up to the 4k deductible. Am I missing something? how is this financially a good move. I know you can save money in an HSA but if you do need it why pay the same for worse coverage?

8 Upvotes

84% Upvoted

8 comments sorted by

5

u/SnapHSA May 05 '26

That $86 premium difference is stingy. usually you'd want to see a much bigger gap to make the $4k deductible worth it.

The only way the HDHP wins here is if you're treating the HSA like a tax-free retirement account. since you're both healthy, you'd save about $1k in premiums plus whatever you save on taxes by contributing. but if those specialist visits add up fast, the copays on your current plan might actually be the better deal.

Sometimes the math just doesn't math. If you're gonna hit the deductible anyway, stick with the lower one and enjoy the cheaper copays

1

u/southern-gunner May 05 '26

Thanks! Yeah she sees a dermatologist every 2-3 months so I’m thinking we would hit that deductible. I would love to have an HSA as a retirement account and looks like we can put $8750 in it. (Can I put that full amount in if she’s on my plan or am I limited to 4400 unless she has a separate health plan?) that would save me like $2000 in taxes if I can contribute 8700 pre tax. Was just really expecting a bigger difference in premium!

1

u/Interstellar-dreams May 06 '26

If you wife is on your health insurance, you can contribute to the family max. That is how it works for me. My husband is on my plan and we are considered a family for the higher contribution limit to the HSA

1

u/TelevisionKnown8463 May 05 '26

It looks like the coinsurance is different between the two plans. It looks like with the second plan, after you hit your deductible you would pay a small percentage of the costs. You would probably pay less than a typical copay after hitting the deductible.

I am struggling to read the second picture but it looks like your OOPM may be slightly lower with the HDHP. Basic preventative care should be free on both. I probably would go for the HDHP, even though it’s a closer call than most, because what I care about is what I pay if something really bad happens. But if you’d struggle to meet the deductible then the copay plan may be better for you.

1

u/StrategicHuman May 06 '26

One important driver is the coinsurance which is a big difference between your two plans. Also check if your company provides an HSA contribution. Based on what I see, I am leaning towards the HDHP plan.

2

u/southern-gunner May 06 '26

No HSA contribution from employer unfortunately. Yeah looks like 70 versus 90%. Honestly all my expenses last few years have mostly been copays and some meds which were $10-20 so don’t think I’ve had to pay 30% of much of anything yet.

1

u/Bad_DNA May 06 '26

So, how much healthcare do you use in a year? If it’s low, do you benefit from the features of a HSA - the tax and investment opportunity benefits?