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Four Ways to Engage High-Deductible Health Care Plans

Posted Feb 08 2013 9:00am
Health Insurance
Visiting the doctor, whether for a routine check-up or a life-saving procedure, has always been a source of anxiety for many, largely due to the many unknowns, big words, and frightening discoveries that the patient can encounter.

While health insurance is intended to make health care more affordable, and it is considered a "benefit" for employees who receive it from their employers, it carries its own baggage in the form of complex plans, terms and conditions that are easy to misunderstand, and countless other "gotchas" that hit directly where it hurts the most: in the wallet.

The rising cost of health care has led employers to seek out lower cost options. One of those is a high-deductible health care plan, and it reduces the cost for employers while increasing the cost for employees until they meet their high-dollar deductible. Once the insurance kicks in, the plan does pay a large percentage of the medical costs sometimes as much as 100 percent but up until that point, the expenses can burden employees and their families.

For those with a high-deductible health care plan, being insured no longer means just being a patient. It now means becoming a consumer in the health care market. Truly understanding the insurance documentation can be overwhelming, and those who surf the Internet to learn more about these plans are confronted by never-ending, but difficult to understand details, lingo, and small print. This leads to uninformed customers who don't know the ins-and-outs of their health-care plans, and who risk an unexpected financial burden, should something happen to them or their family. Subsequently, this lack of understanding can lead employees to avoid medical care altogether for fear of the costs.
Fortunately, high-deductible health-care plans, also referred to as consumer-driven health care plans, can be effective for employees and their families, but it requires time and effort. Following are four tips for making high-deductible health-care plans work.

Thoroughly Understand the Plan
A key to planning for your medical costs for the year is to understand the coverage. Make sure to thoroughly review your high-deductible health care plan, and consult with your employer and the insurance plan manager to better understand not only what is covered, but what is not. It is critical to understand the deductible and the percentage of coverage that the plan covers after you meet it. Most importantly, don't be afraid to ask questions. As the old adage goes, there are no dumb questions, and this is particularly true when making medical decisions with financial implications in a bad economy.

Inquire About Doctor and Procedure Costs
When a customer takes their car to a mechanic for repairs, they always get an estimate before the work is done. This is a valid approach for doctor's visits, too. Call the doctor to learn about the cost of a routine visit and any tests that may be required while there. Get cost information about surgeries or procedures prior to scheduling them. And touch base with your health-care plan manager to see if there is any way to negotiate some of the costs, or if they have recommendations for lower cost options for medication.

Choose a Doctor that is "In-Network"
If the high-deductible plan is a preferred provider organization, which they usually are, employees are encouraged to use a doctor that is "in-network," or in a contract with the plan. Plans cover more of the costs for doctors who are "in-network" versus "out-of-network," making it financially wise to choose a doctor recommended by the insurance company.

Enroll in a Health Savings Account
Most high-deductible health care plans have an option for a health savings account, or HSA. This is essentially a dedicated savings account that employees can deposit money into on a recurring basis. In many cases, employees can choose a direct deposit of pre-tax dollars from their pay checks. Not only will this soften the blow when medical care is required, but any money spent from the HSA account for health care costs goes toward the deductible.
It is no secret that increasing health-care costs are leading employers to less expensive insurance options for their employees, such as high-deductible health care plans. These plans not only come with a higher out-of-pocket cost for employees, but also require them to truly understand and manage their insurance, making them consumers as well as patients. Fortunately, with a thorough understanding of the plans, a willingness to ask questions of both doctors and insurers, and benefits from features such as HSAs, this type of health care can be manageable.

About the Author
As the CEO of Vertical Health, patient care advocate Bill Paquin works to convey accurate health information to consumers. He operates web sites including SpineUniverse.com and other sites focused on improving patient care associated with back pain and endocrine disorders. Bill is a husband, father and chronic pain sufferer who writes about improving our current healthcare system.
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