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Two parents, two kids and one more wanted in spring/summer 2018 so no probable birth but many probable Drs visits in 2017.

Work offers Gold and Bronze plans

gold $6000 per year $1450 per person deductible and 20% copay after to $13000 max and first $950 in expenses paid by employer. 

bronze $1200 per year with $7000 total deductible (no individual deductible) and 30% copay to $13000 max (much easier to get to due to much higher deductible and higher copay) but is HSA eligible which I would max if I chose.

In my shoes, which would you pick and why? Obviously, if I wasn't planning another child i'd pick the cheap plan. I'm looking for advice in my situation.

thank you

 

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rated:
I'd take the Bronze. Your minimum out of pocket is $4800 cheaper. Your health care expectation doesn't sound high. You're likely to come out ahead with the Bronze.

With high expenses they have the same OOP maximum of $13000 so again you're coming out ahead with the bronze.

I can't even figure a situation where you'd save with the Gold after factoring the HSA tax savings.

Do the 2 plans have other differences?

rated:
Take your premium savings ($4800) and deduct it from the family deductible ($7000) and you get a figure of $2200. This is what you will need to pay until the plan begins to pay out. Another difference often between gold and bronze plans is the bronze plans will count prescription copays toward the deductible while the gold will not. Also, is the network the same? Lots of factors to consider. You don't say if you are married, if not, maybe mom and baby can go for a subsidized exchange plan and you can take the bronze through your company as an individual.

rated:
jerosen said:   I'd take the Bronze. Your minimum out of pocket is $4800 cheaper. Your health care expectation doesn't sound high. You're likely to come out ahead with the Bronze.

With high expenses they have the same OOP maximum of $13000 so again you're coming out ahead with the bronze.

I can't even figure a situation where you'd save with the Gold after factoring the HSA tax savings.

Do the 2 plans have other differences?

  $20,000 in bills to one individual would equal less than $5,000 expenses ($1450 deductible plus 20% copay) with the gold plan and $950 of that would be paid by the employer where it would cost $11,300 ($7000 deductible and 30% copay) with the Bronze plan so around $4,000 to pay with gold plan and $11,300 with Bronze. Not saying I shouldn't go Bronze, just saying it's no guaranteed winner either way. Could end up down a few grand with the Bronze. 

rated:
bucksandreds2185 said:   
jerosen said:   I'd take the Bronze. Your minimum out of pocket is $4800 cheaper. Your health care expectation doesn't sound high. You're likely to come out ahead with the Bronze.

With high expenses they have the same OOP maximum of $13000 so again you're coming out ahead with the bronze.

I can't even figure a situation where you'd save with the Gold after factoring the HSA tax savings.

Do the 2 plans have other differences?

  $20,000 in bills to one individual would equal less than $5,000 expenses ($1450 deductible plus 20% copay) with the gold plan and $950 of that would be paid by the employer where it would cost $11,300 ($7000 deductible and 30% copay) with the Bronze plan so around $4,000 to pay with gold plan and $11,300 with Bronze. Not saying I shouldn't go Bronze, just saying it's no guaranteed winner either way. Could end up down a few grand with the Bronze. 

  
Is the $950 your employer pays count to your $1450 deductible?    Or is the $1450 after the 950 contribution?

Whats your tax bracket?    Maxing a HSA with the bronze plan could save you $1-2k in taxes.

Your example there with the $20k bill would be ~$5k out of pocket for gold and $11k for bronze.   Add in the premiums and you're at ~11k gold versus $12k bronze and then subtract your tax savings with the HSA and its around a wash.

 

rated:
jerosen said:   
bucksandreds2185 said:   
jerosen said:   I'd take the Bronze. Your minimum out of pocket is $4800 cheaper. Your health care expectation doesn't sound high. You're likely to come out ahead with the Bronze.

With high expenses they have the same OOP maximum of $13000 so again you're coming out ahead with the bronze.

I can't even figure a situation where you'd save with the Gold after factoring the HSA tax savings.

Do the 2 plans have other differences?

  $20,000 in bills to one individual would equal less than $5,000 expenses ($1450 deductible plus 20% copay) with the gold plan and $950 of that would be paid by the employer where it would cost $11,300 ($7000 deductible and 30% copay) with the Bronze plan so around $4,000 to pay with gold plan and $11,300 with Bronze. Not saying I shouldn't go Bronze, just saying it's no guaranteed winner either way. Could end up down a few grand with the Bronze. 

  
Is the $950 your employer pays count to your $1450 deductible?    Or is the $1450 after the 950 contribution?

Whats your tax bracket?    Maxing a HSA with the bronze plan could save you $1-2k in taxes.

Your example there with the $20k bill would be ~$5k out of pocket for gold and $11k for bronze.   Add in the premiums and you're at ~11k gold versus $12k bronze and then subtract your tax savings with the HSA and its around a wash.

 

  Adding in premium would be $10,000 gold and $12,500 Bronze. $950 counts toward deductible. I make $153,000 this year. 

rated:
I'd figure it about :

Bronze : $1200 + 7000 + (13000)*.3 = $12,100 less tax savings 25% tax bracket savings on 6700 HSA = $1675 = $10,425
Gold : $6000 + $1450 - $950 + (18550*.2) = $10,210

rated:
Thank you, Jerosen for helping me consider the HSA tax benefit in my scenario as I originally wasn't viewing it in that manner. Does anyone else have any advice?

rated:
Are you healthy? Pick Bronze

Are you sick a lot and / or planning to have a baby? Pick Silver or Gold

rated:
forbin4040 said:   Are you healthy? Pick Bronze

Are you sick a lot and / or planning to have a baby? Pick Silver or Gold

  Planning on a baby in early to mid 2018. 

rated:
Best way I have thought about health care plans:

Low Risk in Healthcare Expenses - Low expenses means you should shoot for the lowest costing coverage. Go high deductible (HDHP) and toss in tons in your HSA as an investment add-on
Medium Risk in Healthcare Expenses - Medium expenses would be monthly re-occuring prescriptions that aren't too cheap, decent number of doctor appointments, risk for injury, etc.. - Go PPO or whatever the better plan is.
High Risk in Healthcare Expenses - High expenses indicates you will likely reach your Out of Pocket max (or get close to it). Since all healthcare plans of fairy similar max out of pockets, you might as well max it out with the cheapest month to month costs. Maxing out your HSA can also minimize damage to a certain extent.

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