Health insurance deductible: how it worksEverybody aged 18 or over has a compulsory deductible for healthcare provided under their general insurance policy. In 2022, you pay the first €385 for the costs of healthcare yourself and we reimburse the costs above this amount. Show
What is the deductible?Compulsory deductibleIf you are aged 18 or older, you pay a deductible for the first part of healthcare you receive under the general insurance. This is the compulsory deductible. The amount of the compulsory deductible is set each year by the Dutch government. In 2021, this was €385 and this will remain the same in 2022. The deductible applies to one calendar year (1 January to 31 December). You pay this amount in addition to your premium. Once you have paid the full amount of your compulsory deductible, we will reimburse any costs subsequently incurred. Voluntary deductibleBesides the €385 compulsory deductible, you can opt to add a voluntary deductible. This could be a good option if you do not need healthcare very often, as you can save on the premium this way. Do bear in mind, however, that when you do require healthcare you will be required to pay more of the costs for this out of your own pocket. If you want to change your voluntary deductible, please let us know on ‘Mijn CZ’ before 1 January. How much you can add to your deductible as a voluntary deductible depends on the kind of general insurance policy you have taken out.
Discount on your premiumThe higher your deductible, the greater your discount.
Types of healthcare to which the deductible appliesYou pay a deductible for healthcare covered under the general insurance, like hospital care, blood tests and medicine for example. If you’d like to see whether you need to pay a deductible, check our reimbursement guide. Healthcare that is exempt from the deductibleYou do not have to pay a deductible for things like GP visits, obstetric care and healthcare covered under the additional insurance package. See all the exceptions Do I have to pay the deductible all at once?You can opt to pay the compulsory deductible in instalments so that you don’t have to pay the entire €385 in one go. Your deductible will then be split up into 10 monthly payments of €38.50. If you do not ‘use up’ all of your deductible, we will reimburse you for the excess amount you paid. You can no longer register for 2022. If you want to pay the deductible in instalments in 2023, please notify us before 1 February 2023. Important to know
What is an HDHP and how does it work?True to its name, a high-deductible health plan is a health insurance plan with a high deductible. What’s a deductible? It’s the amount you’ll pay out of pocket for covered medical expenses before your insurance pays anything. With HDHPs that can help make you eligible for the tax advantages of a health savings account, your deductible for 2021 and 2022 will be at least $1,400 for individuals and $2,800 for a family, according to IRS requirements. Once you have covered expenses that reach that annual deductible, your insurance starts paying for care. Keep in mind that after reaching your deductible, you will probably have a copay (a flat fee for visiting a provider or filling a prescription) or coinsurance (a percentage of medical costs you pay) amount that you owe for most covered services for the rest of the year. Though
HDHPs usually have higher deductibles than most PPOs or HMOs, they do come with an out-of-pocket maximum. This is the most you’ll pay in a year for covered services from in-network providers. For 2021, the maximum is $7,000 for a single person and
$14,000 for a family — rising to $7,050 and $14,100 in 2022. Once you have covered expenses that reach this maximum, your plan will pay 100% of your expenses for in-network care for the rest of the year. Many HDHPs do provide 100% coverage for preventive services in your network before you meet your deductible. These include procedures such as yearly physicals, vaccinations, colonoscopies, mammograms, and flu shots Advantages of an HDHPHDHPs are popular because they often have low monthly premiums, which is what you pay every month for your plan. Because the deductibles are high, monthly premiums are lower than similar health insurance plans that have a lower deductible. If you’re generally healthy and don’t have medical expenses beyond annual physicals and preventive screenings, an HDHP could save you several hundred dollars or more a year. Another benefit of having an HDHP is that it can help make you eligible to contribute to a health savings account (HSA) . A health savings account is only an option for those who have an HSA-qualified HDHP — so if you want one, make sure your plan is eligible. Additional HSA eligibility rules are described in IRS Publication 969. HSAs allow you to put pre-tax earnings into an account you can tap into to pay qualified medical expenses, such as doctor visits, prescription drugs, and other medical services and supplies. You save on taxes since the money you put in and take out is either tax free or tax deductible. Because contributions to an HSA roll over year to year, you don’t lose the money if you don’t spend it right away.
Pros
Disadvantages of an HDHPThe main drawback to choosing an HDHP is having potentially high out-of-pocket expenses when you receive covered services during the year. You pay more in upfront costs (your deductible and copays and/or coinsurance) for nonpreventive care until you meet your yearly out-of-pocket maximum. For example, let’s say a routine doctor visit that’s covered by your HDHP leads to a diagnosis of a medical condition that needs expensive treatment. You’ll be responsible for the cost of that care up to your deductible, plus copay and/or coinsurance fees up to your out-of-pocket maximum. So, if you have a chronic condition and need to visit doctors often, an HDHP may not be the best option for you. Another possible downside to HDHPs is that you may find yourself putting off doctor visits because you’re not used to having such high out-of-pocket costs when you use covered services. A 2019 survey found that about half of U.S. adults
say they or a family member put off or skipped some sort of health care or dental care in the past year because of the cost.1 Avoiding doctor visits and prescriptions could lead to more serious health problems and larger medical bills down the road. Cons
When an HDHP might make senseA high-deductible health plan can make sense for you if:
When an HDHP might not make senseA plan with a lower deductible, such as a PPO or HMO that isn’t designed as an HDHP, might be a better choice than an HDHP if:
If an HDHP is right for youOnce you carefully weigh the pros and cons of a high-deductible health plan and decide it’s worthwhile, it’s time to shop around. Compare coverage options of HDHPs available in your area, including premiums, out-of-pocket costs, and provider networks to figure out which would work best for you. If your employer doesn’t offer an HDHP option, or you don’t have coverage through an employer, you can shop for an HDHP plan on the health insurance exchange at HealthCare.gov. Many state-run exchanges also have options for HDHPs. The bottom lineThere’s a lot to consider when choosing health insurance , especially when it comes to high-deductible health plans. Whether an HDHP can save you money depends on the specific plans available to you and your expected medical expenses for the year. While HDHPs often have lower monthly premiums, your personal financial and health situation should determine the type of coverage that’s best for you and your family. Learn more about affordable health insuranceLearn more about Kaiser PermanenteShop our plans Is it worth it to have a high deductible health plan?If you're relatively healthy and generally don't have medical expenses beyond annual physicals and screenings, you're more likely to save money by opting for an HDHP over a low-deductible plan. That's because yearly checkups and screenings count as preventive services, which HDHPs typically cover.
Why do I want a high deductible health plan?A high deductible plan (HDHP) can be combined with a health savings account (HSA), allowing you to pay for certain medical expenses with money free from federal taxes. A type of savings account that lets you set aside money on a pre-tax basis to pay for qualified medical expenses.
What is the point of a high deductible plan?A plan with a higher deductible than a traditional insurance plan. The monthly premium is usually lower, but you pay more health care costs yourself before the insurance company starts to pay its share (your deductible).
What is an advantage of an insurance policy with a high deductible?Lower monthly premiums: Most high-deductible health plans come with lower monthly premiums. If you anticipate only needing preventive care, which is covered at 100% under most plans when you stay in-network, then the lower premiums that often come with an HDHP may help you save money in the long run.
|
Whats the point of health insurance with a high deductible
Related Posts
Copyright © 2024 muatrau Inc.
