[wsdfsayy]

This shouldn't be surprising. If you're on an employer-based healthcare plan, a HDHP only makes sense if you're young, healthy, have no dependents, don't take expensive medication, and your employer pays most of the annual cap into your linked HSA.

I fit most of those checkboxes, but I take PrEP (preventative HIV med) that is something like $1500/month before deductible, and the math for HDHP vs traditional plan does not check out in that case at all.

[lotsofpulp]

If the difference between the premiums for a non HDHP and the HDHP deductible is not too big, I can very well see it being worth it to go HDHP just to take advantage of the triple tax advantage of HSA.

Pay for medical care/medicine with after tax, save the receipts, and let the HSA contribution with pre tax money grow tax free in a Fidelity HSA (since it’s free) and then withdraw it whenever you want, and just pay yourself whenever you need the money.

[uberduber]

There's a whole thing with the $0 copay coupons on many expensive drugs like this, it usually just depends on which insurance you have. In many cases the drug companies have actually set up charities which will donate your entire max out of pocket on an HDHP regardless of income.