My experience with a high-deductible health plan vs a traditional PPO over 5 years, including actual claims data.

Years 1-3: Generally healthy, no major medical events. Premium savings with HDHP vs PPO: $1,800/year. HSA contributions fully invested. Net advantage: clear win for HDHP.

Year 4: Required surgery with significant recovery. Total out-of-pocket under HDHP (hit max out-of-pocket of $4,000): $4,000. Estimated cost under PPO (after deductible and co-insurance): $2,200. HDHP disadvantage that year: $1,800 more out-of-pocket. However, my HSA balance had grown to $18,000 and covered the entire cost tax-free.

Year 5: Back to normal health, premium savings resume.

Net 5-year outcome: HDHP was better by approximately $6,200 in savings, accounting for the bad year. The HSA investment growth added another $2,400 over this period.

Conclusion: for most generally healthy people with adequate savings to cover the deductible, the HDHP + HSA combination wins financially over most 5-year windows. The critical requirement is having the deductible in accessible savings before you choose the HDHP.