Wall Street Journal Examines Consumers’ Misconceptions About High-Deductible Health Plans

The Wall Street Journal on Friday examined some consumers' misconceptions about provisions of health plans with high deductibles, which "have become a common way for employers and individuals to reduce their insurance premiums." Cary Badger, vice president of customer marketing for the Regence Group, said that consumers compare plans and deductibles but often overlook the details of what is actually covered under the plan. For example, some plans may not cover preventative care, such as physicals. In addition, the Journal reports that lower premium plans can make a "deductible that already seems steep ... feel like its ballooning" because of "often-confusing rules that dictate what counts toward your deductible and what doesn't." Gary Claxton, a Kaiser Family Foundation vice president and director of its health care marketplace project, said some health plans provide limited coverage for benefits such as prescription drugs, rehabilitation, physical therapy and mental health services. "People who have relatively high deductibles, or even any deductibles, don't even realize that what the insurer counts against the deductible isn't everything you pay," Badger said. According to America's Health Insurance Plans, health plans' physician networks also can affect health care costs because only "reasonable and customary" charges for costs for treatment by out-of-network health care providers will be counted toward the member's deductible, rather than the payment of the actual services. The Journal reports that in most cases "if consumers don't pay for a certain type of coverage, then they don't get the perks that come with that coverage." Regence BlueShield spokesperson Jodi Coffey said, "We really want people to have access to care, and we want to figure out how to make this work. But the truth of the matter is, it does come down to the contract that you've purchased" (Rubenstein, Wall Street Journal, 1/28).