Does a High Deductible Health Insurance Plan Make You More Reluctant to Visit a Doctor?

Last January I sat on the couch with three large insurance documents spread out across my computer screen. Should I choose an HMO or PPO? Should I opt for a high deductible insurance plan or pay up front for everything in the form of higher premiums? I have to admit I was overwhelmed with details.

With a very complicated medical history I wanted to make certain my family and I have solid coverage. Illnesses can arise unexpectedly at any age. I was only twenty-seven when I was swiftly sidelined by rare medical complications.

One plan seemed to cover more treatments more than an other, but since we do not suffer from chronic conditions, (at least not ones that require medical supervision), it is unclear if we would ever need or use those services.

Ultimately it came down to a question of money. The high deductible plan was $760 less per month than the standard PPO and saving $760 a month seemed like a no-brainer.

Here are the numbers that helped us choose the HSA plan. For the record as a result of ObamaCare we now pay a MUCH larger premium.

Current Monthly Premium: $1525
New Monthly Premium: $765
Monthly Savings: $760
Yearly Premium: $18,300
New Yearly Premium: $9180
Yearly Savings: $9120

At the time I wondered why I hadn’t switched over to a High Deductible, HSA plan sooner. We pay less in premiums and can set aside $6,550, (the maximum contribution permitted in 2014), to our HSA.

But now that I have a high deductible insurance plan I find myself less willing to go to the doctor. A few weeks ago I found myself feeling quite ill, but my first thought was “am I sick enough to go to the doctor?” In fact, I tried a number of alternative treatments before seeking professional help.

When I paid a higher monthly premium I thought nothing of going to the doctor. I didn’t visit a doctor frequently, but if I needed to go I made an appointment and didn’t think twice about it.

Now I immediately wonder how much that appointment might cost. What tests will they want to run? How much will each of those tests cost? Of course, no one can ever tell me in advance what I might expect to pay. Instead I have to wait for the insurance claim to be processed and then pay whatever amount has been negotiated between my insurance provider and my doctor.

It’s interesting how much my mind set has changed now that I have a high deductible plan. It’s silly really. It’s not that I can’t afford to go to the doctor. I also know deep down that I am still paying less than I did with a standard PPO plan and that I am still paying a ridiculous amount of money to remain insured. Yet I still find myself hesitating before calling the doctor and in the doctor’s office I wonder if the tests they run are really necessary. (That’s another hold over from my medical past. A lot of the expensive tests they ran on me were unwarranted.)

So I wonder. Is it just me or do high deductible insurance plans make people more hesitant to visit the doctor?

2 thoughts on “Does a High Deductible Health Insurance Plan Make You More Reluctant to Visit a Doctor?”

  1. I’ve been thinking the same thing. I went through a similar decision process during benefit election time ( By January 1st (start of my new plan) I was nervous about if I made the right decision.

    I agree that it made me more reluctant to go to the doctor (perhaps part of the intention of some of these plans). Before, on the higher premium plan, I’d think “it’s just $20/30 copay, might as well drop in”. But you’re right between everything having individual costs (visit + tests+ other things you might not even expect) it’s hard to know ahead of time if the visit will be “worth it”. I got annoyed after some visits where they’d just say “yep, it’s a cold, get some rest and fluids” and think “I wasted my time and money for this visit!?!” but I think I’d be even more annoyed when I’m paying more (up front).

    I know the insurance company has a “predict your costs” page where you can get an estimate before a visit, but it’s hard to know what exactly will happen.

    It appears that health insurance of this type makes things more like just car insurance or other types: for emergencies only. Though there are some things that ACA has declared must be covered at 100%, so that at least helps a little.

    I’ll definitely be tracking how my medical expenses change this year, and see if the lower premium/higher deductible plan was actually the right choice for me.

  2. Yes, of course they do, which was one of the reasons they were created and how they were marketed. ‘Consumer driven healthcare’ and all. The thought was that people would be more discriminating about when, how, and how much to use their health care benefits, and that this would be a catalyst for controlling health care costs on a more macro level.

    I’ve had an HDHP w/ HSA for years and love it. I have a hard time imagining that I’ll ever go back to a more traditional plan, though much of that depends on what happens with HDHPs over the next few years. On one hand, yes, my health plan makes more thoughtful about health care in general and I do find myself considering cost more than I ever did with a traditional plan. But on the other hand, over the past couple years, I’ve adopted an attitude wherein I’m perfectly comfortable going to the doctor because chances are…I’m GOING to hit my deductible at some point throughout the course of the year, and for me…the sooner the better. But, that’s because of the type of HDHP that I have, wherein there is no co-insurance, which means that once I reach my deductible for the year (which is only $2650, BTW), I’m DONE. I don’t have to pay another cent for health care at that point. If I had a high deductible PLUS 10-20% co-insurance on top of that…I’d likely feel very differently.

    Between that, the fact that there are no copays, the fact that preventive care is included with no cost-sharing, and the fact that my employer pays 100% of my monthly premium (which was NOT the case when we had a much more expensive traditional plan), my HDHP has worked out tremendously well!

    I’ll also add that I work in HR and am my company’s benefits administrator, so I’m intimately familiar with the REAL costs of group health plans, and even WITH paying 100% of of employee premiums under the current plan, my employer is paying over 30% less now than they were when we all had a traditional plan and they only covered 80% of our premiums.

    So it’s a win/win, IMO. šŸ™‚


Leave a Comment