PPO vs HSA vs EPO: Which Health Plan Fits a Freelancer?

Three labels that get used interchangeably and mean quite different things for your wallet.

These three terms answer two different questions, which is why they confuse people. PPO and EPO describe which doctors you can see. HSA describes how the plan is taxed.

PPO: flexibility, at a price

A PPO has a network but will still pay something toward care outside it, usually around half after a separate out-of-network deductible. You do not need a referral to see a specialist. Premiums run higher because the plan is taking on more risk about where you go.

EPO: cheaper, but stay inside the lines

An EPO uses a network too, but outside it you generally pay everything yourself, emergencies aside. If your doctors are already in-network and you do not travel much, you are paying less for flexibility you were not going to use.

HSA: a tax wrapper, not a network

An HSA-qualified plan lets you put money aside pre-tax for medical costs. The catch is that qualification requires a high deductible, so routine care comes out of your pocket until you hit it. Of the Benefit Airship plans, Bronze 4.4 is HSA-qualified with a $6,000 individual deductible.

How to actually choose

Work out what a year costs, not what a month costs. Someone who sees a doctor twice a year is usually better off with a low premium and a high deductible. Someone managing a condition, taking a brand-name drug, or planning a procedure is usually better off paying more each month for a lower deductible and real copays.

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