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I'm following because of something similar. I used to be on my husbands (awesome) insurance due to excellent maternity coverage, but they started charging a monthly $150 fee for spouses who were enrolled and didn't use their own employer healthcare. So I switched to my company health policy and I'm finding that I'm paying tons of copays for things and still getting billed for doctor's visits and literally nothing goes toward my deductible. My OOP max is *only* $4k, but I will never hit that unless there is a hospitalization. ER visits are a $300 copay and urgent care is $100, so I usually end up paying whatever the cash price is (because I only seem to get sick when my PCP isn't open).

I'm annoyed.

Here are the details they use to make the calculations if you want to try to make your own. All costs are the average:

Preventative Care
Adult Physical Exams: $159
Child Well Visits: $134
Adult Screenings: $115
Child Immunizations: $87

Routine Care
Primary Doctor Visits: $119
Specialist Office Visits: $145
Laboratory Services: $65
Chiropractic Visits: $39

Prescription Drugs - Short Term
Generic: $29
Formulary-Brand Name: $342
Non-Formulary Brand Name: $402

Prescription Drugs - Mail-Order
Generic: $58
Formulary-Brand Name: $592
Non-Formulary Brand Name: $745

Maternity
Office Visits: $2,819
Maternity Hospital Stay: $13,651

Hospitalizations
Non-Maternity Hospital Stay (6+ Days): $65,119
Urgent Care Visit: $190
Emergency Room Visit: $1,663
Outpatient Surgery: $3,622

I can't help much in finding a calculator for specific plans, but here's some general ones:

https://www.dinkytown.net/java/HSAvsTraditional.html

https://www.calcxml.com/calculators/ins11

Worse case scenario, I think if you can keep a cash reserve through an HSA or FSA or just in savings that covers your entire OOP deductible, it might be worth a 1 year experiment. If it ends up not working out, you switch back to the better coverage plan next year.

An average doctor's appointment where we live is $150-$300 when paid in cash. Labs are $150-200. An high level MRI is $2500-3000. The last time I had a run of the mill stye in my eye while we were out of town, I had to get antibiotics and drops and it cost me $180, plus $150 to see a doctor at urgent care. When I ran out of my hormone replacement drug while stranded out of town, it cost me $160.

We are on a traditional health plan through my job, but we almost always get sick or need to go to an urgent care when we travel and basically, we assume its going to be $300 per incident. Sometimes its more, sometimes its less, but that's about where we land on average. If you have 20 incidents a year where someone is sick and needs a routine prescription, that's $6000 and usually that's close to a family OOP max. So depending on if that savings works for you, it could be worth a gamble.

@HappyBaker: yep this is pretty much what we do as well. And ours pays 80% after we hit the deductible. I've been surprised by how hard it is some years to even meet the deductible. The negotiated rates have all been much lower than I've expected. I think we've only met our deductible once (the year I gave birth to LO) in the 5 years we've had a HDHP. We are a generally pretty healthy family though. We'd probably hit it yearly if we went to the doctor just a bit more. HSAs are pretty great though...its not use it or lose it like an FSA so I feel like it is less risky than you initially think. We have a nice little nest in our HSA (DHs company fully funds it to meet our family deductible every year; an admittedly great perk of his total compensation package).

I think you've gotten tons of great tips above.

If you go the HSA route, a couple things:
1) Your employer contributions count to your contribution limit.
2) Your HSA funds rollover year-to-year.
3) Make sure you contribute at least the amount of your deductible. So, like, my deductible is $2600, my employer contributes $1000, so I need to come up with at least $1600.... divide that by 24 pay periods, it's $66 per paycheck.

I personally try to max out my deductions bc of TTC, babies, ER visits, and pregnancy. So my family max is 6,750, employer kicks in $1000, I put in (and deduct) 5,750 a year, which is $240 a paycheck. It sucks, but, it lowers our taxable income, it's forced budgeting, and it rolls over.

4) You can change your HSA deduction amount at any time. So, if you don't put in enough, and then you have a medical emergency, you can up your contributions ASAP and probably have the money decently quickly and see if the hospital could put you on an interest-free payment plan. On the flip side, if you contribute a lot then have a financial emergency, you can stop your contributions pretty quickly, as well, thus raising your paycheck amount.

I haven't found a good calculator cause all the details are so personalized. I think you just have to make an excel sheet and enter your details and then make a guess as to how many visits you make and how much it will all cost to make a best choice. I've done this with my plan and the results were quite surprising. It turned out the lowest deductible plan ended up costing the most across the board. I couldn't believe it. If you want to wall me your email address, I can send you what I did and you can see if you can tailor it to your plans.

Does your employer pay toward your HSA at all? Where I am at now plus where I used to be gave you $1000 annually if you had a HDHP. Between that money and the lower premiums, I save money. I see a therapist every other week, DD gets an echo every year, and both of us are on prescriptions. Throw in three sick visits for her, two for me and I am still only up to $1800 in costs.

I'm posting the worksheet I made on your wall. It was by hand and is messy (and factors in tax benefits), but we found it helpful

@Mrs. Tiger: Just curious - are the plans you looked at that had the hospital costs a percentage - was that not included in the out-of-pocket max? Our insurance options list everything hospital related as "80% covered after deductible is met", but it's still subject to our out-of-pocket max, so we'd never spend more than $6,800 as a family.

@HappyBaker: This is what we do too. I compare the worst case scenarios (premium + deductible + to out of pocket max for a family) and see how they all compare. We don't expect to hit our deductible, but of course, you never know what could happen. The only potential thing that we know of is a vasectomy for DH. Any clue how much they cost? I've heard under $500.

My husband just changed jobs, so we literally just went through this exercise a few days ago to figure out coverage for the remainder of 2017. We met our deductible with his former employer, so I'm crossing my fingers that we have a healthy remaining two months and don't have to meet another deductible in 2017.

@Adira: I think you just have to make your best guess at what the likelihood you’ll hit that kind of # is. If the premiums are way lower on a HDHP, even if the OOP max is higher you are going to be better off in some years if you don’t use a lot of care. For my family, the first 3 years we were on a HDHP we did not even hit the deductible so the low premiums were great. The next 2 years we hit our family OOP max of $5000 because we used a lot of care. Actually this year we hit our OOP max early in the year and then I changed employers so now we are back at hitting the deductible again so we will end up spending more than $5000 on care this year. It’s a bummer but that’s one of those annoying things that is driven by healthcare tied to an employer.

Our health insurance got complicated this year because I intended to be on DH's insurance, but this year they have a new rule that there's an extra charge for spouse's that use their ins when they could get their own. I think that's complete BS, but not much I can do at this point.

So we looked at all the of costs. DH almost never goes to the doctor, maybe one or two urgent care visits per year. I might have one specialist visit per year and a couple urgent care visits myself. The kids have 5-10 sick visits. We've never had a hospital stay with either of them.

Ultimately we decided he would get a high deductible plan and put the kids on it, and I would get my own high deductible plan. It didn't seem to make sense to pay the higher premiums for the HMO, especially because his company gives $1500 towards the HSA and mine gives $500. I will also contribute an extra $1k to the HSA. Their deductible will be $3k and mine is $1500. So we'll have 3000 in our HSAs and total deductibles = $4500. At this point I'm not super worried about the difference. We'll see how the year goes and we can always change one of the HSA contributions.

Next year we'll probably all go on my plan but I missed a deadline for getting a reduced rate because I thought I'd be on DH's.