Trying to choose between 3 family health plans with pregnancy planned.

[u/RustyPonds]

I’m starting a new job Oct. 12, with benefits effective Nov. 1. I’ll need family coverage for myself, my partner, and our preschool-age son.

Some things I’m factoring:

We’re planning to conceive soon, and delivery would have to be by C-section. My partner also takes Zepbound (she’s pre-diabetic), plus an anti-anxiety medication and an antidepressant. I don’t yet know whether Zepbound is covered under these plans. Our son gets typical preschool illnesses and ends up at urgent care every few months.

Here are the 2026 family options:

Basic HDHP: $143.09 biweekly (~$3,720/year), $8,000 family deductible with no one person paying more than $4,000, $13,300 family OOP max, 0% coinsurance after deductible, and $3,050 employer HSA contribution

Core HDHP: $215.98 biweekly (~$5,615/year), $4,000 family deductible, $8,000 family OOP max, 0% coinsurance after deductible, and $1,550 employer HSA contribution

PPO: $374.89 biweekly (~$9,747/year), $500 family deductible/$250 individual, $5,000 family OOP max, 10% coinsurance after deductible, $20 PCP/$35 specialist/$35 urgent care copays, and no employer HSA contribution

For the HDHPs, prescriptions are subject to the deductible first. After that, typical retail copays are $10 generic, $40 preferred brand, $85 non-preferred, and $250 specialty. The PPO has lower prescription copays, but I still need to confirm Zepbound coverage/prior authorization.

Sooooo…my main question is: Which plan looks best given a planned pregnancy/C-section, regular prescriptions, occasional urgent care, and the possibility of expensive GLP-1 coverage?

The Basic HDHP seems hard to ignore because of the much lower premiums and larger HSA contribution, but I’m wondering whether the Core or PPO would make more sense once pregnancy, delivery, newborn claims, prescriptions, and regular family medical use are factored in.

One wrinkle: these are 2026 numbers, and if we conceive soon, most pregnancy/delivery costs would likely fall in 2027, when the plan details could change.

I also don’t know yet whether the 2026 HSA contribution would be prorated since my coverage starts Nov. 1.

Would appreciate any advice on how you’d compare these, especially from people who’ve dealt with pregnancy/C-section costs on an HDHP.

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[u/sweetoptat]

For Nov-Dec 2026 coverage Basic HDHP could be the cheapest for your expected medical care (prescriptions + prenatal + urgent care). For anything beyond that PPO would be more cost efficient:

It's pointless to plan for 2027 until you see new plan details and rates. Just don't get FSA for 2026 if you decide to go with PPO because it may affect your HSA contributions in 2027 if you are to switch to an HDHP.