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Your family deductible is $4k, but your employer is putting in $1k, so you'll have to spend around $3k upfront before your insurance kicks in. It's probably unlikely you'd end up spending $12k on stuff, even with a pregnancy!

The Out of Pocket Max of $12k is the worst case scenario for you (but if you take into account your employer's contribution, it is $11k).

You can contribute up to $6750 towards your HSA (IIRC, this includes the employer contribution, so $5750) tax free.

Preventive services are typically covered at 100% without any cost sharing to you, so if you're able to bank most of that $6750 from this year until next year, you'll be able to soften the blow of an expensive pregnancy next year.

Was your old plan an HSA though?

Before you were probably paying several hundred dollars a month for insurance that you basically gambled. You paid the insurance company whether or not you actually used their benefits. With an HSA whatever you put in is held in an account for you to personally use.

@snowjewelz: Our insurance just switched to something like this too, so I totally feel you. And my kids have allergies and asthma, so I'm scared of the upcoming costs!

Your husband doesn't have to pay a premium for insurance? If so that's pretty awesome. Usually you do and it's significantly cheaper to go with a high deductible plan.

My work has options to do a PPO or HSA and it's cheaper for us to do HSA. Even with me being pregnant/having a baby. Check the numbers, it may be cheaper for you as well.

Don't let the $12k freak you out. What was the max out of pocket for your old insurance? Often PPO plans are similar or even higher. $4k family deductible isn't bad, especially since his employer is contributing $1000. Plus, that's $1000 in your HSA that is yours to keep for whenever you need it! I love HSAs because it's tax free when used for medical expenses, so it's like getting a ~30% discount on all medical fees. And the money is yours forever so if you don't use it in one year it will accumulate and most plans will let you invest it over a certain amount. Especially if you don't have any medical concerns at this point.

It sucks that you weren't given a choice and some people don't like HSAs but I think they're great for basically healthy families. We use our HSA as an investment tool because we figure we'll get sick with something at some point, so why not invest it and let it grow?

@snowjewelz: Your plan looks like ours. And as a heads up we did meet that max when we had our second child.

@MamaG:

@snowjewelz: just make sure you try and have a baby over one plan year so you don't need to pay the deductible or OOP Max twice! But yeah, since you have 10% coinsurance on maternity, you could get close to hitting that 12k...

Oh just saw you pay no premiums that is awesome! Definitely worth it!

I have had several plans including our hdhp that we've had for the past 5 years. We love it. Admittedly dh's work funds our hsa to cover a portion of the deductible. We still pay premiums (which are much lower than our old plans). On low health care usage years we end up "making" money as we don't use the contribution from his work and it rolls over. We now have a sizable hsa which would completely cover our OOP max in any given year
It has been a good learning experience. I pay more attention to our bills , what we are charged, errors etc. things are more inexpensive than I thought. For instance I hurt my elbow needed to see a specialist, X-rays etc. I thought that was going to be a $2000 hit to my hsa. Nope. Like $500 total. The negotiated rates with providers are crazy low sometimes. The only time we have met our deductible in 5 years has been the birth of our LO.

@MamaG: Totally agree with you, except that it is impossible to determine how much things will cost. I tried to find out how much my MRI would cost and they basically said "well it depends on what the tech sees, then we would end up having to take more or less images, etc.".

The other thing I've read is that the people who do billing will code the procedure to maximize the payout from insurance companies and this will depend on who your insurer is. Then based on your plan benefits you pay some % of that!

On another forum I read, one doctor at a large practice said he tried to figure out how much one of his patients pays to see him and he couldn't get a straight answer out of his own billing department!

@sunny: So shady! And it's no joke, it's all about the coders. This is exactly why I scheduled myself a physical, just because I really want to have a problem checked out while I'm at it. It will cost me $40 instead of $400 because I'm playing the damn game right back.

I agree with @catomd00: try to get pregnant and give birth in the same year if you can lol.

@Boogs: Let me guess, UHC? I've had nothing but headaches with them on both of my deliveries and how they handled the claims.

If you ever want to read something really different on this front that makes huge sense, Google "Cost Plus Health Insurance". It's a bit mind boggling.

We were on a HDHP when I got pregnant. My delivery was a C-section and we got stuck paying the family max ~$12K. It took us almost 3 years to pay off the birth!