Certified Application Counselor Practice Test

Which health plan is generally not recommended for individuals with chronic health conditions?

1. HMO

2. PPO

3. HDHP

4. EPO

The correct answer is: HDHP

High Deductible Health Plans (HDHPs) are generally not recommended for individuals with chronic health conditions primarily due to their cost structure and financial implications. HDHPs typically have higher deductibles, meaning that individuals are responsible for paying a larger amount out-of-pocket before their insurance coverage starts to pay for services. This can create a significant financial burden for those who require regular medical care and ongoing treatments, as they may end up paying substantial amounts before they receive any insurance benefits. Furthermore, individuals with chronic conditions often require frequent doctor visits, prescriptions, and possibly specialized care. In an HDHP, the high out-of-pocket costs can deter these individuals from seeking necessary medical care or adhering to prescribed treatment plans, which can worsen their health outcomes. In contrast, other plan types, like HMOs and PPOs, have structures that may offer more predictable costs and better access to necessary services for managing chronic health conditions. Therefore, for someone with ongoing health issues, a plan that minimizes out-of-pocket costs and offers broader access to care is usually more advisable than a high deductible plan.