Comparison Chart Source: Milliman
PPO plan costs 20% than the HDHP because it provides first dollar coverage for small claims such as <$100 primary care office visits and low cost lab. Maximum out-of-pocket is reached after $3,000 in covered expenses.
HDHP doesn’t provide first dollar coverage for small claims but counts them towards larger claim reimbursement. Maximum out-of-pocket is reached after $2,800 in covered expenses.
Insurance is designed to protect against unexpected and catastrophic loss. Insuring predictable loss is expensive and unnecessary (and stupid).
The actuarial value between both plans are essentially the same. But one plan costs 20% more than the other.
Which plan would you buy?
