Please explain like I'm 5

[u/93ParkAvenueUltra]

I have two health plans to choose from.

Plan A: $11856 per year premium. Deductible is $1600 with 20% coinsurance afterward. Out of pocket max is $6250. Plan Type: PS1

Plan B: $8050 per year premium. Deductible is $7500. Out of pocket max is $7500. Plan Type: EP1

My wife wants to have another baby, but the last one she had pre-eclampsia and we spent a total of 3 weeks in the hospital.I am fairly confident that she will hit the Out of pocket max.

Question 1: Why does Plan B look like the better bet even though it is cheaper than Plan A? Am I missing something?

Question 2: Is the "out of pocket max" truly a hard limit? Or is there some way for them to weasel more money from us after that?

Question 3: I Plan to put the premium difference ($3805) in a HSA to offset the birth costs. Would it be wiser to go with plan A with less HSA savings? Or plan B with more HSA savings?

Sorry for the long first post and thanks for reading! I've been wracking my brain for hours and I think that I just need another set of eyes on it.

[u/NysemePtem → u/[deleted]]

Chronic health issues make for predictable expenses, meaning you're less likely to be in a situation where all of a sudden your best bet is to see an out of network doctor for a rare pregnancy related issue.

[u/NysemePtem → u/[deleted]]

Travelling is always a whole other ballgame, unfortunately. And the healthcare ecosystem has plenty of issues with care for chronic conditions. But when people aren't sure if they'll make the out of pocket max, it's because they don't have as many predictable expenses.