| So-called "high deductible health plans" are a lot like | | | | Higher out-of-pocket (co-pays and co-insurance) is |
| conventional (PPO/HMO) insurance plans, but they | | | | allowed for out-of-network care. |
| typically have higher deductibles (over $1,000 per | | | | 5. The can't cover prescription drugs before the |
| year). The idea is that even though the deductible | | | | deductible is met. |
| is high, you save so much money from the lower | | | | HDHP's often offer a better value for money as |
| monthly premium costs that the HDHP is a better | | | | compared to a lower deductible plan. HDHP |
| deal in the long run, when used in conjunction with | | | | premiums are significantly lower, and any |
| a tax-free Health Savings Account (HSA). | | | | out-of-pocket cost risk to can be minimized by |
| Last year, in order to setup an HSA, you needed | | | | funding an HSA to cover out-of-pocket costs up |
| to find a High-Deductible Health Plans that met the | | | | to your deductible. Also, HDHP premiums have not |
| following qualifications: | | | | been subject to the kinds of rate increases that |
| 1.A minimum deductible of $1,000 for self or | | | | traditional health plans have seen over the last |
| $2000 for family coverage. | | | | few years. |
| 2. A maximum out-of-pocket limit of $5,100 for | | | | This is not true in all states and for all health plans. |
| individual coverage, and $10,200 for family | | | | Some have said that consumer-driven health |
| coverage. | | | | plans, like the HSA+HDHP combo, works best for |
| 3. Preventive care can have first dollar coverage | | | | relatively healthy people. It is certainly true that if |
| (i.e. without a deductible). Preventive care | | | | you're healthy, and don't use medical services |
| examples include: periodic health evaluations like | | | | during the year, you'll save a lot of money with a |
| annual physicals, screening services like | | | | high-deductible plan. But it's also true that CDH |
| mammograms, routine prenatal and well-child care, | | | | plans, applied wisely, can result in savings and |
| child and adult immunizations, tobacco cessation | | | | greater flexibility for consumers of all kinds. |
| programs, and obesity weight loss programs. | | | | Individuals who are likely to make moderate or |
| Prescription drugs taken to prevent the onset of | | | | heavy use of medical services should be sure to |
| a condition for which a person has developed risk | | | | understand the benefits covered under their plan, |
| factors for can be considered preventive care, | | | | and should pay special attention to the |
| like cholesterol-lowering medication. A general rule | | | | co-insurance, maximum out-of-pocket, and any |
| of thumb for what is or is not preventive care is | | | | exclusions or carve-outs. Healthia's health cost |
| the care does not include any service or benefit | | | | modeling tool can help you decide if a CDH plan |
| which treats an existing illness or condition. 4. The | | | | will work for you. |
| plan can use co-pays to cover preventive care. | | | | |