What is the main disadvantage of choosing a high deductible on an insurance policy?

Asked by: Vincenza Ryan  |  Last update: September 23, 2023
Score: 4.5/5 (14 votes)

The main drawback to choosing an HDHP is having potentially high out-of-pocket expenses when you receive covered services during the year. You pay more in upfront costs (your deductible and copays and/or coinsurance) for nonpreventive care until you meet your yearly out-of-pocket maximum.

What is the downside to a high deductible?

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.

Why would you not choose a high-deductible health plan?

Costly out-of-pocket medical expenses: If you choose a high-deductible health plan and need non-preventive medical care, or costly medical care, you will have to pay all of your deductible before your plan begins to help you pay for covered costs.

What is the upside and downside of a high deductible?

Key Takeaways. High-deductible health plans (HDHPs) are affordable health insurance plans with relatively low monthly premiums. On the downside, these plans have higher deductibles and out-of-pocket maximums. This means more healthcare expenses are paid by the individual and not the insurer.

What is the advantage of a high-deductible health plan?

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.

High-Deductible Health Plans, Explained

26 related questions found

What is the disadvantage of having a higher deductible quizlet?

An insurance policy with a higher deductible will usually have a higher premium for you to pay each month.

Is high deductible health plan good or bad?

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 is the point of a higher deductible?

But why would a plan with a high deductible be a good choice? If you're enrolled in a plan with a higher deductible, preventive care services (like annual checkups and screenings) are typically covered without you having to pay the deductible first. And a higher deductible also means you pay lower monthly costs.

What is a high deductible policy?

A high deductible plan (HDHP) can be combined with a health savings account (HSA), allowing you to pay for certain medical expenses with money free from federal taxes. 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.

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.

What determines a high deductible plan?

Per IRS guidelines in 2024, an HDHP is a health insurance plan with a deductible of at least $1,600 if you have an individual plan – or a deductible of at least $3,200 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.

Is a high deductible plan better than a copay plan?

A high deductible plan may seem cheaper at first, but it can expose you to higher financial risk if you have a major health issue or an unexpected emergency. A low copay plan may seem more expensive at first, but it can protect you from high medical bills and help you manage your cash flow better.

Why does having a high deductible lower your insurance premiums?

The higher a deductible, the lower the annual, biannual or monthly insurance premiums may be because the consumer is assuming a portion of the total cost of a claim.

Do you pay more with a higher deductible?

How it works. A deductible is the amount you pay for health care services each year before your health insurance begins to pay. In most cases, the higher a plan's deductible, the lower the premium. When you're willing to pay more up front when you need care, you save on what you pay each month.

What is the difference between a high deductible policy and a PPO?

An HDHP can mean you pay less every month for your premium. But you may pay more from your own pocket for your healthcare costs because you have a higher deductible. A PPO can mean you pay more monthly for your premium. But you may have fewer out-of-pocket costs.

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).

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

High-deductible health plans, or HDHPs, can offer lower monthly premiums and a tax-advantaged health savings account. However, the high deductible can make it difficult for some individuals to afford necessary healthcare services.

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.

Does a higher deductible make your insurance cheaper?

Collision, comprehensive, uninsured motorist, and personal injury protection coverages all typically have a car insurance deductible. You typically have a choice between a low and high deductible. A low deductible means a higher insurance rate, whereas a high deductible means a lower insurance rate.

Do employers save money by offering high deductible health plans?

While offering an HDHP to employees will likely result in savings for your business, it essentially pushes the costs onto the employee, especially if they're faced with a serious medical situation. However, many proponents of HDHPs argue that they're generally beneficial to both businesses and employees.

Do your copays go towards your out-of-pocket maximum?

Typically, copays, deductible, and coinsurance all count toward your out-of-pocket maximum. Keep in mind that things like your monthly premium, balance-billed charges or anything your plan doesn't cover (like out-of-network costs) do not.

How do you manage a high-deductible plan?

Tips for Managing a High Deductible Health Plan
  1. Shop for procedures. ...
  2. Research prescription costs. ...
  3. Look for prescription assistance programs. ...
  4. Enroll in an HSA. ...
  5. Negotiate your payment options. ...
  6. Know what is free.

Is Medicare considered a high-deductible health plan?

If an individual contributes to an HSA and has Medicare simultaneously, they will usually pay tax penalties on their HSA contributions. This is because an HSA is for a person with an HDHP, and Medicare is a different type of coverage, not an HDHP.

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.

What is true in general about higher deductible amounts?

A lower deductible means higher premiums. Keep in mind that insurance deductibles are based on financial risk. If you opt for a higher deductible, you'll be paying a lower rate, but you're also assuming greater financial responsibility for the expenses you'll be required to pay for a claim.