What's the downside to having a high deductible?

Asked by: Verda Bartell  |  Last update: February 11, 2022
Score: 4.9/5 (60 votes)

The cons of high deductible health plans
Yes, high deductible health plans keep your monthly payments low. But they put you at risk of facing large medical bills you can't afford. Since HDHPs generally only cover preventive care, an accident or emergency could result in very high out of pocket costs.

Is a high deductible worth it?

An HDHP can save you money in the form of lower premiums and the tax break you can get on your medical expenses through an HSA. It's important to estimate your health expenses for the upcoming year and see how much you'll be responsible for out of pocket with an HDHP before you sign up.

What are the disadvantages of high deductible health plan?

HDHP Cons: People managing chronic illnesses find that their out-of-pocket expenses are high. Prescriptions, office visits, and diagnostic tests are completely out-of-pocket until you reach your deductible. If you need surgery, you will need to hit your deductible before the insurance company will pay anything.

Is it better to have a higher or lower 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's the point of a high deductible health plan?

HDHPs are thought to lower overall health care costs by making individuals more conscious of medical expenses. The higher deductible also lowers insurance premiums, leading to more affordable monthly costs. This arrangement benefits healthy people who need coverage for serious health emergencies.

High-Deductible Health Plans, Explained

16 related questions found

Does higher deductible mean lower premium?

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. ... You'll pay more each month, but your plan will start sharing the costs sooner because you'll reach your deductible faster.

Which is better PPO or high deductible?

With an HDHP, you will pay less money each month for premiums, but you will pay more out-of-pocket for medical expenses before your insurance begins to pay for care. ... With a PPO, you pay more money each month but have lower out-of-pocket costs for medical services and may be able to access a wider range of providers.

Is a $3000 deductible high?

A high-deductible plan has a maximum of $7,050 for in-network out-of-pocket costs for single coverage and $14,100 for family coverage. Those costs include deductibles, copays and coinsurance. So, let's say you have a deductible of $3,000. ... With an HDHP plan, you'd pick up the first $3,000.

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

A $1,000 deductible is better than a $500 deductible if you can afford the increased out-of-pocket cost in the event of an accident, because a higher deductible means you'll pay lower premiums. Choosing an insurance deductible depends on the size of your emergency fund and how much you can afford for monthly premiums.

Is a $1000 deductible Good for health insurance?

Your insurance company pays all of your damages – minus your $1,000 deductible. The $1,000 deductible is good for people who earn a healthy income and who have sufficient savings to handle unexpected events, such as car accidents, damages to the home, and the theft of valuables.

Do high deductible plans have copays?

That means HDHPs cannot have copays for office visits or prescriptions prior to the deductible being met (as opposed to a plan that's got a high deductible but also offers copays for office visits from the get-go; people might generally consider the latter to be a high deductible plan, but it's not an HDHP).

Do copays count towards deductible?

A copay is a common form of cost-sharing under many insurance plans. ... A deductible is the amount of money you must pay out-of-pocket toward covered benefits before your health insurance company starts paying. In most cases your copay will not go toward your deductible.

What is considered a high deductible health plan 2020?

An HDHP's total yearly out-of-pocket expenses (including deductibles, copayments, and coinsurance) can't be more than $7,000 for an individual or $14,000 for a family.

How do deductibles work?

A deductible is the amount you pay for health care services before your health insurance begins to pay. How it works: If your plan's deductible is $1,500, you'll pay 100 percent of eligible health care expenses until the bills total $1,500. After that, you share the cost with your plan by paying coinsurance.

Is a 500 deductible good?

It's best to have a $500 collision deductible unless you have a large amount of savings. Remember, this deductible amount has to be paid every time you make a collision claim.

How much should my auto deductible be?

Generally, drivers tend to have average deductibles of $500. Common deductible amounts also include $250, $1000, and $2000, according to WalletHub. You can also select separate comprehensive and collision coverage deductibles.

Do you have to pay your deductible if you're not at fault?

You do not have to pay a car insurance deductible if you are not at fault in a car accident. The at-fault driver's liability insurance will usually cover your expenses after an accident, but you may want to use your own coverage, in which case you will likely have to pay a deductible.

How can I meet my deductible fast?

How to Meet Your Deductible
  1. Order a 90-day supply of your prescription medicine. Spend a bit of extra money now to meet your deductible and ensure you have enough medication to start the new year off right.
  2. See an out-of-network doctor. ...
  3. Pursue alternative treatment. ...
  4. Get your eyes examined.

Is a $0 deductible good?

Is a zero-deductible plan good? A plan without a deductible usually provides good coverage and is a smart choice for those who expect to need expensive medical care or ongoing medical treatment. Choosing health insurance with no deductible usually means paying higher monthly costs.

Is it better to have an HSA or a PPO?

While the option of opening an HSA is attractive to many people, choosing a PPO plan may be the best option if you have significant medical expenses. Not facing high deductible payments makes it easier to receive the medical treatment you need, and your healthcare costs are more predictable.

Are PPO plans good?

PPOs Usually Win on Choice and Flexibility

If flexibility and choice are important to you, a PPO plan could be the better choice. Unlike most HMO health plans, you won't likely need to select a primary care physician, and you won't usually need a referral from that physician to see a specialist.

How much should I contribute to HSA per month?

A monthly contribution of $200, minus a $100 for expenses equals a net savings of $100 per month and assumes a potential savings of $40,746 for 20 years. A monthly contribution of $350, minus a $100 for expenses equals a net savings of $250 per month and assumes a potential savings of $101,864 for 20 years.

Do ER visits go towards deductible?

They will cover expenses barring whatever your deductible and coinsurance/copayments are for IN-NETWORK treatments. In other words, you go to the ER. Your bill is $45,000, your deductible is $5,000 and your coinsurance/copays are $0 after the deductible is met.

Do medications go towards deductible?

If you have a combined prescription deductible, your medical and prescription costs will count toward one total deductible. Usually, once this single deductible is met, your prescriptions will be covered at your plan's designated amount. This doesn't mean your prescriptions will be free, though.

What does 80% coinsurance mean?

Under the terms of an 80/20 coinsurance plan, the insured is responsible for 20% of medical costs, while the insurer pays the remaining 80%. ... Also, most health insurance policies include an out-of-pocket maximum that limits the total amount the insured pays for care in a given period.