Preparing patients for the deductible reset

Over the past five years, the number of Americans under the age of 65 enrolled in a high deductible healthcare plan has increased more than 40 percent.

And this year, the average annual deductible for single coverage was $1,573, up more than 70 percent from the 2010 average of $917. Yet, many Americans are not prepared to pay for these expenses – a problem that is further exacerbated when deductibles reset at the beginning of each year.

Especially for patients enrolled in high deductible healthcare plans, deductible resets often lead to a variety of questions and challenges. These can include changes in insurance coverage, adjustments to monthly premiums, co-pays, co-insurance and annual deductibles, and, ultimately, an increase in out-of-pocket costs.

During this period of increased confusion, it is important for providers and their staff to serve as a resource for patients so they know what to expect and can plan ahead. Here are a few ways you can help your patients be prepared:

• Be proactive about initiating conversations about healthcare costs and making patients feel comfortable during what can often be a difficult discussion. Providers and practice staff should be properly trained to discuss financial issues, offer solutions and make sure patients are clear on the billing process/what is expected of them from a financial standpoint, both during and after their visit.
• If a patient’s treatment plan requires multiple visits/procedures, talk him or her through the full treatment plan and the ideal timing for scheduling each piece. Clearly communicate what the patient’s financial responsibility will look like, and, whenever possible, provide a cost estimate to help prevent “sticker shock.”
• Offer patients several ways to pay. One option is a healthcare credit card, such as CareCredit—it’s easy for patients to enroll and allows them to pay over time for deductibles, copays, co-insurance and other out-of-pocket healthcare costs. Patients can pay at the time of service, or pay their post-care balances online using CareCredit’s Pay My Provider portal.
• Create an educational resource to have on-hand for patients who are less familiar with healthcare vernacular. This should include information on how to read a bill and the differences between deductibles, co-pays and co-insurance. It should also note the importance of Explanation of Benefits documents, which will help patients track how close they are to meeting their deductible or reaching their out-of-pocket maximum as the year continues.
• Update your website and other patient communication tools to showcase patients’ payment options. If your practice offers a healthcare credit card like CareCredit, patients can apply prior to their appointment as part of pre-registration. This will help them understand payment options in advance and allow your office to view their available credit limit, which can also help when planning payment discussions.

While the healthcare industry can sometimes be unpredictable, one important constant is the January 1 deductible reset—and the financial challenges that often follow. By serving as a helpful educational resource, your practice can help patients navigate these challenges and be better prepared to move forward with the care they want or need, regardless of the time of year or the type of healthcare plan they choose.


Tim Donovan is senior vice president and chief marketing officer for CareCredit. CareCredit, a Synchrony solution, is a health, wellness and personal care credit card dedicated to helping people get the care they want and need. For more than 30 years, CareCredit has helped millions of people by offering special financing options with convenient monthly payments. CareCredit is accepted at more than 210,000 locations for a wide variety of health and wellness procedures, treatments, products and services.

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