Family of 4 (2 adults, 2 kids ages 9 & 6) · Kentucky · 12-month projection
One thing not specified that affects cost: how much each prescription costs on the high-deductible plan before the deductible is met. We've estimated retail prices below and flagged them.
⚠️ Plan A (the high-deductible plan) makes you pay full price for routine care until you've spent $8,000.
On this plan, your doctor visits, specialist visits, and even your regular prescriptions are billed at full price until your family has paid $8,000 out of pocket in a year. "Deductible" just means the amount you pay yourself before the insurance starts splitting costs. With a daily asthma inhaler, a daily anxiety medication, two lung-specialist visits, and your usual colds and urgent-care trips, you'll be paying retail for all of that early in the year. That's a real cash-flow hit even though the worst-case total is capped.
⚠️ Braces are almost never covered by medical insurance.
The orthodontia consult for your 9-year-old will likely be a medical visit, but the braces themselves are dental, and none of these three plans appear to include dental. Budget for that separately — typical braces run $4,000–$6,000 out of pocket. (Note: the plan documents you shared don't mention any dental or vision benefit, so we've assumed none.)
⚠️ Plan C is in-network only (HMO) and needs referrals for specialists.
Plan C is the most predictable on cost, but it only covers in-network doctors and requires a referral to see a specialist. Before choosing it, confirm your child's pulmonologist (lung doctor), your therapist, and the dermatologist are all in Humana's Kentucky network. If any of them aren't, those visits could cost you full price.
⚠️ Your therapy needs aren't a problem on any plan — but confirm the count.
About 6 therapy sessions a year for Adult 1 is well under the typical 25-visit cap, so over-the-cap cash spending isn't a concern here. If that number grows substantially, revisit it.
All totals below are after the tax savings each plan generates, for a full 12 months. "OOP max" is the most you'd pay in a year for covered care before insurance picks up 100%.
| Plan | Premium/yr | Family deductible | OOP max | ER | Best | Mid | Worst | Verdict |
|---|---|---|---|---|---|---|---|---|
| A — Anthem HDHP/HSA | $5,040 | $8,000 | $14,000 | 20% after deductible | $4,500 | $8,650 | $15,100 | Lowest premium, highest swing. Good only if you stay healthy. |
| B — Anthem PPO 1500 | $9,120 | $3,000 | $11,000 | $400 then 20% | $9,950 | $11,800 | $15,650 | Middle ground; predictable copays but high premium. |
| 👑 C — Humana HMO Select | $11,760 | $1,500 | $8,000 | $300 | $12,250 | $13,300 | $14,900 | 👑 Most predictable, tightest worst case — fits a cautious family. |
Recurring care everyone needs (rough billed amounts): daily asthma inhaler (~$250/mo retail), rescue inhaler (~$60), daily generic SSRI (~$15/mo retail), 2 pulmonology visits, 4 physicals (free preventive everywhere), 6 therapy sessions, 1 dermatology mole removal (~$300 outpatient), 1 ortho consult (~$150).
Plan A: Until the $8,000 deductible is hit, you pay full price. Best case (light year): ~$3,500 of retail meds + visits, never reaching the deductible → ~$3,500 OOP, minus $1,500 employer HSA money, minus tax savings on premium and HSA. Mid case adds an ER + imaging, pushing you to ~$8,000–9,000 paid. Worst case hits the $14,000 OOP cap. Tax credit: premium deduction (~$1,110) + HSA contribution savings (we modeled the $8,550 family limit funded → ~$1,880 tax savings) + $1,500 employer HSA seed.
Plan B: Copays don't require the deductible — PCP $30, specialist $60, urgent care $75, generic Rx $15. Recurring meds + visits run ~$1,100/yr in copays. Deductible/coinsurance only bite on ER, imaging, mole removal. Mid case adds 1 ER ($400 + 20%) and an MRI. Worst case approaches the $11,000 cap. Tax credit: premium deduction only (~$2,000).
Plan C: Lowest copays (PCP $20, specialist $45, urgent care $50, generic Rx $10, ER $300), 10% coinsurance, $1,500 deductible, $8,000 cap. Recurring care ~$900/yr. Even a rough year tops out near the $8,000 cap. Tax credit: premium deduction (~$2,590).
All projections rounded to the nearest $50. Prescription retail prices are estimates — verify yours, as they swing Plan A's numbers the most.
| Scenario | Plan A | Plan B | Plan C |
|---|---|---|---|
| Best (quiet year, no ER/imaging) | $4,500 | $9,950 | $12,250 |
| Mid (1 ER, 1 MRI, normal visits) | $8,650 | $11,800 | $13,300 |
| Worst (3 ER, 2 MRI, hospital stay) | $15,100 | $15,650 | $14,900 |
Read these as the all-in cost of the year (premium + your share of care, minus tax savings). Notice how Plan A is cheapest when little happens but the most expensive in a bad year — and how the three plans nearly converge in the worst case because the spending caps kick in.
Your described year — steady asthma and anxiety meds, 2 pulmonology visits, 6 therapy sessions, 4 physicals, a mole removal, an ortho consult, several colds, 2–3 urgent-care visits, and one urgent-care-or-ER trip — lands between our "best" and "mid" scenarios. Here's what that realistically costs each plan:
| Plan | What drives the cost | Your-year total (after tax) |
|---|---|---|
| A — HDHP/HSA | Full-price meds + visits eat into the $8,000 deductible; one ER trip pushes you well in | $6,500 |
| B — PPO 1500 | Copays cover most of it; ER + mole removal touch the deductible | $10,600 |
| 👑 C — HMO Select | Low copays across the board, 10% on the few bigger bills | $12,650 |
In a typical year for your family, Plan A is actually the cheapest on paper — the employer's $1,500 HSA money and the tax savings offset a lot of the cash you'd pay. The catch is that "typical" includes one ER trip, and if you get two ER trips or an imaging-heavy month, Plan A's cost climbs fast while Plan C barely moves.
👑 Plan C — Humana HMO Select, with Plan A as a close-second worth considering.
You told us you're a little more cautious than average — you'd rather have predictable bills than gamble on a cheap premium. That tips the scale toward Plan C. It has the lowest deductible ($1,500), the lowest worst-case ceiling ($8,000 of care costs), the cheapest ER ($300 flat), and the lowest copays for the steady stream of asthma refills, anxiety meds, and specialist visits your family actually uses. If a bad year hits — two ER trips, an imaging-heavy stretch, an unexpected hospital stay — then Plan C is the only plan that keeps your exposure under $15,000 and gives you that protection with the least drama.
That predictability isn't free: Plan C's premium is the highest at $11,760/yr, and in a quiet year you'd spend roughly $7,750 more than Plan A. So here's the honest tradeoff: if you value knowing your bills in advance and your doctors are all in Humana's network, then Plan C is the right call. But if you're comfortable fronting cash for routine care and betting on a calm year, then Plan A — with its $1,500 employer HSA deposit and tax-advantaged savings account — is genuinely cheaper most years, and even its worst case ($15,100) is barely above the others.
Plan B sits awkwardly in the middle: it costs $2,640/yr less than Plan C but gives you a higher deductible, a higher worst-case cap, and pricier ER. Unless you specifically want a broad PPO network (no referrals needed) rather than the HMO, Plan C protects you better for not much more, and Plan A saves you more if you'd rather gamble. Plan B's main selling point is network freedom — weigh that if your preferred doctors aren't in Humana's HMO.