Not short sighted at all. Short sighted is paying a couple hundred dollars a month more for marginally better coverage the likelihood of me needing is very low. If my kid gets hit by a car I’ll pay the higher out of pocket max this year and be happy I saved thousands of dollars a year in premiums the previous years I didn’t need the insurance. To each his own. There are certainly those that are better off with the higher plan (chronic illness, etc). My family and I are better off with the lower plan. Besides, I would rather pay the doctor more when I’m sick than pay Fedex more when I’m not.
As long as you have set aside the additional out of pocket dollars and are readily available to meet an unexpected and sometimes catastrophic medical expense that's just fine. At the same time even your out of pocket can run into many, many thousands especially if it involves a long hospital stay followed by many weeks of skilled nursing care and rehabilitation especially if your laying there in a coma.
It still comes down to the same old thing. You get what you pay for and in the case of healthcare services and treatment when you sign that authorization to treat form you are at that point 100% financially liable for every damn dime of billed charges making it imperative that you have a way to see to it that it gets paid.
Needless to say that if you choose the lower premiums/ lower coverage plan you are accepting more of the risks yourself. In fact in my case the hospital/healthcare network is also the Medicare licensed provider/manager When it came time to enroll and deciding between an Advantage and a supplement the licensed provider/manager representative said to me..."Look we have a Medicare Supplement plan but we won't sell it to you unless you demand it for the simple reason that the increased coverage of a supplemental is equal to the increased premium over the premium of the Medicare Advantage plan. So discipline yourself to take the savings premium from a Medicare Advantage plan and park it some place where it will never be used for anything except medical expense purposes".
So Old Falcon Fart is right about a lower premium plan provided that it's accompanied by a personal savings discipline and that's exactly what an HSA is designed for. Trouble is a good HSA seems to be getting harder to find. But, if you don't have that discipline then nobody can help you.