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HSA vs PPO with large family and young kids
Posted on 2/6/24 at 10:20 am
Posted on 2/6/24 at 10:20 am
My employer offers both HSA and PPO plans.
Currently using the PPO with $450/month premium with deductible capped at $1,000 for the family. It is phenomenal insurance coverage as well.
Most out of pocket for HSA is $8,000.
I have always had a PPO plan but considering switching to the HSA. I don’t know a lot about health insurance and need to do more research.
However, my question is generally with young kids, I have 7 kids 12 y/o and younger, is the PPO the best option to keep or is switching to a HSA?
TIA
Currently using the PPO with $450/month premium with deductible capped at $1,000 for the family. It is phenomenal insurance coverage as well.
Most out of pocket for HSA is $8,000.
I have always had a PPO plan but considering switching to the HSA. I don’t know a lot about health insurance and need to do more research.
However, my question is generally with young kids, I have 7 kids 12 y/o and younger, is the PPO the best option to keep or is switching to a HSA?
TIA
5
Posted on 2/6/24 at 10:23 am to hottub
Does $1,000 capped deductible mean $1,000 out of pocket maximum?
Following.
I have kids and went HSA this year. We never hit our deductible.
Following.
I have kids and went HSA this year. We never hit our deductible.
Posted on 2/6/24 at 10:28 am to LSUcam7
Yes. $1000 out of pocket max for the PPO
Posted on 2/6/24 at 10:31 am to LSUcam7
quote:
. We never hit our deductible.
My 7 year old spent 3 nights in the hospital starting January 2nd. Never got close to a deducible the other 6 years. Life comes at you quick
OP if your max OOP is $1000 you better hold that policy for as long as they'll give it to you. I'd kill for that right now.
This post was edited on 2/6/24 at 10:35 am
Posted on 2/6/24 at 10:48 am to hottub
quote:
$1000 out of pocket max for the PPO
Double check this. For my PPO option, my family deductible is $1,000 and my out of pocket max is $4,000.
For the high deductible plan, which I use this year, my fam deductible is $4,500 and OOP max is $8,000.
I switched to high deductible plan to get access to the HSA, but we haven’t hit the deductible for the past several years.
But as previous poster mentioned, you’ve got to be able to be ready to pay for services if you do have unexpected medical bills in any given year.
Posted on 2/6/24 at 11:01 am to LNCHBOX
quote:
OP if your max OOP is $1000 you better hold that policy for as long as they'll give it to you. I'd kill for that right now.
Mostly this. This seems phenomenal with 9 people being covered for $450/mo. The only thing you didn't say was the premium for the HSA plan. Advise.
Posted on 2/6/24 at 11:59 am to LSUcam7
It is $1,000
My parents questioned it too and my dad made me double check a few years ago.
$450/month has been locked for 5 years now.
It is really is great health insurance. Conversation with a co-worker has me looking into the HSA, but our PPO is so good that I don’t want to leave it.
ETA: HSA premium is $160/month
My parents questioned it too and my dad made me double check a few years ago.
$450/month has been locked for 5 years now.
It is really is great health insurance. Conversation with a co-worker has me looking into the HSA, but our PPO is so good that I don’t want to leave it.
ETA: HSA premium is $160/month
This post was edited on 2/6/24 at 12:05 pm
Posted on 2/6/24 at 12:02 pm to hottub
What’s the premium for the HSA eligible plan? Kind of important
Also, what’s the deductive and coinsursance for the HSA?
Also, what’s the deductive and coinsursance for the HSA?
This post was edited on 2/6/24 at 12:04 pm
Posted on 2/6/24 at 12:23 pm to hottub
The details on that PPO plan is probably the best I've ever heard of. We have 5 kids and our PPO is about 600/month. Max out of pocket 1000/2500. I'm pretty happy with that. We have young kids, and seem to use the crap out of it. I might change whenever they get older.
Posted on 2/6/24 at 1:06 pm to hottub
quote:max out of pocket of $1000 for the whole family
Currently using the PPO with $450/month premium with deductible capped at $1,000 for the family.
to you 
Posted on 2/6/24 at 1:52 pm to hottub
With the details you provided, keep the PPO.
I work for a large company (45k+ employees).
My ppo plan including dental/vision is $220/month, $400 deductible per individual, $1200 family, max out of pocket is $2000.
We have 5 of us on the plan. I will take this as long as I can
I work for a large company (45k+ employees).
My ppo plan including dental/vision is $220/month, $400 deductible per individual, $1200 family, max out of pocket is $2000.
We have 5 of us on the plan. I will take this as long as I can
Posted on 2/6/24 at 2:00 pm to hottub
Does the company match the HSA Contribution.
My general argument for HSA is that just the difference in the premium (Put into HSA) plus an HSA match generally is better than PPO with lower deductible but guaranteed out of pocket each year due to higher premiums. Unless you know you will meet your deductible each year HSA is generally the better way to go. After a few years you have enough saved to cover the high deductible if you need it.
Your situation is unique though due to low premium and low deductible of the PPO plan. Probably either decision is good. Most companies eventually price everyone out of the PPO plans.
My general argument for HSA is that just the difference in the premium (Put into HSA) plus an HSA match generally is better than PPO with lower deductible but guaranteed out of pocket each year due to higher premiums. Unless you know you will meet your deductible each year HSA is generally the better way to go. After a few years you have enough saved to cover the high deductible if you need it.
Your situation is unique though due to low premium and low deductible of the PPO plan. Probably either decision is good. Most companies eventually price everyone out of the PPO plans.
Posted on 2/6/24 at 3:11 pm to hottub
Going from $450 to $160 saves you $3,480 per year up front. If you max out an HSA, that saves a couple grand more in taxes.
Worst case PPO max is $6,400
Worst case HSA is probably around $7500 with the potential to be much lower than PPO.
If you think you might have to do braces at some point, I would lean HSA.
Worst case PPO max is $6,400
Worst case HSA is probably around $7500 with the potential to be much lower than PPO.
If you think you might have to do braces at some point, I would lean HSA.
Posted on 2/6/24 at 8:12 pm to notsince98
That is the biggest “pro” to me. A $1,100 gamble each year but could pay out. More knowledgeable people than me on health insurance have told me that a 5 year look back with a HSA is more beneficial than the PPO.
Posted on 2/6/24 at 9:25 pm to hottub
quote:
5 year look back with a HSA is more beneficial than the PPO
Likely if the family is healthy and not often hitting the deductible year to year.
Consider that the HSA is triple tax advantaged.
1) income deduction
2) tax avoidance on interest & gain
3) tax free qualified withdrawals
If you spend +$3-5k/yr on medical costs, then the current PPO plan likely makes more sense. But if you spend <$2k or so and contribute >$6-8k to HSA, the math on growth & tax benefits of the HSA likely outweigh the PPO.
But you just have to be ready to pay $5-7k from cash (or accumulated HSA assets) in the scenario where a larger than normal expense comes up.
Posted on 2/6/24 at 10:01 pm to LSUcam7
quote:
you just have to be ready to pay $5-7k from cash (or accumulated HSA assets) in the scenario where a larger than normal expense comes up.
I'm living this life. We just switched from PPO to HSA HD Plan. Total OOO is like $1,100 difference once you account for premiums. HSA max contrib + HD Premium = PPO Premium/mo
I am maxing out our HSA. I'm betting that our family stays heathy. I'm paying cash for everything reasonable.
I'm hoping to get one full year and bank $8300. After that, continue to contribute. I'll have a hefty sum at retirement in 30 years.
This post was edited on 2/6/24 at 10:02 pm
Posted on 2/7/24 at 6:15 am to LSUcam7
quote:
Double check this. For my PPO option, my family deductible is $1,000 and my out of pocket max is $4,000. For the high deductible plan, which I use this year, my fam deductible is $4,500 and OOP max is $8,000.
This is what I have but my fam deductible $4k. Work also gives $1k to the HSA to help with the high deductible. I have three children 9 and under. We usually hit our deductible by May.
This post was edited on 2/7/24 at 6:17 am
Posted on 2/7/24 at 1:01 pm to hottub
So the HSA premium is 290/mo cheaper, or $3,480/yr.
If there is a $7K difference between deductibles, that covers about half of it.
Does your employer offer a HSA match / their own contribution?
How are the co-pays and co-insurance on the PPO?
If there is a $7K difference between deductibles, that covers about half of it.
Does your employer offer a HSA match / their own contribution?
How are the co-pays and co-insurance on the PPO?
Posted on 2/8/24 at 8:44 am to LSUFanHouston
No match on the HSA
Only copay for the PPO is $100 for ER visit and Hospital Admission and $10 for X-ray
Co-insurance is 10% for physician visit(non wellness or preventative). Everything is covered 100%.
Only copay for the PPO is $100 for ER visit and Hospital Admission and $10 for X-ray
Co-insurance is 10% for physician visit(non wellness or preventative). Everything is covered 100%.
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