Can you have an HDHP and PPO at the same time?
Asked by: Dr. Myles Krajcik I | Last update: November 3, 2025Score: 4.5/5 (65 votes)
Can you have an HDHP and other insurance?
The IRS does allow you to have some types of coverage in addition to your HDHP, without jeopardizing your eligibility to contribute money to your HSA. They include: Workers' compensation. Critical illness/specific disease coverage (a plan that will pay a lump sum if you're diagnosed with invasive cancer, for example)
Can you have two health insurance plans at the same time?
Can I have 2 health insurance plans at the same time? Yes. A process called coordination of benefits determines which insurance plan will pay first. Your primary plan will pay for the health claim first, paying the costs up to the plan's coverage limits, and then your second plan will kick in.
Why can't you have an HSA with a PPO?
No, the PPO doesn't have a ``true'' deductible as you have non-preventive coverage prior to the deductible being met. So it's not HSA-eligible.
Can a PPO be an HDHP?
An HDHP can be an HMO, POS, PPO or EPO. People who are managing a health condition but on a tight budget may find an HDHP saves them money in the long run.
New HSA Rules in 2025 You Need to Know
Can I have a PPO and HDHP at the same time?
The truth is that you can get a PPO plan that's also an HDHP and, therefore, eligible for an HSA.
What is the 12 month rule for HSA?
It means you must remain eligible for the HSA until December 31 of the following year. The only exceptions are death or disability. If you violate the testing period requirement, your ineligible contributions become taxable income.
Which is better, PPO or HDHP?
HDHPs can be a good form of insurance for the young and healthy — especially if your employer offers you HSA contributions. But for anyone with significant medical expenses, an upcoming surgery, or a serious health condition, a PPO could be a better fit because of the lower deductible.
Do I lose my HSA if I switch to a PPO?
You own your account, so you keep your HSA, even if you change health plans or leave Federal Government. However, if your HSA was fully funded and you leave the HDHP during the year, then you will have to withdraw some of the contribution from the account.
Can you switch from HDHP to PPO?
Employees currently enrolled in the group medical plan who experience a HIPAA SER have the right to switch benefit plan options. For example, if an employee is enrolled in HDHP single coverage and gets married, they have the right to add the spouse and switch to a different medical plan option (such as to a PPO plan).
Is being double insured worth it?
Assuming Dual Coverage Is Always Better: While dual coverage can be beneficial, it's not always the best option for every situation. Don't assume that having two plans will automatically save you money. Evaluate the costs, coverage, and your specific healthcare needs to determine if dual coverage is cost-effective.
How do you determine which insurance is primary?
The insurance that pays first is called the primary payer. The primary payer pays up to the limits of its coverage. The insurance that pays second is called the secondary payer. The secondary payer only pays if there are costs the primary insurer didn't cover.
How do deductibles work when you have two insurances?
If both plans have deductibles, you'll have to pay both before coverage kicks in. You don't get to choose which health plan is primary, meaning the one that pays first. You don't get to choose which insurer will pay a certain claim.
What are the disadvantages of HDHP?
Another possible downside to HDHPs is that you may put off doctor visits. If your budget is tight, paying the initial out-of-pocket costs can be difficult. A 2024 survey found that about 1 in 4 U.S. adults said they skipped or postponed getting needed care because of the cost.
Can one spouse have an HSA and the other a PPO?
If your spouse has a traditional health insurance plan, such as a PPO or HMO, that provides individual coverage only, then yes, you are eligible to participate in an HSA, but only if you are enrolled a high-deductible health plan and your spouse doesn't also have a Healthcare FSA or HRA that covers your healthcare care ...
Who should avoid a high-deductible health plan?
While these types of plans can be beneficial to those who are relatively healthy, they can be very expensive for those who have chronic conditions or who experience a medical crisis. It's important to carefully consider your expected medical expenses before choosing to participate in a high deductible health care plan.
Can a PPO be a HDHP?
This means any plan can be a high deductible health plan — whether it's a preferred provider organization (PPO), health maintenance organization (HMO), point of service (POS) or exclusive provider organization (EPO) plan.
Why can't you have an HSA with a PPO plan?
Yes—you can use an HSA with a PPO. But not with just any PPO. Since an HSA isn't actually a type of health insurance, HSAs provide the flexibility to be integrated with any HSA-eligible high-deductible health plan (HDHP). As long as your PPO is an HSA-eligible HDHP, you can use an HSA with the PPO without issue.
What is considered a high deductible health plan in 2024?
For calendar year 2024, a “high deductible health plan” is defined under § 223(c)(2)(A) as a health plan with an annual deductible that is not less than $1,600 for self-only coverage or $3,200 for family coverage, and for which the annual out-of-pocket expenses (deductibles, co-payments, and other amounts, but not ...
What is the downside to a PPO plan?
In general, PPO plans tend to be more expensive than an HMO plan. Your monthly premium will be higher and you will have to meet your deductible before your health insurer starts paying. You will also have to pay more out-of-pocket if you visit a provider who is not part of your PPO network.
Who is HDHP best for?
An HDHP is best for younger, healthier people who don't expect to need health care coverage except in the face of a serious health emergency. Wealthy individuals and families who can afford to pay the high deductible out of pocket and want the benefits of an HSA may benefit from HDHPs.
Do copays count towards deductible?
No. Copays and coinsurance don't count toward your deductible. Only the amount you pay for health care services (like the medical bill you receive) count toward your plan's deductible.
What is the downside of an HSA?
Drawbacks of HSAs include tax penalties for nonmedical expenses before age 65, and contributions made to the HSA within six months of applying for Social Security benefits may be subject to penalties. HSAs have fewer limitations and more tax advantages than flexible spending accounts (FSAs).
What is the 401k limit for 2025?
The annual elective deferral limit for 401(k) plan employee contributions is increased to $23,500 in 2025. Employees age 50 or older may contribute up to an additional $7,500 for a total of $31,000.
Can HSA be used for dental?
Yes, you can use a health savings account (HSA) or flexible spending account (FSA) for dental expenses.