While only 19% of workers were enrolled in qualified high-deductible plans in 2012, participation has steadily increased from 8% in 2009, according to the
For example, even though 84% of participants in a recent study of high-deductible health plans know their plan includes a deductible (and 70% could correctly name the dollar amount within a 20% range), nearly half of all study participants mistakenly believe that their deductible applied to both preventive and non-preventive office visits and medical tests.
Similarly, 48.3% of participants thought that all medical tests applied toward their deductible, unaware that preventive tests or screenings, or both, would cost them little out of pocket. On the other hand, 31.7% of respondents thought that neither preventive nor nonpreventive office visits were subject to the deductible, including those respondents who didn't realize they had any deductible at all. Forty-one percent, meanwhile, believed that neither preventive nor nonpreventive medical tests and screenings were subject to the deductible.
If consumers are unaware of their specific health plan details, they may avoid preventive care unnecessarily, leading to more serious health issues and higher costs down the road.
In fact, despite access to free or modest copayments for preventive care as part of their small-group employer's plan, nearly one-in-five consumers report that cost concerns have led them to delay or avoid preventive office visits or tests. Those unaware that preventive office visits are exempt from their deductible were significantly more likely to avoid these visits because of cost concerns, according to the study of primary subscribers of Kaiser Permanente Northern California health savings account-eligible high-deductible plans in 2008.
The study reveals similar results for participants avoiding medical tests and screenings due to cost concerns.
Even if participants understand that preventive care is free under an HDHP, some forgo doctor's appointments to avoid paying for other nonexempt medical tests or follow-up appointments, explains study coauthor
"It comes down to better education," believes WorldatWork's benefits practice leader,
'What's in it for me?'
Sanicola suggests employers start communicating around the most relevant provisions for participants during and after open enrollment, such as cost, prescriptions, urgent/ER care, and copays/coinsurance amounts for doctor visits.
"I think you need to start with the 'What's in it for me?' approach and build the communication campaign targeted around that [mindset]," he says.
"Try to tie [communication] to key events in the employee's life so they notice [the benefit] and use it," she explains.