High-Deductible Health Plans

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Hey, You With the High Deductible Health Plan — Your Preventive Care is Likely Free

By Jay Hancock, Kaiser Health News 

(Courtesy: Kaiser Health News)

Researchers have known that members of high-deductible health plans, a rapidly growing type of coverage, seem to get less preventive care than people who pay lower out-of-pocket costs. But evidence for why was scanty. After all, under the 2010 Affordable Care Act many preventive screenings and treatments are covered with no out-of-pocket cost at all, even for high-deductible insurance.

Now policy pros at Kaiser Permanente, the giant health plan, have filled in some of the gaps. Perhaps not surprisingly, their research shows that many consumers with high-deductible coverage think the deductible — which can run to thousands of dollars — applies to all doctor visits.

Fewer than one member in five understood that preventive care was free or almost free.

A survey of hundreds of Californians enrolled in health savings accounts, one type of high deductible plan, showed that fewer than one member in five understood that preventive care was free or almost free. A fifth of those surveyed said they had avoided preventive examination or treatment because of cost.

“It’s a reminder that patients usually have a pretty limited understanding of the details of their health insurance plan,” Mary Reed, a Kaiser Permanente scientist and the study’s lead author, said in an interview. ”Even when plans are designed well or thoughtfully, if patients don’t understand they probably won’t behave accordingly.”

The lesson doesn’t apply just to high-deductible plans, she said. The need for member education is rising as all plans “continue to get relatively more complicated,” she added.

Nineteen percent of American workers are enrolled in a high-deductible plan, up from 4 percent in 2006, according to the Kaiser Family Foundation. High-deductible insurance comes with substantially lower premiums than other coverage, partly because patients bear more of the cost when they get sick. But advocates see it as a way to prompt consumers to think more carefully about the kind, amount and expense of health services they seek.

Kaiser Health News is an editorially independent program of the Kaiser Family Foundation. It is not affiliated with Kaiser Permanente.

High-Deductible Health Plans: Health Access or High Risk?

Check the health of your savings account when you sign up for a high-deductible health plan. (401k_Flickr)

Check the health of your savings account when you sign up for a high-deductible health plan. (401k: Flickr)

Health care costs are skyrocketing and premiums along with them forcing some employers — especially small businesses — to drop coverage altogether. But others are moving to “high-deductible health plans.” Five times as many businesses offer high deductible health plans as in 2005, according to the UCLA Center for Health Policy Research.

But how do these plans play out for employers — and workers themselves?

Kelley Weiss of the Center for Health Reporting found unpleasant surprises for both owners and employees. Six  years ago, Casey Coonerty-Protti took over her family’s business – Bookshop Santa Cruz — a 46 year institution in the heart of downtown. Between the lagging economy and pressure from online books, maintaining a bookstore is not easy. Protti has struggled to continue to offer health insurance. When she started, her company offered a $2,000 deductible, but she’s had to steadily increase the amount of the deductible to $5,000.

From Weiss’ report: Continue reading