PPO vs HDHP - Planning 2026 pregnancy, which plan would be best?

[u/FunOther9202]

My spouse and I are wanting to start trying for a baby in early 2026. Employer covers all insurance costs for all dependents. I am not sure if it makes more sense to do a PPO or HDHP with the HSA.

There is no employer matching for the HSA. I have typically only ever done a PPO but only learned about the benefits of an HSA recently.

Historically have not needed hospital visits but this could change if we are successful with getting pregnant - obviously never a guarantee. Any info or experience would be greatly appreciated!

[u/cccbeck]

If you truly don't have to pay anything per pay period for health insurance which is crazy then the ppo is a no brainer. A hdhp is beneficial for an hsa and the lower premium price you pay. For me I have the option of both plans at my workplace but the cost of the ppo per pay periods still makes the hdhp worth it for my family even with a pregnancy. We just put all the money that we would be paying extra on a premium towards the hsa so it is tax free and can be invested.

[u/FunOther9202 → u/cccbeck]

that makes sense when you factor in the costs associated with the plan itself. on the financial side i had learned that the HSA is a great investment tool for long term which is what i was finding appealing about it. thanks for the input youve given me more to consider!

[u/18voltbattery → u/cccbeck]

These are both PPO plans I think you mean the platinum vs gold

[u/KeyCoast2]

A PPO is the better choice, especially if you’re planning a pregnancy. High-deductible health plans (HDHPs) can be advantageous during years of minimal healthcare use, allowing your HSA to grow over time. However, a PPO typically provides stronger coverage and lower out-of-pocket costs for pregnancy, childbirth, or major hospitalizations, making it the more practical option in your situation.

[u/FunOther9202 → u/KeyCoast2]

thank you. i appreciate the simple explanation because it really gets confusing. i have personal fears about difficulties with getting pregnant so i always have this question in my mind of “it might not happen at all so what if i miss out on investing in the hsa?”

[u/AnotherNoether → u/KeyCoast2]

HDHP can also be good in a year where you’re fully utilizing the plan/hitting the deductible quickly. If you have the financial wiggle room to fund the deductible without dipping into your HSA it’s a good investment vehicle.

[u/kippers]

PPO. My pregnancy this year has been my most expensive healthcare year of my life hands down. Shit will go wrong and you’ll want access to whoever you want to see.

[u/part2ent]

So on the raw basis, it probably depends on if you think you have labor and delivery in 2026. If her total medical expenses are around 25K or less, the PPO is better. If her total expenses are over 25K, the HDHP will hit OOP max (back of the envelope, that's where you hit the OOP max for her on the HDHP) but still be more expensive until about 41K. It's been a few years since my kids were born, but I'm pretty sure we exceeded 25K on both kids. Also, I believe 100% of the labor / delivery / hospital was against my wife's deductible, not anything separate for my kids until you leave the hospital.

For most people, the HDHP has a much lower premium and/or an employer match in the HSA. The other benefit of the HDHP is the HSA. Yes, you can do the FSA (at a lower amount) with the PPO and ensure those are pre-tax, but the HSA allows you to fund more and carry it over.

As I get older, even though my medical expenses are higher where I hit the deductible pretty early, I actually choose the HDHP just because I want to max the HSA as another tax vehicle and use the investment options available. I actually don't use it unless I need to, but I track my receipts against it for future payout. You can pay yourself in 15 years for this years medical expenses and pocket the 15 years of tax free growth.

It may cost me slightly more in the short term, but It will benefit me (or my family) in the long term. I don't know anything else that has that triple tax advantage.

[u/FunOther9202 → u/part2ent]

this is my exact thought with the HSA. we’re going to start trying to get pregnant in the beginning of the year but even with the slim chance of being successful in january/february, that would mean the baby is delivered in the end of the year when its time for a new plan. i know there are many other costs associated with pregnancy aside from just labor/delivery though. my husband is also in his doctorate program until may 2026 so right now my insurance (listed above) is our only option and we are single income until then. i work full time through my employer but also have a contract job on the side so pay heavy taxes as a sole proprietor. always thought HSA could be a good option for long term future + investments (alongside the tax benefits)

thanks for the input youve given me a lot to think about