Yeah, I was just replying specifically to the comment I replied to and their struggle with the mental hurdle of paying more directly to the provider. I was just sharing what has helped me psychologically get over that hurdle and see the larger picture and how it is actually saving money.

For the OP, yes, the PPO absolutely makes more sense, mainly because the employer is fully covering the premiums. That's also why I don't really like the "standard" advice for HDHP/HSAs, since the specifics of the plans and expenses are really what determines if its worthwhile or not. I don't really think there's a good one-size-fits-all (or one-size-fits-most) rule for HSAs.

One great way to get over that hurdle is to actually compare your costs on each plan. I've done it every year for the past 7 years, and there has not been a single time where the cheapest, highest deductible plans wasn't the best financial option: https://imgur.com/a/GL0z8h1

I should note that, while I do invest some of my HSA money, I'm not as enamored with the long-term investing as many are. I use the HSA for all current medical expenses, and only what I don't need gets invested for the long term.

It should be specified when you sign up for it. Talk with your HR to get the details.

Yeah, sounds like that makes sense. Keep the HSA for investing, and use the FSA for known expenses. Just be aware that if your wife has a regular FSA, then neither of you can contribute to an HSA. The FSA counts as other coverage and disqualifies both of you from HSA eligibility. On the other hand, a Limited Purpose FSA would be compatible with the HSA, but would only cover Vision and Dental (and, I believe, medical expenses after you've hit your deductible). So, be aware of the limitations there.

With the two of you on a plan together, you'll qualify for the family HSA contribution limit, if you're not already (I don't know if you have any kids covered on the plan currently). So, that may increase your limit.

> Since my wife would be a dependent on my Medical next year (and cannot contribute to her own HSA)

Sure she can. Since she would be covered by an eligible plan, she absolutely can contribute to her own HSA (keeping in mind the FSA note, above). She may not be able to do it through payroll deductions, but she can contribute. It's largely a matter of how you divide your finances, though, since either HSA can be used for expenses either of you incur. The two of you together cannot contribute more than the family limit, but how you divide up those contributions is up to you.

Yeah, in that case, it makes sense. If you're maxing out the HSA with no intention of touching it, and still have funds to contribute to the limited purpose FSA that you know you will use during the year, then it's worth getting the tax savings.

What would be the reason for the FSA in this scenario?

As others have noted, unless it is a limited-purpose FSA, then it would make you both ineligible to contribute to an HSA, thus negating the main benefit of the HDHP.

Unless there is a compelling reason to have a limited-purpose FSA, there's no reason to have one. Anything that you can do with an FSA, you can do with the HSA. The only difference would be that the FSA is fully funded at the start of the year. But, if you already have an HSA balance, it's irrelevant. And, in any case, nearly every medical provider would be happy to setup a payment plan for large expenses if you happen to incur that at the start of the year before the HSA has enough funds.

So yeah...what's your reasoning for wanting an FSA on top of the HSA?