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Working Moms
WBMom
member
NWMR: Has anyone successfully had a HDHP with young children?
WBMom
member
in Working Moms
I apologize if this has been covered and I cannot find it. My company offers a choice plan and a HDHP. (Both my husband and I work for the same company so it's a wash on who carries the insurance) When I talk with people at work the general consensus is that no one with young children is on the HDHP - they felt it was too risky. The people who have the HDHP are young and healthy or older with no young dependents.
The HDHP for us (assuming in-network): family deductible $3K; Out of pocket max $10K, Coverage at 80% after the deductible has been met, $264.92/month premium. The non-hdhp plan: family deductible $5K; Out of pocket max $8K, Coverage at 80% after the deductible has been met. Company funds $2K into an HRA account. $365.23/month premiums. ((I have no idea why the deductible on the HDHP is lower than the non-HDHP plan- seems odd to me))
Any positive experiences using a HDHP and not getting caught during the year with extremely high medical expenses.
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Re: NWMR: Has anyone successfully had a HDHP with young children?
So your non-HDHP with the $2K funded by your employer is like having no expenses for the first $2K of medical expenses, being responsible for the following $3K after that and then paying 20% of your expenses until you've hit $8K and then everything is free.
Your HDHP is paying the first $3K in full, then paying 20% until you reach $10K and then everything is covered after that.
The difference in premiums between the too is about $1200 / year higher for the non-HDHP.
If your medical expenses are below $1200, then the HDHP is the most cost effective.
If your medical expenses are above $1200 but below $4000 the non-HDHP plan is cheaper.
If your medical expenses are above $4000 but below $31000, the HDHP is cheaper.
Above $31000 the non-HDHP plan is cheaper.
In the HDHP, everything after $38K in medical is covered. In the non-HDHP, everything after $30K in medical is covered.
In a really bad year (over $38K in medical expenses) the most you'd pay with the HDHP plan is 13200 (3200 in premiums, 3K deductible +7K to the OOP Max). The amount you'd pay in the non-HDHP plan would be 12400 (4400 in premiums, 3K in deductible + 5K to reach OOP max).
We have a HDHP with a 3K deductible and 4K OOP max, we have an HSA that rolls over and it works out for us.
It seems from what you layout here the ONLY advantage to the traditional plan is a lower total out of pocket maximum.
You are going to be paying approximately $1200 more in premiums with the traditional plan than the HDHP plan...and you have a higher deductible (which doesn't really make sense at all)
Anyway, I will say my employer started offering a high deductible plan with HSA years ago (before I was married) and it saved me a boat load then...eventually, they started to ONLY offer this type of plan and now married and with an 18month old daughter it is still less expensive than a traditional plan.(and much cheaper then anything offered by husbands employer) We are still relatively young and all healthy. It is possible that families with members that have chronic or severe medical conditions might come out ahead with a traditional plan, but you have to crunch the numbers.
My personal preference is for my money to pay for my healthcare and not pay for premiums. HSA's are fabulous, triple tax advantaged money (we max ours out every year) and if your employer matches or kicks in money to them to reduce your expense that is great too (mine kicks in $1500/year to HSA, our family deductible is $3500, each person has a $2000 max deductible and our max out of pocket is $5800, we pay 10% in network after deductible and 30% out of network up to the max out of pocket).
We have never been caught paying more with the HD plan (been using it for around 6yrs), even in 2012 when we had DD (which ended in pre-e for me, mega lab work, NST's, ultrasounds, 36hr failed induction, C-section, 5days in the hospital, and around 20pediatric visits and blood work to get DD through jaundice)...all that and we didn't even meet our family deductible for the year. Obviously, our insurance has negotiated some very good reimbursement rates, which is important to understand to understand how much your medical needs might cost.
Good luck with your decision.
My only choice is a high deductible plan with HSA and I have had it for years...before marriage and babies. This year with a baby it saved us a ton!
Good luck with your choice
DS #1 born January 2010. DS #2 due June 2014.