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Affordable Self-Directed Health Plans
Self-directed plans are a new choice for consumers that became available in 2002. They give patients some further freedom and flexibility in choosing their doctors and medical services and are especially useful for those without chronic conditions, who want preventive care at minimal costs.
Self-directed plans bypass some of the roadblocks that patients experience in managed care plans. In many HMO or PPO plans for example, administrators control the package of benefits that are offered. This menu of services defines which doctors the patients are allowed to see and what types of preventive care they can have. However, in self-directed plans, these limitations are lifted.
How Self-Directed Health Plans Work
Self-directed plans work much differently. Patients pay a comparatively low monthly premium. Then, the insurance plan creates a health care savings account for the patient or family with a pre-determined amount of money that is set aside for preventive care costs. The account is replenished after a period of time (for example, $250 every 3 months for individuals and $500 for families). One of the benefits of this method is that costs roll over from period to period and year to year.
Preventive care visits don’t require a co-payment and aren’t subject to a deductible either. These costs come directly from the savings account, so patients can choose how to spend them. Some preventive costs covered may include the following:
- Consultations and routine physical exams
- Diagnostic screening and lab tests such as mammograms, X-rays, and more
- Pre-natal and post-natal care
- Immunizations
- Home visits
- Some may also cover prescriptions
These plans also include a provider network that offers more affordable services. Patients don’t need a referral to see a specialist, and they can go outside the provider network, but extra co-payments will apply.
Non-preventive Care with a SDHP
Any non-preventive care is managed differently – patients must pay co-payments for services and there may be high deductibles for non-preventive visits. Unlike the savings account funds, the deductible doesn’t roll over, so the amount must be met yearly before coverage kicks in.
Self-directed plans are not very suitable for those with chronic care needs, because those costs will be subject to the plan’s co-payments and deductible. These types of costs might include the following: doctor’s follow-up visits, medical supplies and equipment, hospital care, and emergency care.
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Affordable-Health-Insurance.com is an informational resource only and not an insurer or broker. The information on this site is provided for research purposes only, and is not necessarily affiliated with any specific carrier. We are not necessarily associated with any provider profiled on our site, and make no guarantees about the carrier affiliation of any broker that contacts you. Coverage options and policies may not be available in every state, and no guarantees of the same are made herein.
