Americans In High-Deductible Plans Are Skipping Out On Preventative Care Because They Don’t Know It’s Free

A new Health Affairs study finds that Americans enrolled in so-called “consumer-driven” or high-deductible health insurance plans are likely to forgo crucial preventative care services because they don’t realize those services are cheap, or even free, with their coverage.

High-deductible plans — which increasing numbers of employers are beginning to offer to their workers — charge enrollees lower monthly premiums, but significantly higher out-of-pocket deductibles. And Kaiser Health News reports, consumers enrolled in those plans often don’t know that certain services — such as regular screenings and checkups — don’t carry the same high out-of-pocket price tag as the other services on their plan, leading them to skip out on that preventative care:

A survey of hundreds of Californians enrolled in health savings accounts, one type of high deductible plan, showed that fewer than one member in five understood that preventive care was free or almost free. A fifth of those surveyed said they had avoided preventive examination or treatment because of cost.

“It’s a reminder that patients usually have a pretty limited understanding of the details of their health insurance plan,” Mary Reed, a Kaiser Permanente scientist and the study’s lead author, said in an interview. ”Even when plans are designed well or thoughtfully, if patients don’t understand they probably won’t behave accordingly.”

The lesson doesn’t apply just to high-deductible plans, she said. The need for member education is rising as all plans “continue to get relatively more complicated,” she added.

High-deductible health plans attempt to lower health spending by shifting costs onto Americans, forcing them to choose between exorbitant out-of-pocket costs and forgoing treatment for many of their medical services. And the fact that such a high number of Americans are choosing the latter, even for their preventative services that would have been covered, exposes the dangerous nature of high-deductible plans — and serves as a stark reminder that Americans don’t necessarily have much in-depth knowledge about what their health care plans or providers’ policies include. For instance, a recent survey found that Americans are still largely uncertain about what Obamacare means for them.

This trend has troubling implications for high-deductible plans. If Americans under those plans continue to skip out on preventative care because they falsely believe they will be charged high out-of-pocket costs, then those insurance pools will simply become sicker and costlier. Fortunately, Obamacare requires employers to distribute materials to their employees to properly educate them about their plans’ benefits and costs — a provision that is now particularly important for the Americans who are skipping care because they’re unsure about what their high-deductible plans will cover for them.