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NY Health's High Deductible Health Plans and Health Savings Accounts

High Deductible Health Plan and Health Savings Account Option

Healthy NY now offers a new option - a high deductible health plan that can be used with a health savings account.

What Is a High Deductible Health Plan?

A high deductible health plan (HDHP) is a type of health insurance coverage. The HDHP has a lower premium, but you must meet a deductible before most coverage begins. The HDHP has the exact same benefits and co-payments as Healthy NY without a deductible. The 2008 deductible is $1,150 for individuals and $2,300 for families (more than one person).

How Does the High Deductible Health Plan Work?

With the HDHP, you are responsible for the cost of most services until you meet the deductible. You should ask your health care provider about the cost of any services you will have to pay for out-of-pocket. Only expenses for benefits covered under the Healthy NY plan count towards meeting the deductible. Once you meet the deductible, you will only pay a co-payment for services.

You can get preventive services before meeting the deductible by paying a co-payment. Preventative services include well-child visits, child immunizations, routine prenatal care, prostate cancer screening, mammograms, Pap tests, and adult checkups and immunizations. Money spent on co-payments for preventive services does not count towards the deductible.

With a family plan, one family member or a combination of family members included in the health plan must meet the $2,300 family deductible in order for coverage to begin.

If you choose the HDHP with a prescription drug benefit, the overall deductible of $1,150 for individual coverage or $2,300 for family coverage applies to the drug benefit as well, and there is no separate $100 prescription drug deductible. You will be covered for prescription drugs once you reach the $1,150 or $2,300 deductible. Out-of-pocket costs for prescription drugs count towards the deductible, as long as the drug would be covered under Healthy NY. If you choose the HDHP without a prescription benefit, then out-of-pocket expenses for prescriptions do not count towards the deductible.

You may only choose between the HDHP and the standard plan when first enrolling and during yearly recertification.