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High Deductible Health Plans

If you get coverage through your employer

A high deductible health plan, also known as HDHP, has a lower monthly premium, but you’ll pay for most of your care until you meet your deductible. When an HDHP is paired with a Health Savings Account, you can set aside tax-free money for current health care expenses and build savings for the future. Learn more about how to manage your costs with an HDHP plan.

See how it works

There are a few things you need to know:

Deductible: This is the amount you pay first before sharing your costs with us.

Copay: A fixed amount, like $25 you pay when you receive care or pick up a prescription.

Coinsurance: This is similar to a copay but instead of a fixed dollar amount, it is a percentage of the total bill. For example, if your child’s eyeglasses are $100 and you’ve met your deductible, your coinsurance payments of 50% would be $50. We would pay the rest, or $50.

Out-of-pocket maximum: This is the most you could ever pay in a year on covered health care services, excluding your monthly premium. Any deductible, copay, coinsurance or out-of-pocket cost for covered services goes towards your out-of-pocket maximum. If you reach this amount, all you need to do is to continue paying your monthly premium. We’ll pay 100% of the cost when you get care for covered services.

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Managing Your HDHP

Managing Costs Example

It’s also important to know what is covered and what something might cost you. Preventive care for the most part is covered in full. But costs vary based on the provider you see, the facility you visit and the procedure you may need. And there are a few ways to find out how much something might cost:

  1. Call your doctor or specialist ahead of time and ask how much the anticipated service will cost.
  2. Log into your member account to check your benefits or call our Customer Care Advocates at the number listed on the back of your member card.
  3. Use our cost estimator (login required). This tool provides an estimate of what a procedure might cost among different doctors in the area.

Funding Account Options for your HDHP

Talk to your employer or benefits administrator about what funding options might be available for you for your HDHP.

  • A Health Savings Account (HSA) is a tax-free account that you own and you can use to pay out-of-pocket medical expenses. The money in an HSA can roll over each year.(If you have dependent(s) on your plan, the Internal Revenue Service has rules about how you use your HSA funds for them)
  • A Health Reimbursement Account (HRA) is a tax-free account that your employer funds that you can use for qualified medical expenses each year.
  • A Flexible Spending Account (FSA) is a tax-free account used for qualified medical expenses which must be used in full each year.

HDHP Tips and Tricks

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Take advantage of free preventive care like immunizations and screenings. Nearly all preventive care is covered under every plan.

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Getting lab work done? All routine lab work ordered by your physician may not be covered at 100%. Customer Care Advocates are available to answer any questions you may have.

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If you're on a high deductible plan, set up a Health Savings Account (HSA) to pay out-of-pocket expenses. You can also check to see if your employer offers a Flexible Spending Account (FSA).

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Create a savings account you only use for you health care expenses. Check with your bank to see what options may be available.

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Get a credit card with a low interest rate that you can use for health related expenses.

Shop around for doctors, hospitals and services because prices can vary. You can use our cost estimator.