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A High Deductible Plan Was My Only Choice: Now What?

More than three quarters of large employers are offering high deductible plans, and in increasing numbers it is the only plan. Although the premiums are often lower, the deductible can be as high as $6550 for an individual or $13,100 for a family. In order to keep out-of-pocket expenses manageable, consider the following:


Preventative services. Under the Affordable Care Act, even high-deductible plans must offer free preventative care with no copays or deductibles. Preventative care can include vaccinations, cancer and other health screenings and wellness visits. Taking advantage of these services can help you avoid paying for others that aren’t covered.

Use in-network providers. Although insurance won’t pay until the deductible is met, plans have negotiated discounts with providers and hospitals. Participants are entitled to those discounts as long as they use the providers within the network. Some health insurance plans have preferred provider networks. Discounts in preferred provider networks can be even more significant than those offered through standard in-network providers.

Be an educated consumer. High deductible plans are frequently called consumer-driven health plans. Participants who need medical services should shop not only for the best provider, but also for the best price. A variety of online comparison tools are available to help participants evaluate hospitals, providers and other services.

Pay close attention to your bills. Before playing a bill, compare it to the Explanation of Benefits (EOB) that your receive from your provider. If you find an error, call your provider and ask for the bill to be resubmitted with the appropriate codes. It will take the insurance company some time, but follow up to be sure it is processed correctly.


Contribute as much as possible to a health savings account. High deductible health plans can be tied to health savings accounts which allow contributions to be made on a tax deductible basis to help pay for unreimbursed medical expenses. Unlike traditional flexible spending accounts, there is no requirement that the funds be depleted annually so that funds can be accumulated over time. For 2016, an individual can contribute $3,350 and a family can contribute $6,750 to a health savings account. Individuals who are age 55 or older can make additional catchup contributions annually.

For additional information, contact EAB HealthWorks.