How to survive a high-deductible health plan

Brace yourself: Within a few years, your only choice for health insurance through your employer may be a high-deductible health plan, according to Consumer Reports.

These plans have smaller monthly premiums, but there’s a trade-off: You have to pay a lot more out-of-pocket before your insurance begins to cover a portion of your bills. Those upfront payments, or deductibles, as defined by the IRS, are a minimum of $1,300 per year for individual insurance coverage and $2,600 for a family. And that’s only the minimum.

How to Make the Best of a High-Deductible Plan

Consumer Reports consulted health-policy and insurance experts, talked with doctors and conducted its own research to uncover the most cost-effective ways to use your high-deductible plan while getting the medical services you need.

Know what’s free. Many routine health services intended to keep you well or catch problems early (including colonoscopies, mammograms and vaccinations) are free in all insurance plans now. So make sure you go to a doctor for the care you’re entitled to get.

Comparison shop. High deductibles are supposed to nudge you to shop around for lower prices for nonemergency care. But few people are doing that. Most health-insurance sites provide information on where to find in-network services. And some offer cost-estimator tools that give the price you’ll pay different providers for, say, an MRI or knee surgery. (If your health insurance company doesn’t offer one, call your insurer directly to ask for quotes.)

Spending the time to research costs can be worth it. Prices for medical treatments can vary considerably from provider to provider, even within the same city.

But don’t shop by price alone. Among the insurance websites Consumer Reports evaluated, a majority scored well on price information. But users said that the sites were difficult to navigate and that they lacked information on the quality of services from sources, such as independent ratings of doctors and hospitals, and user reviews. “Prices vary a lot, but quality does, too,” warns Orly Avitzur, M.D., a neurologist and medical director of Consumer Reports.

Interview your doctor. Doctors can be a valuable resource for patients trying to balance cost with quality of care. Researchers at Duke University analyzed recorded conversations from 1,800 doctor visits. Cost came up 30 percent of the time. And in almost half of those conversations, doctors offered ideas about how patients could find less-expensive prescriptions, diagnostic tests or other health services. You can also use online resources such as ConsumerHealthChoices.org, which Consumer Reports created as part of its partnership with the ABIM (American Board of Internal Medicine) Foundation’s Choosing Wisely campaign.

Get care on the calendar. Keep track of your spending against your annual deductible, which resets every year. If you expect you’ll need an expensive procedure that will get you close to or over your deductible, schedule it early in the year if you can. That way, if you need more care later in the year, your insurance will kick in.

To learn more, visit ConsumerReports.org.

2016, Consumers Union, Inc.

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