Should my partner decline her new job’s coverage?

We're in a bit of a unique situation so I'm hoping to get some advice – apologies for the length, lots of details to account for. Gah.

We're in Massachusetts.

My partner quit her job last year so she hopped onto my health insurance as a domestic partner (the premium is $90/bi-weekly paycheck and we pay taxes on $240 per paycheck, which is the part of the cost that my company covers). Our plan is a high deductible one ($3,750 deductible and $6k out of pocket max for the family). My company also offers Progyny and we've been doing fertility stuff this year so we've used them a lot. We both opened HSAs and are planning on contributing the full family maximum (domestic partner loophole).

We are already $5.2k into our out-of-pocket maximum for this year (yikes). With fertility treatments plus some ongoing appointments unrelated to that (therapy, physical therapy), we'll hit our out-of-pocket max soon.

The plot twist: My partner started a new job this week and their benefits are amazing. They cover 100% of the premiums, and she has two plan options: a high deductible one ($1500 deductible, 90% coverage in most areas after that, $3.5k out of pocket max) and a PPO ($500 deductible, ~$30-40 copays when applicable, and 100% coverage in most areas after that, $2.5k out of pocket max).

So, would it be worth it for her to sign up for the new plan? My thinking is that given we've basically hit our out-of-pocket max, the main trade-off is the premium+tax cost that we could drop ($1530 premium + $1200ish tax for the rest of 2024). That's obviously on its own a lot more than the $500 deductible for PPO, and basically her out-of-pocket max on that plan.

If it makes sense for her to drop my plan and pick up her own, would the PPO be worth it even if we had to stop contributing to her HSA for the rest of the year (and I'd also have to change my contributions to meet the non-family limit)?

submitted by /u/lbs-stepmom
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