High deductible health plans (HDHP) have been rising in popularity over the years as a way to get patients to have more “skin in the game.” They can be a great solution for cutting healthcare costs, depending on an individual’s situation. HDHPs have lower monthly premiums, which is a big benefit, but of course have a deductible so high (hence the name) that most people won’t meet it unless they have a major procedure. So when someone on a HDHP has a health need, they’re on the hook for a large portion of the bill. For this reason, HDHPs are best for people who are generally healthy; but unfortunately, accidents or unforeseen illnesses can happen.
So, can patients do anything to make their HDHP work better for them? As a matter of fact, there are a few things that can be done to make the most of a high deductible plan.
We know what some might be thinking, “isn’t the point of a high deductible plan to cut down on healthcare costs?” Yes, it certainly is but when patients consistently visit the doctor’s office or buy medications and pay for it all out-of-pocket, it’s wise to increase the funds put into an HSA. It’s especially helpful if someone has an HSA plan that has employers match employee contributions. Since that account is purely for healthcare costs, the burden will feel lessened when a patient can use it instead of their personal credit card to pay. HSA contributions are also tax-deductible, so they reduce your income taxes. Plus, an HSA works like a normal bank account and the funds stay with the person year over year; unlike the high deductible that starts at zero every year.
This can’t be stressed enough, no matter what kind of health plan a patient has. The reason it’s so important to go in-network is because the health insurer and providers that are partnered have made a deal to give patients lower price tags on services. When a patient goes to an out-of-network doctor, they’re not guaranteed that lower rate. Additionally, many plans have separate in-network and out-of-network deductibles so you really want to stay in-network if you hope to meet your deductible.
If a patient is quite certain they won’t have a chance of meeting their deductible before the year is over, it can be beneficial to be treated as a cash pay patient instead of using insurance. Yes, that means the amount paid won’t go towards meeting a deductible, but if someone is positive they won’t meet it anyway then they might as well choose the care option that’s most affordable for them. Also, even if a patient chooses to go cash pay (which is often much less expensive than going through insurance) they can still use their HSA card to pay.
Most health plans, including HDHPs, offer preventative screenings at no cost to the patient. Mammograms, vaccinations, yearly physicals, and colonoscopies are a few examples of healthcare services that are often 100% covered by health insurance. These preventative services and screenings are crucial to ensure that a patient doesn’t get sick with something in the future that will cost them. At the very least, these services can catch illnesses and conditions early on before it gets worse and more expensive to treat. Of course, each plan is different and patients will need to do their part to check what’s fully covered, partially covered, and not covered at all.
When it’s time to enroll in a health plan, it’s important to reflect on health history and possible health events that can be planned. If someone knows they want to get pregnant in the next year, a HDHP might not be right for them. If someone is finally going to get a joint surgery they’ve been putting off, it’d be wise for them to choose a low deductible health plan. If it’s reasonable for someone to assume they won’t need healthcare beyond a physical and maybe a doctor visit or two for common illnesses, then a high deductible plan is an excellent choice. The monthly premiums are low, and most basic healthcare services are covered. No matter someone’s situation with their HDHP, it’s beneficial to apply these tips to get the most out of their healthcare plan.