Health care plans now come in all shapes and sizes, and are intended to help fit the needs of a wide variety of American families. HMOs, PPOs and self-directed plans all have their proponents, and a new type of plan, the high deductible health plan (HDHP) is now gaining ground. In combination with what is known as a health savings account, a number of Americans are finding their medical expenses easier to manage. While this kind of plan has its share of detractors as well, it is important to understand its essential characteristics before making a judgment either way.

A high deductible health plan is just that - health insurance coverage that requires a large deductible to be paid by a client before any medical expenses will be covered. In order to be a "qualified" HDHP in the United States, these plans must have a minimum annual deductible of $1,200 for an individual and $2,400 for a family, as of 2011. These plans have lower monthly premiums than a standard health care plan because the use of services is correspondingly lower. Individuals on these plans typically do not use them unless absolutely necessary.

In order to give those using HDHPs a viable way to access health services in addition to a standard claim, the Bush administration created health savings accounts in 2003 as part of an act to help modernize the way Medicare works. Any money deposited into an HSA is not subject to federal income tax when deposited, and can be used to pay for any qualified medical expense. Expenses of this type claimed under a health savings account are tax-deductible and money in an HSA will roll over from year to year if it is not used. Deposits can be made by the policy holder, an employer, or any other individual who chooses to add to the account. Recent changes to the way these accounts work no longer allow consumers to buy OTC drugs with them unless accompanied by a prescription from a doctor. In combination, a health savings account and high deductible health plan can provide an effective solution for health care, with emergent or costly events being handled by the HDHP and smaller things like check-ups or medications being paid for out of the health savings account.

While an HDHP is not for every individual or every American family, this kind of plan can offer the security of health insurance but with a far lower premium than typically seen. When combined with an HSA, the benefits of easy access to tax-deductible medical care from the account often outweigh the costs of higher premiums when the insurance plan is used.