At least a quarter of all employers, and well over half of large employers, are offering their workers a choice of a high-deductible health plan, according to Mercer, a benefits consultant. This is the time of year when many employers ask you to sign up for health insurance, so if you are going to take the high-deductible plunge, here are some things to consider:
How High Is High?
The days of having a health plan that covers all out-of-pocket costs are largely gone. Even H.M.O. plans, which require you to go to a doctor or hospital within a specific network, may require you to meet a deductible before your coverage kicks in.
There is no precise definition of a high-deductible plan, but it is widely considered to be a plan that is paired with a special savings account and with a deductible of at least $1,300 for an individual and $2,600 for a family. There are often different deductibles covering your prescriptions, a hospital stay or an emergency visit, as well as more routine care.
The Affordable Care Act sets annual limits on how much employees can be expected to pay out of their own pockets. In 2017, an individual is responsible for as much as $7,100, and families face a cap of $14,300.
Savings and Cash Flow
If you have saved the paperwork from your insurer from previous years, you may be able to get a pretty good sense of how much you might typically spend, barring a medical emergency.
If you really don’t have the money to pay for even minor medical emergencies, like an unexpected trip to a specialist, an expensive blood test or an M.R.I., you should think twice about a high-deductible plan.
Also factor in a health savings account. That can help offset the out-of-pocket costs. These accounts can accumulate funds tax-free, you can often invest the money and use it for a medical rainy day in the distant future. And some employers even pitch in $500 or $1,000 to the account.
Free Is Free
Make sure to figure out what services are covered with no out-of-pocket costs. Some primary care doctor visits, for example, or preventive procedures like colonoscopies or a flu shot can be fully covered.
A Call to Save Money
Companies are increasingly offering telemedicine services as part of a health plan or as an additional benefit. These virtual consultations, by phone or through a computer, may be a good alternative to a more expensive visit to the doctor or the urgent care center around the corner.
Be a Smart Shopper
One of the main ideas behind the idea of a high deductible plan is to make the employee a smarter shopper because personal money is on the line. There can be tremendous variations in the price of an M.R.I. or going to a dermatologist, and doing some comparison shopping could save you money.
But it can be impossible to get a hospital or doctor, or even your insurer, to give you a straight answer about what something might cost. Still, many insurers now offer shopping tools on their websites so it makes sense to check them out to see if you can find a less expensive option.
NY Times
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