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Frankly, not everyone can afford the level of medical coverage provided by a comprehensive insurance plan. One way to address this is to seek a plan with a high deductible. In general, the higher the deductible, the lower the monthly premium you pay.
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How SDHP Plans Compare
- Low cost
- Covers some preventive care
There is an increasing awareness, however, that the old saying “an ounce of prevention is worth a pound of cure” is true. If you are generally in good health, getting regular preventive care (such as routine checkups and immunizations) will go a long way to keep you healthy. This is what a Self Directed Health Plan (or SDHP) is all about.
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Important Points About SDHP Plans
- A high deductible means that your monthly premiums are low.
- The plan provides “up-front cash” for you to use on certain preventive care (often in the range of $250 for three months) as you see fit. This allows you to maintain your own wellness care.
- If you don’t use your allowance (“up-front cash”) during a given quarter, the funds roll over for use later.
- For medical expenses above the preventive care allowance, you are responsible for paying the amount up to the deductible. Once you’ve paid this amount, coverage starts.
- After you’ve paid your annual deductible, you will also be responsible for coinsurance (the percentage of medical costs not paid by the provider).
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In other ways, an SDHP plan is like a PPO plan, for example:
- Generally, SDHP plans use an approved network of doctors and other healthcare providers (hospitals, specialists, etc.). As a member, you pay less for your healthcare when you use the network.
See the PPO Plans section for further details.
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You Might Not Want a SDHP Plan If...
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You’d like more complete coverage and are willing to pay a little more for it.
See the HMO, PPO, POS or Fee-for-Service plans sections.
- You feel you can provide your own “up-front cash” and better handle your own finances.
See the HSA Plans section.
For details on which plans are offered in your area, please see the Texas-Health-Plans Providers List.
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