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Don’t Bother Complaining About High-Deductible Health Plans
Don’t Bother Complaining About High-Deductible Health Plans
by Leah Binder
In Maine, where I grew up, our number-one pastime is complaining about the weather. Yet we hate umbrellas and stubbornly never carry them. The rain inevitably comes, so many of us get wet.
As I travel the country attending health care conferences, the mere mention of high-deductible health plans (HDHPs) raises hackles. People instantly start opining that HDHPs are a terrible idea, or a great idea, or both. These debates, while interesting, divert attention from an unalterable fact: HDHPs are rapidly becoming the plans of choice — for employers, for other purchasers of health benefits, and for public sector plans offered through state exchanges under the Affordable Care Act (ACA). In short, HDHPs have unleashed forces that will compel stakeholders to adjust to new realities — and everyone will get wet.
A Primer on High-Deductible Plans
HDHPs are typically defined as plans with deductibles that exceed $1,200 for individuals or $2,400 for families. Employers often pair HDHPs with a tax-protected health savings account (HSA) that helps employees meet the deductible or, if they remain healthy, pocket the money as savings. According to the 2014 Employer Benefits Survey from the Kaiser Family Foundation/Health Research & Educational Trust (HRET), the average deductible for individual coverage paired with an HSA is $2,098 — but 18% of workers have a deductible of $3,000 or more. For family coverage, deductibles average $4,059, and almost a third of covered workers have an aggregate deductible of at least $5,000. People enrolled in HDHPs pay for every dime of their care until they reach the deductible (with the exception of certain preventive services that plans are required to cover). That means the whole price for the MRI, the entire emergency room visit, and so on.
This makes for a potentially dramatic shift in patient behavior and thinking. In traditional plans, even if you have a deductible, you skim to the section of the bill that says “patient responsibility.” It’s usually a nice, round copay like $25 or $50 — the same predictable amount regardless of which services you received. In contrast, with an HDHP, the whole bill is yours to pay.
https://hbr.org/2014/11/dont-bother-complaining-about-high-deductible-health-plans
by Leah Binder
In Maine, where I grew up, our number-one pastime is complaining about the weather. Yet we hate umbrellas and stubbornly never carry them. The rain inevitably comes, so many of us get wet.
As I travel the country attending health care conferences, the mere mention of high-deductible health plans (HDHPs) raises hackles. People instantly start opining that HDHPs are a terrible idea, or a great idea, or both. These debates, while interesting, divert attention from an unalterable fact: HDHPs are rapidly becoming the plans of choice — for employers, for other purchasers of health benefits, and for public sector plans offered through state exchanges under the Affordable Care Act (ACA). In short, HDHPs have unleashed forces that will compel stakeholders to adjust to new realities — and everyone will get wet.
A Primer on High-Deductible Plans
HDHPs are typically defined as plans with deductibles that exceed $1,200 for individuals or $2,400 for families. Employers often pair HDHPs with a tax-protected health savings account (HSA) that helps employees meet the deductible or, if they remain healthy, pocket the money as savings. According to the 2014 Employer Benefits Survey from the Kaiser Family Foundation/Health Research & Educational Trust (HRET), the average deductible for individual coverage paired with an HSA is $2,098 — but 18% of workers have a deductible of $3,000 or more. For family coverage, deductibles average $4,059, and almost a third of covered workers have an aggregate deductible of at least $5,000. People enrolled in HDHPs pay for every dime of their care until they reach the deductible (with the exception of certain preventive services that plans are required to cover). That means the whole price for the MRI, the entire emergency room visit, and so on.
This makes for a potentially dramatic shift in patient behavior and thinking. In traditional plans, even if you have a deductible, you skim to the section of the bill that says “patient responsibility.” It’s usually a nice, round copay like $25 or $50 — the same predictable amount regardless of which services you received. In contrast, with an HDHP, the whole bill is yours to pay.
https://hbr.org/2014/11/dont-bother-complaining-about-high-deductible-health-plans
28 replies
= new reply since forum marked as read
= new reply since forum marked as read
"Patients don't tolerate confusing bills. The bills are confusing precisely because the insurance companies demanded a complex and confusing system of medical coding."
Exactly.
I know I'll be using my ins. I have to see a doctor every 2-3 months for psych meds. I have two medications that I get refilled monthly and I know I will be on for a long time. So, is it better for me to have the lower deductible plan? My choices are zero, $500, $1250, and $2000. I've had the zero deductible for a while but it is now about to change to an over $500 monthly premium. My brain is getting confused trying to figure out the numbers here, lol. Thanks if anyone can offer some insight 
I'm still crunching numbers 
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