HDHPs are better nearly 100% of the time. For PPO's you're paying more monthly to pay less at point of service, which is only an illusionary benefit because HDHPs pay 100% once the deductible is met. PPOs also don't allow you to utilize an HSA. Unlike FSA, HSA funds carry over year to year and can be invested.
However, given your situation, sticking with the PPO might be the safer bet. With your low medical needs, the higher deductible of the HSA plan could be a burden if anything unexpected happens. The PPO offers predictable costs with copays for visits and a lower deductible, which seems to fit your usage pattern better.
In general, PPO plans tend to be more expensive than an HMO plan. Your monthly premium will be higher and you will have to meet your deductible before your health insurer starts paying. You will also have to pay more out-of-pocket if you visit a provider who is not part of your PPO network.
Namely, you're responsible for paying a larger portion of your healthcare expenses out of pocket. This can be a significant financial burden for those with a lot of medical expenses and could lead to financial strain. HDHPs may not be the best choice for those with chronic or frequent medical needs.
HDHPs Are Increasingly Popular
For many people, HDHPs are a practical way to control the rising cost of health plan premiums. When paired with an HSA, HDHPs can also help employees save for retirement while offering a safety net in case of unexpected health issues.
HMO plans might involve more bureaucracy and can limit doctors' ability to practice medicine as they see fit due to stricter guidelines on treatment protocols. So just as with patients, providers who prefer a greater degree of flexibility tend to prefer PPO plans.
One of the biggest advantages of PPO policies is their flexibility. Given that PPO plans offer a larger network of doctors and hospitals, you have a lot of say in where and from whom you get your care.
Is PPO insurance worth the cost? It depends on your health needs, lifestyle and financial situation. For some people, the choice to see any doctor or specialist, even out of network, is worth the extra cost. For others, a more affordable plan like a Health Maintenance Organization, or HMO might be a better option.
You own your account, so you keep your HSA, even if you change health plans or leave Federal Government.
HMO plans typically have lower monthly premiums. You can also expect to pay less out of pocket. PPOs tend to have higher monthly premiums in exchange for the flexibility to use providers both in and out of network without a referral. Out-of-pocket medical costs can also run higher with a PPO plan.
The main downside of an HSA is that you must have a high-deductible health insurance plan to get one. A health insurance deductible is the amount of money you must pay out of pocket each year before your insurance plan benefits begin.
The bottom line. A PPO is a type of health insurance plan, while an HSA is an account you use to save and invest money for healthcare. An HSA can be a smart way to save for health-related costs. The money stays with you and can help you pay for future medical expenses if you don't need the money in a given year.
The truth is that you can get a PPO plan that's also an HDHP and, therefore, eligible for an HSA.
9 Health savings accounts (HSAs) are associated with high deductible health plans (HDHP), which require you to pay expensive deductibles before your coverage begins. Since pregnancy and childbirth bring hefty costs, a lower-deductible PPO plan may be a more affordable option.
PPO plans often have higher monthly premiums and out-of-pocket costs than HMO plans. You may also need to pay a deductible before your benefits begin. If you see an out-of-network doctor, you'll typically have to pay the full cost of your visit and then file a claim to get money back from your PPO plan.
HDHPs can be a good form of insurance for the young and healthy — especially if your employer offers you HSA contributions. But for anyone with significant medical expenses, an upcoming surgery, or a serious health condition, a PPO could be a better fit because of the lower deductible.
With PPO insurance, you'll pay less out of pocket when you get care within that network. You can still see an out-of-network provider, but you'll get the most coverage when you stay within the PPO network. PPO health plans may be a good fit for someone who lives in 2 different states or travels often within the U.S.
Best Choice for You. While the upfront costs of a PPO might be higher, it can be worth it if you need significant medical care or have an unexpected accident or emergency. The PPO network of contracted doctors gives you a place to go for care and may encourage the development of a relationship with providers.
A PPO plan provides more flexibility in choosing your health care providers, but it may cost more than an HMO. Key areas to remember: Your maximum copay or coinsurance is less when you stay in network for services.
But, PPO plans frequently enable more freedom in selecting specialists and could have wider provider networks. However, PPO plans could also have more excellent patient out-of-pocket expenses, making them less appealing to some doctors.
Cons. Higher deductible: If your deductible is higher, it means you are required to pay for your medical care out of pocket up to that amount before your health plan begins to help pay for covered costs.
Large medical expenses: Since HDHPs generally only cover preventive care, an accident or emergency could result in very high out-of-pocket costs. Future health risks: Because of the costs, you may refrain from visiting a physician, getting treatments, or purchasing prescriptions when they're not covered by your HDHP.
For families, the deductible has to be at least $2,700, with a $13,500 max out-of-pocket. Many high deductible plans actually have a much higher deductible ($5,000-$7,000).