By Tom Gregory

There’s a common situation encountered during open enrollment: the choice between traditional copay plans and high-deductible health plans (HDHPs). Let's explore the key differences between these two options to help you make an informed decision about your health insurance coverage.

Here are the important points to consider:

Both traditional copay plans and HDHPs have individual and family deductibles, but they operate differently in terms of cost-sharing: Traditional copay plans typically require fixed copayments for certain services, such as office visits, urgent care visits, and prescription drugs. These copays are usually around $25 or $30 for primary care office visits and are also applicable to urgent care, emergency room visits, and prescriptions.

In contrast, HDHPs require individuals to pay all medical expenses out-of-pocket until they reach the calendar year deductible. However, preventive care services are covered at 100% without requiring payment towards the deductible. One unique advantage of HDHPs is their eligibility for Health Savings Accounts (HSAs): HSAs are tax-advantaged accounts that allow both employers and employees to contribute pre-tax funds, which can then be used to pay for qualified medical, dental, and vision expenses without incurring taxes on the withdrawals. HSAs provide flexibility and control over healthcare expenses, making them a valuable tool for managing healthcare costs and saving for future medical needs.

During your company's open enrollment period, it's essential to review your plan options carefully: Consult with your HR department or insurance advisor to understand the details of each plan option and determine which one aligns best with your financial needs and healthcare preferences.

By understanding the differences between traditional copay plans and HDHPs, you can choose the plan option that provides the most value and meets your healthcare needs effectively. Don't hesitate to ask questions and seek clarification on any aspects of the plans to ensure you make a well-informed decision for yourself and your family.