What type of health plan is considered an HDHP?
A health plan is an HDHP if the plan satisfies the following
annual deductible and out-of-pocket expense requirements for self-only or
family coverage.
Self-only coverage: Annual deductible of
at least $1,350 for 2019 and $1,400 for 2020, and an out-of-pocket expense
(deductibles, co-payments, and other amounts, but not premiums) cap of $6,750
for 2019 and $6,900 for 2020.
Family coverage: Annual deductible of at least
$2,700 for 2019 and $2,800 for 2020, and an out-of-pocket expense (deductibles,
co-payments, and other amounts, but not premiums) cap of $13,500 for 2019 and
$13,800 for 2020.
Family coverage with individual deductibles:In cases where family
coverage has individual deductibles, the plan is considered an HDHP if no
amounts are payable from the health plan until the family has incurred covered
medical expenses in excess of the minimum annual deductible ($2,700 for 2019
and $2,800 for 2020), and the plan has an out-of-pocket expense cap of $13,500
for 2019 and $13,800 for 2020.
NOTE: These amounts may be increased for annual cost-of-living adjustments.
EXAMPLE: Which plan is considered an HDHP?
Plan A:Steve Johnson
purchases health insurance for himself and his family for 2020. His plan has a
$5,000 family deductible with a $1,000 individual deductible.
Plan B:Steve Johnson
purchases health insurance for himself and his family for 2020. His plan has a
$5,000 family deductible with a $2,800 individual deductible.
Answer: : Plan A provides payment of covered medical
expenses for any member of Steve’s family if the member has incurred covered medical
expenses during the year in excess of $1,000, even if the family has not
incurred covered medical expenses in excess of $2,800. Thus, benefits are
potentially available under the plan even if the family’s covered medical
expenses do not exceed $2,800. Because Plan A provides family coverage with an
annual deductible of less than $2,800, the plan is not an HDHP.
Plan B satisfies the requirements for an HDHP because
the plan only provides payment for covered medical expenses if any member of
Steve’s family incurs covered medical expenses during the year in excess of
$2,800.