What is a high deductible health plan for 2021?
Asked by: Rafaela Hudson | Last update: December 25, 2025Score: 4.9/5 (68 votes)
How much is a typical high-deductible health plan?
On average, if you are a covered employee with a high-deductible health plan in the United States, you may pay $8,217 annually and $22,404 for a family. HDHPs have lower monthly premiums and are a good fit for those who anticipate needing preventive care only.
Is it worth it to have a high-deductible health plan?
HDHP is great for generally healthy people who don't take medications and don't visit the doctor often. It'll cover you for very serious illnesses and you can just save the money you would have otherwise spent for the occasional doctor's visit.
What does IRS consider a high-deductible health plan?
HDHP deductible and out-of-pocket maximum
For 2025, the Internal Revenue Service (IRS) defines a high-deductible health plan as any plan with an annual deductible of at least $1,650 for an individual or $3,300 for a family.
What is an HSA insurance plan and how does it work?
“HSAs are intended to help you save pre-tax or tax-deductible dollars to pay for qualified medical expenses — both now and in the future — that aren't covered by insurance,” says Jennifer Goldsmith, managing director and head of Health Benefit Solutions at Bank of America.
New HSA Rules in 2025 You Need to Know
What is the downside of having an HSA?
Drawbacks of HSAs include tax penalties for nonmedical expenses before age 65, and contributions made to the HSA within six months of applying for Social Security benefits may be subject to penalties.
What are the disadvantages of a high deductible health plan?
- You pay all costs for nonpreventive care until you've paid the high deductible.
- Possible unplanned high out-of-pocket costs when you receive covered services.
- Worries about money might influence your health care decisions.
How to tell if your health plan is a high deductible?
Per IRS guidelines in 2025, an HDHP is a health insurance plan with a deductible of at least $1,650 if you have an individual plan or a deductible of at least $3,300 if you have a family plan. The deductible is the amount you'll pay out of pocket for medical expenses before your insurance pays anything.
What is the 12 month rule for HSA?
It means you must remain eligible for the HSA until December 31 of the following year. The only exceptions are death or disability. If you violate the testing period requirement, your ineligible contributions become taxable income.
What happens if I contribute to an HSA without a HDHP?
There is no 20% penalty on excess contributions. If you no longer are enrolled in an HDHP you are not eligible to make contributions to your HSA, but you may request withdrawals for qualified medical expenses.
Who should avoid a high-deductible health plan?
While these types of plans can be beneficial to those who are relatively healthy, they can be very expensive for those who have chronic conditions or who experience a medical crisis. It's important to carefully consider your expected medical expenses before choosing to participate in a high deductible health care plan.
How much should I put in my HSA?
The short answer: As much as you're able to (within IRS contribution limits), if that's financially viable. If you're covered by an HSA-eligible health plan (or high-deductible health plan), the IRS allows you to put as much as $4,300 per year (in 2025) into your health savings account (HSA).
Who should not get an HSA?
HSAs might not make sense if you have some type of chronic medical condition. In that case, you're probably better served by traditional health plans. HSAs might also not be a good idea if you know you will be needing expensive medical care in the near future.
Is it better to have HDHP or PPO?
HDHPs can be a good form of insurance for the young and healthy — especially if your employer offers you HSA contributions. But for anyone with significant medical expenses, an upcoming surgery, or a serious health condition, a PPO could be a better fit because of the lower deductible.
Can you open an HSA on your own?
Your employer may offer a High Deductible Health Plan (HDHP), or you may purchase an HDHP on your own. Once you are enrolled in an HDHP, check to see if an HSA was automatically opened for you by your insurer. If not, you can open one with a bank or another financial institution that offers HSAs.
Can HSA be used for dental?
Yes, you can use a health savings account (HSA) or flexible spending account (FSA) for dental expenses.
What disqualifies you from contributing to an HSA?
If you can receive benefits before that deductible is met, you aren't an eligible individual. Other employee health plans. An employee covered by an HDHP and a health FSA or an HRA that pays or reimburses qualified medical expenses can't generally make contributions to an HSA. FSAs and HRAs are discussed later.
What is considered a high deductible health plan in 2024?
For calendar year 2024, a “high deductible health plan” is defined under § 223(c)(2)(A) as a health plan with an annual deductible that is not less than $1,600 for self-only coverage or $3,200 for family coverage, and for which the annual out-of-pocket expenses (deductibles, co-payments, and other amounts, but not ...
What is the average high-deductible health plan?
In 2023, the median annual deductible for private industry workers participating in HDHP plans was $2,500. For private industry workers participating in non-HDHP plans, 18 percent did not have an annual individual deductible. For the 82 percent with a deductible, the median annual deductible was $750.
What are the problems with high deductible health plans?
High-deductible health plans (HDHPs) are characterized by higher deductibles and lower monthly premiums compared with a typical health plan. HDHPs may reduce, or delay, needed care, which will ultimately lead to poorer access to care for chronically affected participants.
Do copays count towards deductible?
No. Copays and coinsurance don't count toward your deductible. Only the amount you pay for health care services (like the medical bill you receive) count toward your plan's deductible.
Why would someone want a high deductible health plan?
Savings tip: HDHPs have lower premiums. That means you pay less every month for your plan. Plus, you're covered for many preventive services and screenings at no cost without having to meet your deductible. When the plan year begins, you pay the full cost of your care until you reach a fixed dollar amount.
How much does a doctor visit cost with a high deductible health plan?
A rough guide is: New Patient Office Visit: $200 - $450 depending on how much time is spent on evaluation and/or how many medical conditions are addressed. Subsequent Office Visits: $75 - $300 depending on how much time is spent on evaluation and/or the number of medical conditions being addressed.
Do high deductible plans cover prescriptions?
Because high deductible health plans often come with the same benefits as traditional health insurance, prescription drugs are covered with coinsurance in the same way as medical care.