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Choosing Between a High Deductible Health Plan (HDHP) and a Non-HDHP

Posted 9:22 a.m. Thursday, Oct. 10, 2024

ABE 2024

The Annual Benefits Enrollment (ABE) period is September 30-October 25, 2024. ABE gives you the opportunity to enroll in or make changes to most benefits for coverage effective January 1, 2025. It is important to select the health insurance plan design and carrier that best fits your needs.

To help you prepare for ABE, the following information highlights the similarities and differences of the High-Deductible Health Plan (HDHP) and Non-HDHP.

Similarities between the HDHP and Non-HDHP

  • In-network preventive services are covered at 100 percent
  • Federally required preventive drugs are covered at 100 percent
  • Both have a premium (a premium is the amount deducted from your paycheck to pay for your health insurance)
  • Both have a deductible (a deductible is the amount you pay for medical care before your insurance plan starts to pay)
  • In-network coinsurance is 10 percent (coinsurance is the amount you pay after the deductible for specific services)
  • In-network providers will have lower out-of-pocket expenses than out-of-network providers
  • Both allow participation in the Well Wisconsin program to earn a $150 wellness incentive
  • Both allow you to include coverage for preventive dental services
  • Both have an Access plan option which provides nationwide coverage

Differences between the HDHP and Non-HDHP

  • HDHPs have lower premiums but a higher deductible. Non-HDHPs have higher premiums but a lower deductible.
  • HDHPs have an annual deductible that includes medical services and pharmacy benefits. Non-HDHPs have an annual deductible for medical services and do not have a deductible for pharmacy benefits.
  • HDHPs have a combined annual out-of-pocket limit that includes medical services and pharmacy benefits. Non-HDHPs have separate annual out-of-pocket limits for medical services and pharmacy benefits.
  • HDHPs include a tax-deductible Health Savings Account (HSA) to help you prepare for out-of-pocket expenses.
  • HDHPs include an employer contribution to the HSA of up to $828 for individual coverage and $1,650 for family coverage.

For more information, review the State Group Health Insurance web page.


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