Sorry I did not fully explain it. I am probably skipping some assortment of plans but the way I see it, you have PPO, HMO and HDHP. PPO is like a la carte to me, you generally have a wide network of doctors to pick from at your choosing, more flexibility with seeing specialists etc. HMO requires you to follow a funnel, with a single Primary Care doctor. HDHP is most similar to a PPO but you have a high deductible alongside it, while the deductible is higher than the PPO, the noticable difference is usually that you are paying for the majority of costs until hitting that deductible. So when seeing a primary care doc I would be paying for close to the full cost of that visit. The trade off is the monthly premium is significantly lower AND I get access to a health savings plan.
So when looking at it from a total annual loss perspective, the HDHP in the worst case would cost a few thousand more $3-5k than the equivalent PPO. There is nuance between plans but it can work well even if the individual as chronic conditions. Financially it makes sense and also I have strong beliefs that primary care is better served outside of insurance schemes.
So when looking at it from a total annual loss perspective, the HDHP in the worst case would cost a few thousand more $3-5k than the equivalent PPO. There is nuance between plans but it can work well even if the individual as chronic conditions. Financially it makes sense and also I have strong beliefs that primary care is better served outside of insurance schemes.