Self-Directed Health Plans
The Self-Directed Health Plan (SDHP) provides the user with a high degree of flexibility in the way they manage their healthcare. These plans combine features of Preferred Provider Organization plans and Health Savings Accounts. Under a SDHP, you have the option to choose any healthcare provider you wish; however choosing network providers incurs fewer out-of-pocket costs.
As with a Health Savings Account, the owner of the account has access to a personal account containing funds that can be used for healthcare expenses. However, in the case of the SDHP, it is the insurer and not the owner of the account that deposits the funds—the owner of the plan is not required to make any contributions to the account.
How Self-directed Health Plans Differ from Other Health Insurance
SDHPs differ from other healthcare plans in that they focus on providing preventative healthcare. These plans have low monthly premiums, but include a high deductible. However, they differ from other high-deductible plans in that preventative healthcare can be obtained without the requirement for co-payment or a deductible payment.
Every quarter, the plan provides money (typically around $250 for individuals and $500 for families) that can be used for preventative healthcare, which you can use for any preventative care that is covered under the terms of the plan. Any unused cash rolls over and can be used for future preventative expenses. The typical SDHP covers the following preventative healthcare options:
- Routine physical examinations and regular check-ups
- Pre- and post-natal care for mother and child
- Cervical screening and mammograms for women
- Diagnostic tests
- Vaccinations
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Other Services with Self Directed Health Plans
Other services such as in-patient hospital services and emergency healthcare are not covered by the preventative portion of the plan. Instead, these expenses are covered by the plan after the deductible has been paid. Some plans also include prescription drug coverage.
SDHPs are ideal for families and individuals who do not have high ongoing health costs, and do not typically need much in the way of healthcare beyond routine check-ups and preventative care. The flexibility of SDHPs allows users to pay for only what they need, while ensuring that unused funds carry over from one year to the next, to accumulate for such times where more extensive healthcare is required. These plans are typically not suitable for people with chronic health conditions such as diabetes, however, due to the higher cost of non-preventative healthcare in comparison to other healthcare options such as HMOs.
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