A High Deductible Health Plan (HDHP) is a health plan offering that combines a Health Savings Account (HSA) with the uniform benefits offered by the State of Wisconsin Group Health Insurance Program. An HDHP paired with an HSA gives you greater flexibility and discretion over how you use your health care dollars.
HDHPs have higher annual deductibles and out-of-pocket maximum limits than other traditional health plan offerings. With an HDHP, the annual deductible must be met before the health plan pays for services other than in-network preventive care services (as mandated by federal law). Preventive services are covered 100% before the deductible is met. In exchange for the increased cost sharing this plan offers a lower monthly premium cost.
Plan Design Options
There are two different HDHP plan options available to you:
- High Deductible Health Plan
- Provides local coverage and limited out-of-network coverage (emergency and urgent care only)
- Access High Deductible Health Plan
- Provides nationwide coverage and out-of-network coverage
If you enroll in one of these plan options, you must enroll in the state-offered HSA program. Many members contribute the money they save on their health insurance premiums to their HSA. If you are eligible, your employer may contribute up to $750 individual/$1,500 family.
Annual Deductible
For more detailed benefit information, see the In-Network Health Services page.
|
In-Network Deductible Single / Family Coverage |
Out-of-Network Deductible1 Single / Family Coverage |
|
|---|---|---|
|
2024 |
$1,600 / $3,200 | $2,000 / $4,000 |
|
2023 |
$1,500 / $3,000 | $2,000 / $4,000 |
1Out-of-network deductible only applies to the Access HDHP.
HDHP Eligibility
A few eligibility requirements include:
You must be covered by a High Deductible Health Plan (HDHP) and enrolled in the Health Savings Account (HSA) offered by ETF.
You cannot have any other health coverage that pays for out-of-pocket health care expenses before you meet your plan deductible (including Medicare).
How an HDHP Works
High Deductible Health Plans (HDHPs) usually have lower monthly premiums than plans with lower deductibles. By using the untaxed funds in your Health Savings Account (HSA) to pay for expenses before you reach your deductible, you reduce your overall healthcare costs.
There are three types of expenses associated with an HDHP: deductible, coinsurance, and out-of-pocket limit. These may work differently than you expect if you haven't had an HDHP before.