Researchers that members of聽high-deductible health plans, a , seem to get聽less preventive care than people who pay lower out-of-pocket costs. But evidence for why was scanty.聽After all, under the 2010 Affordable Care Act many聽preventive screenings and treatments are covered with no out-of-pocket cost at all, even for high-deductible insurance.
Now聽policy pros at Kaiser Permanente, the giant health plan, have .聽(Kaiser Health News is not affiliated with the insurer). Perhaps not surprisingly, their research shows that many consumers with high-deductible coverage聽think聽the deductible — which can run to thousands of dollars — applies to all doctor visits.
A聽survey of hundreds of Californians enrolled in health savings accounts, one type of high deductible plan, showed that fewer than one member in five understood that preventive care was free or almost free.聽A fifth of those surveyed said they had聽avoided preventive examination or treatment聽because of cost.
鈥淚t鈥檚 a reminder that patients usually have聽a pretty limited understanding of the details of their health insurance plan,”聽Mary Reed, a Kaiser Permanente scientist and the study’s lead author, said in an interview.聽“Even when plans are designed well or thoughtfully, if patients don’t understand they probably won’t behave accordingly.”
The lesson doesn’t apply just to high-deductible plans, she said. The need for member聽education is rising as all plans “continue to get relatively more complicated,” she added.
Nineteen percent of American workers are enrolled in a high-deductible plan, up from 4 percent in 2006, the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.) High-deductible insurance comes with substantially lower premiums than other coverage, partly because patients聽bear more of the cost when they get sick. But advocates see it as a way to prompt consumers to think more carefully about the kind, amount and expense聽of health services they seek.
