Why do employers offer high-deductible health plans?

Asked by: Trent Satterfield  |  Last update: October 25, 2023
Score: 4.2/5 (56 votes)

Traditional PPOs and HMOs are expensive for employers as well as employees. The Institute of Medicine estimates that 30 percent of health spending is waste. HDHPs are designed to reduce unnecessary healthcare spending and encourage consumers to take an active role in managing their own healthcare costs.

Why do companies have high deductible health plans?

The pros of HDHPs

Higher deductibles usually mean lower premiums for small businesses trying to find ways to cut costs and save. In 2021, the average annual premium for an employer-sponsored family coverage plan was $22,221.

Do employers save money by offering high deductible health plans?

High-deductible health plans (HDHPs) can save employers about $900 per worker per year compared with PPO plans. HDHPs cost less, in part, because they discourage unnecessary care. The trouble is, they can also discourage care employees and their dependents do need—especially people with chronic conditions.

What is the point of a high deductible 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.

What are the disadvantages of high-deductible health plan?

Cons of High Deductible Healthcare Plans

Individuals who are stretched thin for funds may delay or avoid seeking medical treatment due to the high cost of treatment. For example, someone injured may avoid the emergency room if they know it will result in an expensive bill that will be applied to the plan deductible.

High-Deductible Health Plans, Explained

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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.

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.

Is it better to have a high or low deductible health plan?

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

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.

Do high deductibles save money?

Drivers who increase their deductibles can save between 7% to 28% a year on average, according to a Forbes Advisor analysis of car insurance deductibles and rates. The biggest savings are typically available to drivers who make a substantial change to their deductible, such as jumping from $250 to $2,000.

Do high deductible health plans make sense?

A high-deductible health plan can make sense for you if: You're healthy and rarely get sick or injured. You have no existing medical conditions. You can afford to pay the high deductible out of your pocket if an unexpected medical expense arises.

What percent of Americans have high deductible health plans?

The report says that more than 55% of Americans were enrolled in HDHPs in 2021, a new record. The rate rose from 30.3% in 2013 (the lowest enrollment in the 10 years studied) to 55.7% in 2021, an 83.7% increase.

Why would someone ever choose a higher deductible on purpose?

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.

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 much does increasing deductibles affect premium rates?

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.

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).

Is a $4000 deductible high?

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.

Do most people reach their deductible?

Some people have very high health spending and therefore will likely meet their deductibles early in the year. Those with very low health spending may never meet their deductible, nor will the 1 in 8 people with employer coverage who have no health spending at all in a given year.

When did high deductible health plans begin?

High-deductible health plans are a form of catastrophic coverage, intended to cover for catastrophic illnesses. Adoption rates of HDHPs have been growing since their inception in 2004, not only with increasing employer options, but also increasing government options.

Can accepting a higher deductible can reduce insurance costs?

Deductibles are what you pay before your insurance policy kicks in. By requesting higher deductibles, you can lower your costs substantially. For example, increasing your deductible from $200 to $500 could reduce your collision and comprehensive coverage cost by 15 to 30 percent.

What percentage of Americans can't afford health insurance?

WASHINGTON, D.C. — Mar. 31, 2022 — An estimated 112 million (44%) American adults are struggling to pay for healthcare, and more than double that number (93%) feel that what they do pay is not worth the cost.

Can you have a high-deductible health plan without an HSA?

HSAs are only available to those covered by an HDHP who don't have any other type of health insurance. However, many people don't realize that having an HDHP alone doesn't necessarily make it HSA-qualified.

Is Kaiser Permanente better than Aetna?

Kaiser's HMO the best, Aetna's the worst in California health plan report card. In newly released rankings, Kaiser Permanente's HMO plans outranked seven other California insurers when it comes to quality care--though Aetna's HMO did not do as well.

Is 1000 deductible too high?

Most insurance professionals recommend choosing a deductible you can comfortably afford to pay. If you want a lower premium, you could consider a higher deductible if you can afford it. However, if a $1,000 deductible is not feasible, it may make sense to take the lower deductible and pay a higher premium.