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HDHP - High Deductible Health Plans

You must be enrolled in a High Deductible Health Plan (HDHP) to be eligible to open and fund a Health Savings Account (HSA). An HDHP – as defined by the Treasury Department’s 2013 guidelines – is a health insurance plan that meets the following criteria:

Minimum Deductible Amounts for HSA-Compatible HDHPs

  • For individual coverage: $1,250
  • For family coverage: $2,500
  • Maximum Annual Out-of-Pocket Amounts for HDHPs

  • For individual coverage: $6,250
  • For family coverage: $12,500
  • In addition, an HSA-Compatible, High Deductible Health Plan can only provide first dollar coverage for benefits that are considered preventive care, such as an annual physical. For all other benefits, such as office visits or prescriptions, the insurance cannot go into effect until the member has met the annual deductible.

    Finding a High Deductible Health Plan

    All of the major health insurance companies throughout the United States offer a variety of HSA-qualified, High Deductible Health Plans. These HDHPs are available as a PPO from carriers like Aetna, United HealthCare, Celtic, Health Net, Unicare, Blue Cross and Blue Shield. Kaiser Permanente is among the carriers that offer HSA health insurance plans as HMOs.

    The easiest way to find a High Deductible Health Plan is to view the free HSA insurance quotes available on HSAConnect. Here you will find personalized quotes and plan summaries of all the HSA-qualified, health insurance plans from the major carriers in your state.

    Using Your HDHP

    Here is how it works. Let’s assume that you have individual coverage under an HDHP with the following benefits structure:

    Out-of-Pocket Max
    Annual Physical

    On this plan, you will be responsible for the first $1,500 of all medical expenses; however, you will receive the contracted rate the carrier has with the providers (not the off-the-street rate) for these expenses.

    The one exception to the $1500 deductible is an annual physical, which is considered preventive care. On this plan the member will pay $75 for their annual physical regardless of the deductible.

    Once you have paid out $1,500 in medical expenses your co-insurance benefit will begin. You will be responsible for 30% of all subsequent charges until you reach the out-of-pocket maximum of $2,400. At this point the carrier will pay 100% of any additional charges for the remainder of the calendar year.

    Non-HDHP, health insurance plans

    While other high deductible health plans may meet the deductible and out-of-pocket limits for an HDHP, they cannot be considered HSA-compatible if they offer first dollar coverage for services other than preventive care.

    Although many traditional health insurance plans have high deductibles, they typically offer some sort of co-pay for Office Visits and Prescription Drugs that is outside of the deductible. These benefits are considered first dollar coverage and therefore, the plan is not an HSA-qualified, High Deductible Health Plan.

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