PPO/EPO/HDHP choice
This is for family coverage at a new job. Two parents and 3 kids. No major medical issues but might need an outpatient surgery this year. From what I can tell, the PPO and EPO networks are the same providers, so really the only difference is having the option to choose an out of network provider. We don’t typically go out of network, but it’s always a little scary with kids to not have the option. That aside, I think the EPO gives the best benefit for the money, but I’m not sure if there’s anything I’m missing.
Option 1 PPO:
Premium - 1,180 per month
OOP max - 14,700
No deductible
No coinsurance for in network, 20% OON
$25 PCP copay, $40 specialist copay
$500 copay for hospitalization (but surgical services covered in full)
Option 2 EPO: in network only
Premium - 1,015 per month
OOP Max - 14,700
Deductible - 500/1,250
No coinsurance
$30 PCP copay, $50 specialist copay
$500 copay for hospitalization
$500 copay for surgery
***On this plan, the co pays all go towards the deductible***
Option 3: HDHP: in network only
Premium - 770 per month
OOP max: 10,000
Deductible: 5,000/10,000
No coinsurance or copay’s