Physicians Health Plan 
High Deductible Health Plans

Physicians Health Plan (PHP) recently created a number of High Deductible Health Plans (HDHPs). These plans assist employer groups that qualify for establishing a Health Savings Account (HSA) for their employees.

Benefit guidelines for these HDHPs are different than our traditional benefit plan designs because the guidelines are determined by the Internal Revenue Service (IRS). To help you understand how benefit coverage is applied for those PHP members who are covered by one of our HDHPs, we have summarized the basic coverage highlights below.

The Basics of High Deductible Health Plans

 

• HDHPs have higher annual deductibles and out-of-pocket limits than most traditional plans.
   
• With the exception of preventive care, the annual deductible must be met before any medical and/or prescription plan benefits are covered.
   
• Preventive care services are excluded from the annual deductible and receive first dollar coverage. (Click here for a list of Preventive Health Service Codes that are not subject to the annual deductible for PHP High Deductible Health Plans.)
   
• Once the annual deductible is met, a coinsurance may apply to physician office visits and other health care services.
   
• Except for prescription drugs, these plan designs do not include any flat dollar co-payments.
   
• The single annual deductible amount applies only when a single individual has coverage.
   
• The family annual deductible amount must be satisfied before any member in a family receives covered benefits.
  

  PHP will continue to keep you informed of new PHP healthcare benefit designs. For more information about our HDHP products, call your Provider Relations Coordinator at 517.364.8312.