Every time it has been offered, I have done the math to see whether we would come out ahead with it, when you consider the increased out-of-pocket expenses offset by the monthly savings on premiums (and potentially the incentive from your employer to choose the HD plan).

And in every scenario, it has made sense to choose the HD plan.

That is, in a hypothetical year with significant healthcare needs, the HD plan has been, at worst, a wash.

But in a hypothetical year with low healthcare needs, the HD plan has been a big win.

YMMV, but that’s been my experience and I suspect it is not unique to my employers.