High Deductible Health Plan (HDHP)
You probably noticed that the High Deductible Health Plan (HDHP) has a higher deductible and lower monthly premiums than a typical health plan like the university鈥檚 85/60 PPO plan. If you would typically choose your health plan by premium cost, be sure you understand the tradeoff for a lower monthly premium.
The HDHP requires you or your family to pay the full cost of your health care, including your medications, until you reach a fixed dollar amount. This is called your plan鈥檚 annual deductible.
With the HDHP, non-preventive medication drugs must be paid for in full until the deductible is met. Once your annual deductible has been met, covered medical expenses are covered at 100% and prescription drugs are covered at the coinsurance levels.
The HDHO is a non-grandfathered health plan and must cover routine immunizations and other services required by healthcare reform (the Patient Protection and Affordable Care Act (ACA).
If these services are performed by an in-network provider, members cannot be charged a copayment, coinsurance or deductible. Out-of-network charges may apply if the services are performed by a non-network provider.
Like all university medical plans, preventive care is covered at 100%. This means when you receive annual physicals, mammograms, colonoscopies and well-child care, there is no deductible or coinsurance. Remember, immunizations are covered by the medical plan only.