Blue Cross Blue Shield is one of the most famous health insurance plan providers. They offer a variety of options to consumers, and part of their opposition to healthcare reform is based on its potential to limit their ability to sell certain types of plans. So why are they only allowing their Florida employees to sign up for a high-deductible health insurance plan in 2010? They’re part of a growing trend of employers passing a larger percentage of healthcare costs to the consumer. These plans are tied to a tax-free Health Savings Account, to which the company will contribute a certain sum (individual employees can add more money to the HSA).

On the positive side, HSAs force people to give more thought to their spending; they could cut unnecessary costs, making healthcare reform more affordable. Unfortunately, many consumers aren’t knowledgeable enough to make informed decisions–they could forgo needed treatment to save money, eventually costing them more in both financial and wellness terms. BCBS is trying hybrid HSA health insurance plans, in which they offer either 10% or 20% co-insurance to lower the cost of annual physicals and other preventative care. In addition, the health insurance company covers basic screenings (e.g. colonoscopies, mammograms) that may otherwise be avoided.

HSAs can be very useful to younger people in good health; they often result in lower premiums, since you only pay for the care you need. However, they’re not for everybody. A PPO or an HMO could be a better option for you. While some employers are no longer allowing you to choose, there are still options on the open market. You should always talk to an insurance agent to see what’s best for you.

Last year, a representative from Texas was the true Republican maverick in the presidential race. Ron Paul may not have won the nomination, but he is still bringing his unique libertarian perspective to Congress’ table. His proposals for healthcare reform are no different. He recognizes that the current health insurance situation is untenable, but is against governmental involvement. Recently, he presented several intriguing bills to the House of Representatives.

1. The Comprehensive Health Care Reform Act of 2009 would give Americans a 100% tax credit on their health care costs (e.g. prescriptions, hospital stays, doctor visits). Health Savings Accounts (HSAs) with high-deductible health insurance plans would also be tax-free. Low-wage employees who don’t file tax returns can have the credit refunded against their payroll taxes, so the bill would help those who need it most afford healthcare. Currently, only medical expenses that reach over 7.5% of an individual’s income can be deducted.
2. Dr. Paul’s Coercion Is Not Health Care Act of 2009 would forbid the government from enacting a health insurance mandate. There has been some speculation as to the legality of such a mandate. Congressional Democrats, along with the Obama administration, believe that it has to be part of healthcare reform legislation. Their view is that universal coverage must include the young and healthy in order for the insurance pool to afford covering those with pre-existing conditions. This interference in the free market is anathema to Paul. Incidentally, if there is no public option, such a mandate might not be necessary.
3. Finally, his Freedom From Unnecessary Litigation Act of 2009 would save money through indirect tort reform. This act would establish so-called “negative outcomes insurance”, which would pay off if a patient’s medical treatment goes wrong; it would also offer a tax credit to make the purchase more affordable. The goal is to decrease some of the unnecessary (and costly) testing done in order to avoid malpractice liability, as well as lessen the need for hospitals and physicians to carry billions of dollars in insurance.

As Paul is himself a doctor, his views on the healthcare industry are worth listening to. His opinions tend to be shortchanged in the House because he doesn’t walk in lockstep with either party’s platform, giving his bills little chance of passing.  However, many Americans–who fear socialized medicine, yet acknowledge that we need more affordable health insurance as soon as possible–could find something to applaud in his plans.

Catastrophic health insurance plans—more formally known as High Deductible Health Plans (HDHPs)—were created as a way to lower overall medical costs by providing a lower monthly premium in exchange for a higher annual health insurance deductible. With catastrophic health insurance plans, you pay for almost all medical care until you reach the annual deductible amount. After that, traditional health insurance coverage begins.

Where to Get Catastrophic Health Insurance

High deductible health insurance can usually be purchased either as an individual plan or as a group plan. Certain pre-existing conditions, such as diabetes and mental health disorders, might mean you can’t qualify for an individual catastrophic health plan without prior qualifying group coverage, or at least that you can’t get coverage for those pre-existing conditions. Group catastrophic health plans are subject to HIPAA regulations, meaning you can’t be denied enrollment or coverage, but may have to wait for coverage of pre-existing conditions, depending on your prior health insurance coverage.

What Do High Deductible Health Plans Cover?

The type of coverage varies based on which high deductible health insurance plan you choose. Always read and understand the full policy and what it covers when comparing health insurance plans. Ask your agent or company to explain anything that seems unclear, and make sure you will get or can add coverage for medical conditions you might develop. In the past, catastrophic health plans did not cover things like routine care and prescriptions. Today, however, many high deductible health plans offer coverage for routine and non-catastrophic care. However, as a general rule, the more a plan covers, the higher the premium will be. Agreeing to pay more out of your own pocket shifts some of the risk away from the health insurance company on to you, resulting in a lower monthly premium.

Should You Get a High Deductible Health Plan?

If you’re sure you can cover the deductible and want to save money on the monthly premiums, a high deductible health plan may make sense. If you qualify for an HSA or other tax-exempt medical savings account and can contribute the deductible amount, you may have an easy way to pay your out-of-pocket medical costs while saving on premiums. Most people who consider catastrophic health insurance either are getting their own health insurance for the first time or are nearing retirement. The younger group tends to be less likely to incur medical expenses because they are young and healthy, while the older group tends to have enough money to pay for most medical care unless they experience a serious illness or emergency. Typically, high deductible health plans provide the most benefit to those who don’t require frequent prescriptions or office visits.