High-Deductible Health Plan (HDHP)
The HDHP gives you the flexibility to spend your health care dollars as you choose.
The High Deductible Health Plan (HDHP) offers RWJBarnabas Health employees and their families the option of a cost-effective plan and the opportunity to set aside money on a pre-tax basis in a Health Savings Account (HSA). Preventive care is covered at 100% in-network with no deductible. Therefore, services such as routine physicals and well-child visits are covered at no cost to you.
If you set up an HSA, it can be used to pay for a portion of health care expenses until the plan’s high deductible is met. Then the HDHP functions much like the Direct Access plan for those services subject to coinsurance (which can also be paid for with an HSA).
It is important to note the following:
- Services performed at RWJBarnabas Health facilities, including Inner Circle providers, are subject to deductible and coinsurance and are not covered at 100%.
- If you cover anyone other than yourself, you are considered to have “family” coverage for purposes of meeting deductibles.
- The full family deductible must be met before the plan pays coinsurance.
- Deductibles apply to the out-of-pocket maximum.
- All beneﬁts, including prescription drugs, are subject to the deductible and coinsurance.
- Deductibles and out-of-pocket maximums run on a Calendar Year (1/1 – 12/31) basis.
- There are two network tiers for the HDHP — in-network and out-of-network. Plan beneﬁts for out-of-network are based on an allowed amount fee schedule, not on provider billed charges, therefore, members using out-of-network providers may have additional out-of-pocket costs.