Open Enrollment season!
I've been enrolling in the HDHP plan since being offered at my company a few years ago. I max out the HSA contribution and invest it all in SP500. However, one thing that caught my eye this year is that the "Value Plan" with similar deductible is about 73 bucks less per paycheck. Over the course of the year, that's about $1900. So, I'm wondering if the $1900 additional premium is worth the privilege of investing the 4300 per year or if i'm better off investing $6,200 elsewhere. I currently max out Roth IRA, HSA, and contribute about 10% of paycheck to 401k (which is about 12,000 per year).
Am I crazy for being tempted by the Value or Network plans? I'm a pretty healthy 35 year old with just routine visits and maybe an urgent care visit or two. One thing that might set 2025 apart is wanting to seek some mental therapy. But I’d have the option of paying for this OOP or using the HSA funds.
HDHP: $120.00 per paycheck
Value: $47.00 per paycheck
HSA-eligible
HDHP: Yes
Value: No
Annual deductible (individual)
In-network
HDHP: $1,600
Value: $1,500
Out-of-network
HDHP: $3,200
Value: $3,000
Coinsurance
In-network
HDHp: You pay 10%, plan plays 90%
Value: You pay 30%, plan plays 70%
Out-of-network
HDHP: You pay 30%, plan pays 70%
Value: You pay 50%, plan pays 50%
Annual out-of-pocket maximum (individual)
In-network
HDHP: $5,000
Value: $5,000
Out-of-network
HDHP: $10,000/$20,000
Value: $10,000/$20,000
Preventive care
HDHP and Value: Covered 100% with in-network providers: you pay nothing
Office visit (primary care)
In-network
HDHP: 10% after deductible
Value: $35 copay
Out-of-network
HDHP: 30% after deductible
Value: 50% after deductible
Office visit (specialist)
In-network
HDHP: 10% after deductible
Value: 30% after deductible
Out-of-network
30% after deductible
50% after deductible
Office visit (mental health)
In-network
HDHP: 10% after deductible
Value: Covered 100%, no deductible
Out-of-network
HDHP: 30% after deductible
Value: 50% after deductible
Teladoc visit
In-network only
HDHP: Covered 100% after deductible
Value: Covered 100%, no deductible
CVS MinuteClinic Services
In-network only
HDHP: Covered 100% after deductible
Value: Covered 100%, no deductible
Urgent care visit
In-network
HDHP: 10% after deductible
Value: $45 copay
Out-of-network
HDHP: 30% after deductible
Value: 50% after deductible
Emergency room visit (in- and out-of-network)
In- and out-of-network
HDHP 10% after deductible
Value 30% after deductible
Hospital Admissions/ Room & Board (Semi-private room)
In-network
HDHP: 10% after deductible
Value: 30% after deductible
Out-of-network
HDHP: 30% after deductible
Value: 50% after deductible
Ambulatory Surgery (Outpatient Facilities and Surgery Centers)
In-network
HDHP: 10% after deductible
Value: 30% after deductible
Out-of-network
HDHP: 30% after deductible
Value: 50% after deductible
Prescriptions: Your costs
30-day supply (retail pharmacy)
Generic
HDHP: 10% after deductible
Value: $10 copay
I've been enrolling in the HDHP plan since being offered at my company a few years ago. I max out the HSA contribution and invest it all in SP500. However, one thing that caught my eye this year is that the "Value Plan" with similar deductible is about 73 bucks less per paycheck. Over the course of the year, that's about $1900. So, I'm wondering if the $1900 additional premium is worth the privilege of investing the 4300 per year or if i'm better off investing $6,200 elsewhere. I currently max out Roth IRA, HSA, and contribute about 10% of paycheck to 401k (which is about 12,000 per year).
Am I crazy for being tempted by the Value or Network plans? I'm a pretty healthy 35 year old with just routine visits and maybe an urgent care visit or two. One thing that might set 2025 apart is wanting to seek some mental therapy. But I’d have the option of paying for this OOP or using the HSA funds.
HDHP: $120.00 per paycheck
Value: $47.00 per paycheck
HSA-eligible
HDHP: Yes
Value: No
Annual deductible (individual)
In-network
HDHP: $1,600
Value: $1,500
Out-of-network
HDHP: $3,200
Value: $3,000
Coinsurance
In-network
HDHp: You pay 10%, plan plays 90%
Value: You pay 30%, plan plays 70%
Out-of-network
HDHP: You pay 30%, plan pays 70%
Value: You pay 50%, plan pays 50%
Annual out-of-pocket maximum (individual)
In-network
HDHP: $5,000
Value: $5,000
Out-of-network
HDHP: $10,000/$20,000
Value: $10,000/$20,000
Preventive care
HDHP and Value: Covered 100% with in-network providers: you pay nothing
Office visit (primary care)
In-network
HDHP: 10% after deductible
Value: $35 copay
Out-of-network
HDHP: 30% after deductible
Value: 50% after deductible
Office visit (specialist)
In-network
HDHP: 10% after deductible
Value: 30% after deductible
Out-of-network
30% after deductible
50% after deductible
Office visit (mental health)
In-network
HDHP: 10% after deductible
Value: Covered 100%, no deductible
Out-of-network
HDHP: 30% after deductible
Value: 50% after deductible
Teladoc visit
In-network only
HDHP: Covered 100% after deductible
Value: Covered 100%, no deductible
CVS MinuteClinic Services
In-network only
HDHP: Covered 100% after deductible
Value: Covered 100%, no deductible
Urgent care visit
In-network
HDHP: 10% after deductible
Value: $45 copay
Out-of-network
HDHP: 30% after deductible
Value: 50% after deductible
Emergency room visit (in- and out-of-network)
In- and out-of-network
HDHP 10% after deductible
Value 30% after deductible
Hospital Admissions/ Room & Board (Semi-private room)
In-network
HDHP: 10% after deductible
Value: 30% after deductible
Out-of-network
HDHP: 30% after deductible
Value: 50% after deductible
Ambulatory Surgery (Outpatient Facilities and Surgery Centers)
In-network
HDHP: 10% after deductible
Value: 30% after deductible
Out-of-network
HDHP: 30% after deductible
Value: 50% after deductible
Prescriptions: Your costs
30-day supply (retail pharmacy)
Generic
HDHP: 10% after deductible
Value: $10 copay
Statistics: Posted by BeauCormier — Tue Dec 17, 2024 8:19 am — Replies 4 — Views 124