A plan with a higher deductible than a traditional insurance plan. The monthly premium is usually lower, but you pay more health care costs yourself before the insurance company starts to pay its share (your deductible). A high deductible plan (HDHP) can be combined with a health savings account (HSA), allowing you to pay for certain medical expenses with money free from federal taxes.
The IRS defines a high deductible health plan as any plan with a deductible of at least $1,300 for an individual or $2,600 for a family. An HDHP’s total yearly out-of-pocket expenses (including deductibles, copayments, and coinsurance) can’t be more than $6,550 for an individual or $13,100 for a family. (This limit doesn’t apply to out-of-network services.)
Preventative Care Services Provided:
- HDHPs have a maximum limit on the sum of the annual deductible and out-of-pocket medical expenses that you must pay for covered expenses. Out-of-pocket expenses include copayments and other amounts, but don’t include premiums.
- An HDHP may provide preventive care benefits without a deductible or with a deductible less than the minimum annual deductible. Preventive care includes, but isn’t limited to, the following.
- Periodic health evaluations, including tests and diagnostic procedures ordered in connection with routine examinations, such as annual physicals.
- Routine prenatal and well-child care.
- Child and adult immunizations.
- Tobacco cessation programs.
- Obesity weight-loss programs.
- Screening services. Including screening services for the following:
- Heart and vascular diseases.
- Infectious diseases.
- Mental health conditions.
- Substance abuse.
- Metabolic, nutritional, and endocrine conditions.
- Musculoskeletal disorders.
- Obstetric and gynecological conditions.
- Pediatric conditions.
- Vision and hearing disorders.
[Source: Healthcare.gov Glossary “High Deductible Health Plan”: https://www.healthcare.gov/glossary/high-deductible-health-plan/ ]
[Source: IRS-High Deductible Health Plans: https://www.irs.gov/publications/p969/ar02.html#en_US_2016_publink1000204030 ]