IS your medical insurance bad for your health?

If you have a high-deductible plan, the answer may be yes.

Kathleen Stoll, the director of health policy at the advocacy group Families USA, says high-deductible medical insurance has many potential pitfalls.

The investment firm Fidelity recently surveyed employees at various companies who had opted for a high-deductible health plan linked to a health savings account. About half of those workers said they or a family member had chosen not to seek medical care for minor ailments as many as four times in the last year to avoid paying the out-of-pocket expenses.

As any doctor will tell you, small health problems left untreated can become big problems, warns Kathleen Stoll, director of health policy at the health care advocacy group Families USA. ?This is just one of the many high-deductible pitfalls consumers need to watch out for,? Ms. Stoll said.

High-deductible health plans are essentially insurance policies that charge lower monthly premiums than traditional plans because the consumer is responsible for paying the first $1,000 to $5,000 or more in medical bills before the insurance kicks in. The plans, sometimes called catastrophic insurance, are often used in conjunction with a health savings account.

With these accounts, earnings on savings are allowed to accumulate tax free and roll over year to year, as long as the money is ultimately used to pay for medical expenses. To qualify for one of these tax-sheltered savings accounts, an insurance plan must have a deductible of at least $2,300 for families and $1,150 for individuals.

A person can put up to $3,000 annually in these accounts, or $5,950 for a family.

People who can best take advantage of this tax break are those who can afford to contribute the maximum but do not spend it all on health care. The idea is that the money accumulates over the years, providing a cushion down the road when health problems or the need for long-term care arise.

To encourage employees to choose a high-deductible option, many employers put money into employees? accounts or match part of the workers? contributions. High deductibles, though, can pose problems for people who cannot afford the out-of-pocket costs associated with the plans. For a low-income family earning $25,000 a year, for example, the out-of-pocket costs of a high-deductible plan would eat up an estimated 15 percent of the annual household budget, according to a Kaiser Family Foundation report.

What?s more, low-income families don?t benefit from the tax breaks associated with health savings accounts the way middle- and high-income earners do.

Even if you can afford the costs, the loopholes that insurers often weave into these plans to reduce premiums can mean that even after your deductible is met, you may not have the coverage you need to handle a serious illness or accident.

?For most people, a high-deductible plan is basically a bet against yourself,? said Ms. Stoll. ?You?re betting that you won?t get sick and you won?t have an accident. But isn?t that exactly what insurance is supposed to be? A bet that something might happen, and if it does you?ll be protected??

Whether you are considering a high-deductible policy because you are healthy and don?t think you need much coverage or you want the tax-sheltered savings account or you simply cannot afford anything else, you need to carefully consider the following.

WHY IS THE PREMIUM SO LOW? It is not always simply because the deductible is high. There may be other cost-reducing limitations on the plan as well. If the premium looks too good to be true, look for one of these lurking loopholes: