Essay On High Deductible Health Plans

The only way for some people to reasonably afford health insurance is to buy a policy with an extremely high deductible. This does not seem like a fair or reasonable exchange.

Health insurance comes as second nature to many of us. We grab that blue and white card and put it in our wallet and forget about it until we are sick or injured. When this happens, there it is, cushioning our fall like the extra padding it provided to cushion our wallets. This is not the case with everyone, however. Many Americans have no cushion to fall back on, no blue and white card to show the emergency room when they have an unexpected health concern. No HMO with a convenient co-pay amount when their son or daughter develops an ear infection.

The consumer driven health plan (CDHP) is a combination plan, one with a high deductible plan and one with a tax-preferred savings account plan directed by the patient. The plans work together for the patient with the high deductible for major losses and the savings accounts for out of pocket expense or non-covered expenses. With the CDHP, patients are more inclined to research their medical care in order to make informed decisions (Valerius, Bayes, Newby, Seggern , 2008).

Rising health insurance premiums have made healthcare unaffordable in the United States. Health insurance premiums in this country have undergone a steady rise over the past few years while incomes have remained the same. More than 50% of individuals with low incomes holding private insurance in the United States are unable to afford their healthcare costs (Collins, Gunja, Doty & Buetel, 2015). In addition, costs related to healthcare are equally unaffordable to 25% of working-age individuals who hold private health insurance policies (Collins et al., 2015). According to the Kaiser Family Foundation/Health Research and Educational Trust (Kaiser/HRET) survey on employer health benefits, employer-sponsored health insurance plans have also had moderate rises in premiums in 2013 for both individuals and family coverage (Claxton et al., 2013). While

There have been many studies performed focusing on the rising costs of health care and some of the findings state that the rising cost of healthcare premiums is a worldwide problem. However, I believe they are higher in the U.S. In 2015, U.S. health care costs were $3.2 trillion. That makes healthcare one of the largest U.S. industries, equaling 17.8 % of the Gross Domestic Product (GDP) in comparison to the late 1960s; where healthcare costs were only $27 billion, or 5% of the GDP, which averaged $9,990 per person each year. The main reason for the rising cost of healthcare is a combination of government policies and lifestyles changes. Examples included lack of coverage or costly coverage, lack of available coverage for

Recently, a Consumer Driven Health Plan (CDHP), was created. There are many variables to a CDHP, such as benefits covered and coinsurance amounts, however there is one thing that all CDHP’s have in common – a high deductible. By having a high deductible, such as $1,200, it forces the plan participant to think about the medical services they are seeking. Do they really have to go to the emergency room for that cough or can they go to urgent care, or better yet, their physician the next day. When the plan

Each state has their own policies for Medicaid eligibility, services and payments. Medicaid plans have three eligibility groups such as categorically needy, medically needy and special groups. Children's Health Insurance Program (CHIP) is a program that offers health insurance coverage for uninsured children under Medicaid. If Medicaid does not cover a service, the patient may be billed if the following conditions have been met such as the physician informed the patient before the service was performed that the procedure was not covered by Medicaid and if the patient has signed an Advance beneficiary Notice form. However, there are also conditions where the patient cannot be billed if necessary preauthorization was not obtained or service

Unit 2 AssignmentKelley WhitcombKaplan UniversityHI215-01: Reimbursement MethodologiesProfessor Kathleen SobelJuly 20, 2015Medicaid is one of the biggest insurance plans you can get in any state. In the state of Indiana, it is based off of your income. There is a certain amount (income) you have to make to determine if you will receive Medicaid or Healthy Indiana Plan (HIP). HIP is still a form of Medicaid, but you would have to pay monthly cost for it and have certain set of co-pays for certain services that is needed. HIP Plus is the recommended plan for members as it provides health coverage for a low, predictable monthly cost. HIP Plus also covers dental and vision services. If you do not pay your monthly payment you can be removed from

When Americans enroll in health insurance they opt for cheaper premiums, rather than premiums that would be suitable for them. The issue with enrollees choosing cheaper premium leads to higher deductibles. According to the Centers for Medicine and Medicaid Services, 68 percent of marketplace enrollees have chosen silver plans and 21 percent bronze plans. Enrollees who have silver plans could potentially see relatively small deductibles, but bronze enrollees may be subjected to higher deductibles that are too expensive to afford. Janet Varion, an

For those Americans not covered or find their work coverage too expensive, there is a new way for them to buy insurance on their own called Health Insurance Marketplaces. Some states have named these marketplaces something else. The Health Insurance Marketplace is like a virtual insurance megamall where private insurers compete for American’s business. Americans can pick out how much coverage they want, how much they want to pay for it, from cheaper high deductible plans to more expensive plans. Regardless what plan is chosen, all plans will cover a complete set of services like hospital visits, doctor visits,

A Health Savings Account (HSA) plan requires a high-deductible medical insurance policy, which means that the premiums on the policy will be less than for a low-deductible policy. The contributions to the HSA are deductible for AGI, which reduces the nondeductible amount of itemized deductions subject to certain limitations, and the taxpayer does not have to itemize to obtain the deduction. The HSA distributions pay for the deductible medical expenses and they are not included in gross income. Also, the income earned on the HSA is not included in gross income if it is used to pay medical expenses not covered by the high-deductible plan.

With so many insurance companies and employers going to High Deductible Health Plans (HDHP), it would be beneficial to patients if the cost of healthcare was lower. According to Gapenski & Pink (2011), “Most employers pay some (or all) of the HDHP premium but require the employee to fund the HSA.” HSA’s were created so that anyone that participates in the program can use the money set aside to help pay for certain medical cost, dental care, vision care, some medical supplies and some over the counter drugs. I believe that HSA’s will have an impact on healthcare cost for the following reasons:

A sample size of approximately 160,000 American employees (including their dependents) were provided with free health insurance (i.e. 0% co-pay) by their firm until they were forcibly switched into a non-linear, high-deductible health insurance plan (HDHP). What would be the impact of such a demand-side policy on their health care spending behaviour? This is a central question that the authors, Brot-Goldberg et al., of their 2015 paper (What Does a Deductible Do? The Impact of Cost-Sharing on Health Care Prices, Quantities, and Spending Dynamics) seek to address. With their unique opportunity to explore this issue in a natural experiment, the authors find that the switch caused a spending reduction of medical

For instance, if you increase your deductible from the customary $500 to $1,000, you'll save as much as 25% on your insurance plan.

One of the things I don’t understand is how healthcare insurance works in some cases. I have a friend of mines that pays almost three hundred for health insurance a month and still pay a deductible when seen by a doctor. After she thinks this is all she has to pay for, she gets another bill, as if paying three hundred a month and paying the deductible isn’t enough. I understand we have to pay a certain percentage deductible, while the insurance pays the rest. So why should we pay a high amount of money a month to get health insurance when no matter how much we pay or what kind of insurance we get, we never get out of debt.