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High Deductible Health Plan

Health care in the United States
Government Health Programs

Private health coverage

Health care reform law

State level reform
Municipal health coverage


In the United States, a high-deductible health plan (HDHP) is a health insurance plan with lower premiums and higher deductibles than a traditional health plan. Being covered by an HDHP is also a requirement for having a health savings account. Some HDHP plans also offer additional "wellness" benefits, provided before a deductible is paid. High-deductible health plans are a form of catastrophic coverage, intended to cover for catastrophic illnesses. Adoption rates of HDHPs have been growing since their inception in 2004, not only with increasing employer options, but also increasing government options. As of 2016, HDHPs represented 29% of the total covered workers in the United States; however, the impact of such benefit design is not widely understood.

Participation in a qualifying HDHP is a requirement for health savings accounts and other tax-advantaged programs. A qualifying plan must have a minimum deductible and out-of-pocket maximum which the Internal Revenue Service may modify each year to reflect change in cost of living. According to the instructions for IRS form 8889, "this limit does not apply to deductibles and expenses for out-of-network services if the plan uses a network of providers. Instead, only deductibles and out-of-pocket expenses for services within the network should be used to figure whether the limit is reached."

When a consumer purchases a health insurance policy, there is a moral hazard risk because the consumer may utilize too much medical care because the full cost of care is defrayed (i.e. he/she has a lower marginal cost for care than the open market). Advocates of Consumer-driven healthcare (CDHC) such as HDHPs operate on the premise that imprudent choices made by patients may be avoided if they are held financially responsible through high copayments and deductibles. However, in practice, studies show that HDHP may actually promote behavior such as avoiding preventive care visits and reducing much needed ambulatory care, especially for those with chronic conditions or low socioeconomic status.


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