A qualified High Deductible Health Plan is a health plan that meets
the requirements below for annual deductibles and out-of-pocket expenses.
High Deductible Health Plans typically do not have co-pays for doctor visits
or prescription drugs. However, these plans could be "network plans".
Coverage
Annual Deductible 2010/2011
Annual Out-of-Pocket Expenses 2010/2011
Individual
$1,200 minimum*
Not more than $5,950 *
Family
$2,400 minimum*
Not more than $11,900 *
Embedded deductibles in family health plans are allowed in qualified
High Deductible Health Plans only when the individual embedded deductible
is at least $2,400 in 2010 and 2011.
Some qualified plans may have a first-dollar benefit or low-deductible
benefit for preventive care only. Preventive care includes the following:
Periodic health evaluations, such as annual physicals (and the tests
and diagnostic procedures ordered in conjunction with such evaluations)
Well-baby and/or well-child care
Immunizations for adults and children
Tobacco cessation and obesity weight-loss programs
Screening devices
* IRS Guidelines state: "preventive care generally does not include
services or treatments intended to treat an existing illness, injury
or condition."
* For the High Deductible Health Plan to be an eligible plan,
prescription drugs must be covered under the deductible. A prescription drug discount program is allowed.
