A high deductible health plan is a health insurance plan whose annual deductible amount meets a minimum dollar amount. To qualify as a high deductible health plan for an individual, the deductible amount must be at least $1,250 in 2013. High deductible health plans that cover a family of beneficiaries have a higher deductible amount than for individuals. The minimum deductible for a family is $2,500 in 2013 in order to qualify as a high deductible health plan. High deductible health plans are associated with lower premiums as compared to health plans with smaller deductibles.
Minimum deductible amount to qualify as a high deductible health plan is set by the Internal Revenue Service (IRS) annually. The IRS sets this annual amount in part by analyzing on cost-of-living data.
A deductible is the dollar amount that you must pay for healthcare service before a health plan will start contributing money. Deductible amounts are not standardized and can vary by health plan. Below is an example of how a deductible operates.
Deductibles normally get reset to their full amount at the beginning of a new calendar year. If your health plan has a $2,000 deductible and on January 1st you visit the doctor, you would be responsible to pay the complete doctor visit charge of $100. That would leave you with $1,900 more to pay in medical services before the health plan would pay any money towards medical services.
Under the Affordable Care Act, preventative services such as immunizations or colorectal cancer screening are exempted from a health plan’s deductible amount. High deductible health plans are also subject to the same maximum out-of-pocket limits as traditiional health plans.
High deductible health plans are not differentiated from other health plans based on benefits or healthcare providers. In other words, a high deductible health plan can have the same insurance benefits and doctor choice as other health plans.
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