Chapter 1: What is the main topic discussed in this episode?
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Hey, it's Marielle. Today we're talking about health insurance, specifically high deductible health plans. High deductible health plans are common in the U.S. A lot of people choose them because they have much cheaper premiums, and premiums are what you pay every month just to have the insurance, even if you don't use it.
If you get your insurance through work, these will come out of your paycheck. The thing is, high deductible plans also have high deductibles.
Your deductible is the amount that you have to pay for covered services before your insurance starts sharing costs.
This is Jackie Fortier. She's been reporting on high deductible health plans for an NPR and KFF health news series called Healthcare Helpline. Now, sharing costs means that after you've paid a certain amount out of pocket, your deductible, your insurance will pay a portion of each medical bill and you'll pay the rest. Could be an 80-20 split, a 70-30 split. It depends on your plan.
A lot of folks sign up for high deductible plans because of the cheap premiums, but then they get surprised later.
I talked to Madison Burgess. She's an elementary school teacher in San Diego, and she was shopping around for a good deal for her husband.
And when I initially got the plan, I just looked for the cheapest thing. And I didn't know what a deductible was. I just went with what was cheap.
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Chapter 2: What are high-deductible health plans and why are they popular?
Hey, Mariel. You mentioned that someone you interviewed has to meet a $6,000 deductible before insurance will start paying for their care.
Is that common? Yeah, it's kind of middle of the road. The IRS actually defines high deductible health plans. The minimum deductible for this year is $1,700 for an individual. But some individual, like catastrophic deductibles, can exceed $10,000 for a single person a year. That would be a pretty big shock if you haven't had a high deductible plan before. Yeah.
And I think high deductible plans can be like confusing because the timing of the costs is so different. So under a traditional plan, you know, you might pay like $20 copay to see your doctor. But under a high deductible plan, you pay the full negotiated price of the visit until you hit your deductible. So you might pay, you know, $100 for the same doctor visit. Yeah.
Takeaway one, if you have a high deductible plan, find out what your deductible is. If you take out your insurance card, it'll probably be on there. Or you can also look in your portal online or in your plan documents. And then if you go to the doctor, remember you might have a lot of bills to pay up front. These can range.
You know, maybe you're used to paying a $30 copay when you go to see the doctor, but now the office is asking you to pay $130 for the same visit. Or you get a blood test done and you have to pay a couple hundred dollars for that. So one of the challenges, right, is that when you have a high deductible plan, you end up with a lot of upfront costs. How does that play out for a lot of folks?
I think it really changes how some people choose to use their healthcare.
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Chapter 3: What should you know about deductibles in high-deductible health plans?
I talked with Thomas Lehman. He's a dog walker and pet sitter in the Atlanta suburbs, and he's had a high deductible plan for a few years now. You know, he spends thousands of dollars a year just on premiums. That doesn't leave a lot left over. So he and his wife only see a doctor when it really feels unavoidable.
So we're kind of stuck in this situation where, I mean, we only use it for maybe emergencies or semi-emergencies.
And he told me that he would go to the doctor more if he had more traditional insurance. But with a high deductible plan, he's just not comfortable doing that. So he only goes when he feels like he really has to.
Takeaway two, though, is there are ways to manage these upfront costs. At LifeKit, we've reported on how to apply for financial assistance, also known as charity care, from a hospital. Even if you haven't met your deductible yet, hospitals might lower or eliminate your bill depending on your income. Another option is to get on an interest-free payment plan with your hospital or doctor's office.
And here's how that works. Imagine it's January. You have a $6,000 deductible and you have to go to the hospital for something. Then you get a bill and it's $2,000. You're expected to pay that bill directly to the hospital because you haven't hit your deductible yet. But that doesn't mean you have to pay it off all at once.
Ask the medical billing office to put you on an interest-free payment plan. That way you can pay in installments every month without accruing interest. Now, it is possible that when you ask, they'll say no, but these types of payment plans are very common. And to be clear, we're not talking about signing up for a credit card or a loan.
This is just an installment plan that you set up with the billing office. And before you start paying, you want to confirm in writing that you won't be charged any interest. Another strategy, if you have a high deductible health plan, is to see if you can benefit from timing your health care visits so that if you're going to hit your deductible, you do it early in the year.
There is an advantage to meeting your deductible early in the year if you can. I talked with Caitlin Donovan with the Patient Advocate Foundation, and she said it does pay off to sort of strategically schedule those big ticket medical treatments.
You might want to schedule those treatments up front, a surgery up front, so that way you're paying for your coverage and then the rest of it kicks in for the rest of the year and you get to enjoy that kind of safety cushion.
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