Study: Consumer-Driven Health Plans on the Horizon


 Study: Consumer-Driven Health Plans on the Horizon

If you've ever been in a health insurance debacle, then you probably know the frustration of having to pay for all your bills yourself. It would be nice if there was an alternative way, but with most plans, it's just not possible. Thanks to Obama Care and provisions for consumer-driven health care plans that are on the horizon of becoming a reality, that may soon change.

The Affordable Care Act was enacted by the federal government in 2010 and created these new types of healthcare plans as another type of option for patients to consider while making decisions about their coverage. The plan will be available to small businesses with fewer than 50 employees and individuals who may want a level of coverage that's more in their own hands.

The idea is that the consumer pays for more of the direct costs associated with healthcare, such as office visits or prescription needs. The medical industry hates the program because it puts them at risk for losing money on each transaction. However, many analysts are forecasting that this new type of health coverage is expected to become increasingly popular over time. And if predictions for its growth are accurate, then by 2019 these new plans could potentially cover three million Americans.

Under ACA, insurance companies have to sell all types of plans during open enrollment periods beginning in October 2013 and lasting until March 2014. After that, they'll continue selling high-deductible plans but only as long as individuals or employers want to purchase them.

Consumer-driven plans are similar to high deductible health plans (HDHPs) because in both cases the patient has to pay a lot of money out of their own pocket before the insurance kicks in. HDHPs are still popular since most Americans don't have any other option. Consumer-driven health care plans should gain popularity for two reasons:

1. They offer a better value and lower costs.

This is true because patients have incentives to keep their medical bills low on account of the high deductibles that they're required to pay if they incur treatment expenses out-of-pocket. The idea is that if the patient has more of a stake in managing costs, then they'll try to avoid unnecessary expenses.

2. They offer more flexibility in how patients pay for their healthcare.

Another reason for the popularity of consumer-driven plans is that they're often paired with health savings accounts (HSAs). These accounts are funded fully by the employer, and the money can be used to cover any portion of major medical costs that aren't covered by the insurance company's payments. The accounts also allow patients to build up an emergency fund for future treatments.

Some experts also claim that because consumers will have financial incentives to cut down on unnecessary healthcare services, then it should save money for everyone else as well. However, the consumer-driven plans that will be available through ACA will likely offer limited coverage. So you won't be able to rely on it as your only form of protection. It's still waiting for approval from the Obama administration, and if they give it the green light, then Obama Care will likely start offering it in 2014.


Published with permission from RISMedia. The above article was originally published at and is republished here with permission from RISMedia. Author:

Date: 20 Feb 2013 13:00 UTC


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Frequently Asked Questions About Consumer-Driven Health Plans

-------------------------------------------------------------------------------- What is the purpose of a consumer-driven health care plan? Consumers are afforded more power when they're in control of purchasing their own health insurance. These plans are available near the end of 2013, and will be marketed as part of Obama Care. Why is this type of plan becoming more popular? This type of plan will become increasingly popular because it offers better service to consumers. Additionally, this change will provide some flexibility for patients in terms of managing their healthcare bills, while also offering more affordability to small businesses on the individual marketplace. In other words, the plan will be less costly, but it's also a lot more flexible. Who will be eligible to purchase consumer-driven health care plans? These plans aren't going to be available for everyone. They're designed with certain consumers in mind: qualified individuals and small businesses who don't have access to employer-sponsored coverage will purchase these plans through ACA's marketplace. That's because they're mainly designed for healthy people who are younger than age 40 without any major pre-existing conditions. How long have these types of consumer-driven health care plans been around? These types of plans have been around since the 1990s. However, most of them have a high deductible and only a limited range of benefits.


President Obama's Affordable Care Act will bring many changes to the healthcare system, and they'll affect a wide array of individuals. However, not everyone is going to be affected by the same initiatives. That's because certain groups of people will have access to different programs depending on their annual income and their employment status.

One of the biggest changes that Obama Care will introduce into the market is a whole new category of insurance known as consumer-driven health care plans. It will replace HMOs, PPOs, and other types of plans in order to cater to younger workers who don't have employer-sponsored coverage.

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