What are the pros and cons of taking an insurance premium with a high deductible?

Asked by: Dr. Leonie Harris  |  Last update: September 23, 2023
Score: 4.1/5 (47 votes)

High-deductible health plans usually carry lower premiums but require more out-of-pocket spending before insurance starts paying for care. Meanwhile, health insurance plans with lower deductibles offer more predictable costs and often more generous coverage, but they usually come with higher premiums.

What are the pros and cons of a high deductible plan?

The bottom line

In some cases, HDHPs can help you save money by allowing you to pay lower premiums and giving you a tax break through an HSA. Your employer may contribute to your HSA, too. Plus, you may save money if the plan covers all of your routine care. But HDHPs aren't always the most affordable option.

What is the downside to having a high deductible is?

It Is More Expensive to Manage a Chronic Illness With an HDHP. A chronic illness, such as heart disease or diabetes, can be much more expensive to manage under an HDHP than a traditional health care plan. With these conditions, regular medications and health screenings may be required.

Is it better to have a high deductible or high premium?

If you are generally healthy and don't have pre-existing conditions, a plan with a higher deductible might be a better choice for you. Your monthly premium is lower, since you're only visiting the doctor for annual checkups, and you're not in need of frequent health care services.

Is a high deductible plan good or bad?

Due to the higher out-of-pocket costs that come with HDHPs, this type of plan may be best for healthy people who expect little to no healthcare expenses. In these cases, the lower premium of the HDHP will likely save you more money than you would spend on medical care.

High Deductible Health Plans vs PPO Explained // PPO vs HDHP

16 related questions found

Why do people choose high deductible plans?

Lower monthly premiums: Most high-deductible health plans come with lower monthly premiums. If you anticipate only needing preventive care, which is covered at 100% under most plans when you stay in-network, then the lower premiums that often come with an HDHP may help you save money in the long run.

Who is a high deductible plan good for?

A high-deductible health plan is a health insurance plan with a sizable deductible and lower monthly premiums. Only HDHPs qualify for tax-advantaged health savings accounts. An HDHP is best for younger, healthier people who don't expect to need health care coverage except in the face of a serious health emergency.

What is the point of a high deductible?

High-deductible health plans usually carry lower premiums but require more out-of-pocket spending before insurance starts paying for care. Meanwhile, health insurance plans with lower deductibles offer more predictable costs and often more generous coverage, but they usually come with higher premiums.

Is it better to choose a high or low deductible?

Low deductibles are best when an illness or injury requires extensive medical care. High-deductible plans offer more manageable premiums and access to HSAs.

Why would consumers ever choose insurance plans with large deductibles?

The general rule is that if your policy comes with a high deductible, you'll pay lower premiums every month or year because you're responsible for more costs before coverage starts. On the other hand, higher premiums usually mean lower deductibles. In these cases, the insurance plan kicks in much quicker.

Is it better to have a $500 deductible or $1000?

Having a higher deductible typically lowers your insurance rates, but many companies have similar rates for $500 and $1,000 deductibles. Some companies may only charge a few dollars difference per month, making a $500 deductible the better option in some circumstances.

How do I choose a good deductible?

Evaluate Your Cash Savings

If you don't have savings or an emergency fund to cover a high deductible, it may be better to choose a low-deductible policy. The higher monthly bills for insurance premiums may be a better way to protect your finances if you have an accident.

What is the difference between a premium and a deductible?

To better understand these terms, think of it like owning a car. A premium is like your monthly car payment. You must make regular payments to keep your car, just as you must pay your premium to keep your health care plan active. A deductible is the amount you pay for coverage services before your health plan kicks in.

What is a typical high deductible plan?

For 2022, the IRS defines a high deductible health plan as any plan with a deductible of at least $1,400 for an individual or $2,800 for a family. An HDHP's total yearly out-of-pocket expenses (including deductibles, copayments, and coinsurance) can't be more than $7,050 for an individual or $14,100 for a family.

How does a high deductible plan work?

You're covered for major medical expenses and preventive care is covered at 100%. The primary difference is that you have a higher deductible amount. Then, you can use an HSA to reimburse yourself for the out-of-pocket expenses, including the deductible and coinsurance.

How do you use a high deductible plan?

You'll have to meet the deductible in your plan before the plan starts to kick in for covered costs. The plan will pay for preventive medical care such as routine visits and well-baby check-ups, but an accident or unexpected illness could mean thousands of dollars in payments to medical providers.

What percentage of people have high deductible plans?

ENROLLMENT IN HDHP/HRAS AND HSA-QUALIFIED HDHPS

Twenty-nine percent of covered workers are enrolled in an HDHP/SO in 2022, similar to the percentage last year (28%) [Figure 8.4]. Enrollment in HDHP/SOs has increased over the past decade, from 19% of covered workers in 2012 to 29% in 2022 [Figure 8.4].

How do I get around a high-deductible health plan?

Ways to Make Your Health Insurance Affordable—7 Tips
  1. Supplemental Health Insurance. ...
  2. Get Preventive Care Done Early in the Year. ...
  3. Take Action to Maintain or Improve Your Health. ...
  4. Shop Around for Healthcare Services. ...
  5. Use a Health Savings Account. ...
  6. Use a Flexible Spending Account. ...
  7. Review Your Medical Bills with an Eagle Eye.

What is a normal deductible for health insurance?

What is a typical deductible? Deductibles can vary significantly from plan to plan. According to the Kaiser Family Foundation (KFF), the 2022 average deductible for individual, employer-provided coverage was $1,763 ($2,543 at small companies vs. $1,493 at large companies).

Why would a higher deductible make the premium lower?

Yes, a higher deductible means a lower premium, in most cases. By choosing a higher deductible, you are agreeing to pay more out of pocket in the event of a claim, so you will pay less for your monthly premium in exchange.

Does a higher deductible result in lower premiums?

You may have come across important terms like deductible and premium. While the premium is the monthly payment for your insurance plan, the deductible is the amount you will pay out of pocket before your benefits kick in. The higher your deductible, the lower your premium will be, and vice versa.

Can I negotiate deductible?

Negotiate a Payment Plan

Your healthcare provider can't waive or discount your deductible because that would violate the rules of your health plan. But they may be willing to allow you to pay the deductible you owe over time.

Do you ever pay more than your deductible?

A health insurance deductible is a set amount you pay for your healthcare before your insurance starts to pay. Once you max out your deductible, you pay a copayment or coinsurance for services covered by your healthcare policy, and the insurance company pays for the rest.

Is 2000 deductible too high?

Car insurance deductible options range from $250 to $2,500, so a $2,000 deductible is relatively high. The higher your deductible is, the lower your car insurance premiums will be. For instance, the premiums for a $2,000 deductible are 35% lower than the premiums with a $500 deductible, on average.

Why is having too much insurance a bad idea?

Having ample insurance coverage can be a good way to protect yourself if disaster strikes. However, it's possible to carry so much insurance that the premium costs start to work against your financial health. Being over-insured means you have more insurance than you need or can afford.