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What is a high deductible health plan?
A high deductible health plan meets the following
criteria: (1) For self-only policies, a qualified health
plan must have a minimum deductible of $1,150 with a
$5,800 max out-of-pocket expenses. (2) For family
policies, a qualified health plan must have a minimum
deductible of $2,300 with a $11,600 max out-of-pocket
expenses. Out-of-pocket expenses include deductibles,
co-payments, and other amounts the participant must pay
for covered benefits, but do not include premiums for
covered benefits. Generally, a plan that does not
specify an out-of-pocket maximum is not an HDHP.
However, if a plan is structured in such a way that the
account owner would never exceed the out-of-pocket
limitation, then the plan could be considered a HDHP.
High deductible health plans can have first dollar
coverage (no deductible) for preventive care and higher
out-of-pocket expenses (copays & coinsurance) for
non-network services. In order to create an HSA, you
need to be covered by an insurance plan that has a
deductible that is considered high. Many people already
own a plan that qualifies or will do so in the near
future due to the lower premiums that such plans offer.
The dollar amounts described above are subject to annual
cost of living adjustments beyond 2009. You must have an
HDHP if you want to open an HSA. Sometimes referred to
as a "catastrophic" health insurance plan, an HDHP is an
inexpensive health insurance plan that generally doesn't
pay for the first several thousand dollars of health
care expenses (i.e., your "deductible") but will
generally cover you after that. Of course, your HSA is
available to help you pay for the expenses your plan
does not cover.
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Who can offer a high deductible health plan?
A high-deductible health plan may be offered by a variety of
entities, including insurance companies and health
maintenance organizations (HMOs).