High-Deductible Plans: Could This Be The future?


Even though millions of Americans have health insurance through their employers, many of them can find themselves forking over thousands of dollars before their coverage kicks in.

That’s a consequence of signing up for a consumer-directed health plan, which is being offered by an increasing number of employers. A survey by the National Business Group on Health found that 81 percent of large employers will offer at least one of these plans in 2015, up from 63 percent five years earlier. Even more significant, 32 percent of large employers will offer only high-deductible plans in 2015, up from 22 percent this year, which means fewer workers will have the option of choosing another type of coverage.

Consumer-directed plans typically carry deductibles of $1,500 for individual coverage. A Kaiser Family Foundation report found that high-deductible plans hit an average deductible of $2,215 in 2014.

That’s a lot of doctor visits and a lot of lab tests that workers will have to pay for out-of-pocket before insurance starts covering the bills.

And for workers who are getting family coverage, the out-of-pocket tab could rise even higher. That’s because some family plans have a separate per-person deductible, requiring each family member to meet a particular deductible amount before the plan covers expenses for that member. If you have four people in the family, for example, who each need to meet a particular deductible amount before insurance kicks in — well, you do the math.

But while high-deductible plans can come with sticker shock, there is an upside to them.

Those who are covered under these plans benefit from lower monthly premiums. Also, many employers contribute to savings accounts to help workers cover these costs. Annual checkups and preventive exams, such as colorectal screenings and mammograms, are free, as mandated by the Affordable Care Act.

However, some workers don’t see the plans as being much benefit to them. They are nearly twice as likely to skip going to the doctor when sick or injured as those with traditional plans, according to a recent survey by the Associated Press-NORC Center for Public Affairs Research. Also, they are more likely to have difficulty paying other bills and to have decreased the amount they save.

The big questions in all this are:

- Will the Affordable Care Act push premiums to the point where employers will no longer be able to afford traditional health insurance plans for their workers?

- Will workers who are covered be afraid to go to the doctor or put off getting necessary care for fear of an unplanned bill?

- And weren’t health care costs supposed to go down under the Affordable Care Act?


Susan Rupe is assistant editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Connect with Susan →

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