Living With High Deductible Health Care Plans

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In an attempt for employers to provide better benefits for their employees in a time where spending was being cut due to the economy, the high-deductible health plan was born.  By shifting more costs on to their workers with higher deductibles to be met before coverage kicks in, employers are able to provide more workers with insurance policies.

Many workers, especially those with families who need care, saw high-deductible plans as a win-win situation, as their out-of-pocket costs were already fairly steep.  These plans are often combined with employer-funded Health Savings Accounts (HSAs), allowing patients to set aside money before taxes for any health related costs they incur. The popularity of these “consumer-driven” health plans does not appear to be a trend that is slowing down according to a new paper from Rand Corp which speculates that half of all workers would be on high-deductible insurance within the decade.

So patients are left wondering, “is this consumer-based plan really the best thing for me?” In an article by Paul Levy, it was stated, “Supporters of high deductible plans say that the only way to make sure consumers have some “skin in the game” when it comes to society’s rising health care costs is to assign some of those costs to the consumers. If you know, for example, that you will pay for the first $1000 of your annual health care costs, perhaps you will shop around when you need that MRI. Instead of going to the local hospital, you will go to a specialized imaging center. Perhaps, too, you will be less likely to go the emergency room for something that could wait a day or two.”

Let’s look at some Pros and Cons of our own:


Pros

       patients in control of their own care

       covered in case of costly medical emergencies

       promotes price shopping and cost awareness

       encourages preventative health measures

       there are some loop holes within each insurance provider and incentives for price shopping

       there are resources like Save On Medical that provide accurate and up-to-date reviews of physicians in areas across the country

Cons

       could end up paying thousands of dollars out-of-pocket each year

       might not even reach your deductible

       patients might be unaware of quality and the difference between high and low quality care

       more employee responsibility and less weight on employer does not mean “benefits”

       often limited to low-quality networks of care

       not truly transparent in pricing yet, meaning shopping is sometimes ineffective

       spend less as an uninsured patient at cash-pay prices

Every patient’s situation varies, and in some cases high-deductible plans make sense. Whatever column a person fits in, they can take advantage of the resources available to them. By focusing on the following items, patients can feel confident that no matter their coverage, they are getting the best care at fair prices:

1.     Demand price transparency and turn to transparency tools like Save On Medical, Brighter and Health Care Blue Book

2.     Compare competing facilities’ quality and take into account things like; convenience, technology, physician involvement and patient reviews

3.     Negotiate pricing when possible

4.     Understand that high costs do not always mean better care and bigger does not always mean better.

Explore your options as a patient and you can be sure of the value of your care.