A high-deductible health plan is precisely what it sounds like: a health insurance plan - joined through an employer or a private market - that gives you a higher-than-average deductible. For 2022, that’s any plan with a deductible of at least $1,400 for an individual or $2,800 for a family. And while $1,400 sounds like a lot, most Americans have a much higher deductible, sometimes paying up to $7,000 out-of-pocket before insurance kicks in.
If you’re one of the millions of Americans enrolled in an HDHP, you’re responsible for 100% of your health care until you hit your deductible. You may even be liable for more depending on your co-insurance (don’t worry - we get into co-insurance in another post!)
1. Most providers have cash prices. You can pay less by asking about them.
There’s a price provider's bill to your insurance for a given service - and then there’s a price they charge patients directly. Most providers refer to that price as their “cash price,” which may be up to 50% lower than what they bill insurance.
If you’re under the age of 50 and generally healthy and seeing out-of-network doctors, paying cash might be a better option than buying an expensive health plan.
2. Get familiar with your plan and any in-network providers or benefits your plan may offer.
Spend time getting familiar with your insurance plan so that you can take advantage of as many benefits as possible. While the paperwork insurance companies or benefits managers provide is often dense and overwhelming, doing so can help you get a better grasp on how best to use your plan efficiently to maximize your benefits while lowering your out-of-pocket costs.
HDHPs, like most plans, offers a network of providers and doctors who you can choose from. Your plan may also cover out-of-network doctors at a lower rate than in-network ones. Your insurance will often have pre-negotiated rates with in-network doctors, which can help significantly lower out-of-pocket costs.
That means whenever you go to a new doctor or clinic, you should call ahead to ask if they’re in network. Typically, you can call the front desk, tell them your insurance plan, and ask if they’re in network.
That phone call may go something like this:
If you don’t feel like hopping on the phone - or don’t get the answer you need - most large insurance plans also offer an online portal where you can search for doctors and see if your plan has an existing relationship.
Here's a great resource to findout more information
3. Price shop every time you see the doctor.
You wouldn’t buy anything else without shopping around. Health care services should be no different. Call a few offices and ask for their cash prices. You’ll be surprised at how much the cost of a routine check-up can change from practice to practice, especially if you’re willing to pay cash.
