Help employees handle out-of-pocket health care costs


“…For some people…the Affordable Care Act is becoming the Unaffordable Care Act,” writes Richard Eisenberg, a contributor to In a recent article, Eisenberg explains that while fewer people are now uninsured, more are underinsured. Why? Because employers are increasingly requiring employees to sign up for high-deductible health plans, also known as consumer-driven health plans.

Unfortunately, “employees in high-deductible plans are seeing huge increases in out-of-pocket costs and some are trimming medical care as a result.” Eisenberg cites a Commonwealth Fund report1 that says 44 percent of underinsured adults reported not getting needed medical care in the past year because of the cost. The report also found that 41 percent with deductibles of $3,000 or more reported problems paying their medical bills or were paying off medical debt.

How high-deductible plans work

Consumers who elect HDHPs pay lower premiums but have higher deductibles, which they cover using the money they place in tax-deferred medical savings accounts such as health savings accounts or health reimbursement arrangements.

Employers who offer HDHPs save on health care costs, and by being conscientious about preventive care and medical procedures, employees may save, too. But even savvy consumers who understand what they’re getting into when they enroll in an HDHP may not anticipate or be able to cover the out-of-pocket medical expenses not covered by HDHPs. In 2015, 52 percent of employees reported having less than $1,000 to pay out-of-pocket expenses associated with unexpected serious illnesses or accidents.2

Employees come clean about their HDHP experiences3

While high-deductible plans do work for some, roughly half of workers (52 percent) with HDHPs at least somewhat agree they regret choosing them. Even more bleak: 59 percent at least somewhat agree they were financially detrimental to themselves and/or their families. Both numbers are up from 2014.

Still, many will select a high-deductible plan again, some because it’s the only employer-sponsored insurance option available, some because cost is the driving factor for plan selection. Forty-six percent of employees say the amount of monthly premium or the coinsurance they have to pay for health care services is the most important factor when choosing their major medical insurance each year.3

Help ease employees’ financial burdens

If your company offers or is considering offering an HDHP, find out how you can help employees offset out-of-pocket health care costs.

One tactic to consider is offering voluntary insurance. Policies such as accident and critical illness complement HDHPs because benefits are paid directly to policyholders, allowing them to use the money to help with out-of-pocket expenses such as deductibles, medical procedures and prescriptions, and nonmedical expenses such as rent, child care and other bills that can accumulate when a worker is hurt or sick and can’t work.

1The Problem of Underinsurance and How Rising Deductibles Will Make It Worse: Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2014.” The Commonwealth Fund. Accessed July 27, 2015.

2 2015 Aflac WorkForces Report, conducted by Research Now Jan. 26 – Feb. 11, 2015, among 1,977 benefits decision-makers and 5,337 employees at U.S. companies with at least three employees.

3 2015 Aflac Open Enrollment Survey, conducted by Lightspeed GMI June 23 – July 2, 2015, among 2,000 adults ages 18 and older who are employed full or part time in the US at a company with three or more employees.

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