As I begin a presentation on consumer-directed health plans to a roomful of employees, I can usually pick out those with chronic diseases, like cancer, heart disease or diabetes or other chronic conditions. They tend to be the most anxious-looking - wondering how the new plan will affect their ability to manage their conditions.

I'm a veteran of the health benefits business, and I am a diabetic, diagnosed as a child more than 30 years ago. So I have been in their shoes. I often weave my personal experience into my presentations. I also point to studies of CDHP experience that show chronically ill people get the care they need. Here are some insights:

•  Chronically ill members seek preventive care as often or more often than their peers in PPOs.

•  Chronic CDHP members had more lab and radiology services than PPO members, but their hospitalization rates were the same.

•  Prescription costs for all members under CDHPs were 19% to 23% less than in PPO plans, while utilization rates were equivalent.

When my employer switched from a PPO to a CDHP with a health reimbursement account a few years ago, I was concerned about how I was going to pay for my medications and ongoing physician check-ups. Like many of the employees I face in benefits enrollment meetings, I had to learn to look at my health care in a whole new way.

The key, I found, is to focus not just on the deductible when comparing a CDHP to a PPO or other plan, but on the total cost of medical care. When I switched plans, for instance, my deductible increased, but the plan's features enabled me to save some money through lower premiums, an HRA funded by my employer, tax-free contributions to an FSA, full coverage of preventive care outside the deductible, and no copayments for doctor's visits.

CDHPs typically offer people the option to budget for some of their health care costs through accounts - HRAs, FSAs or health savings accounts.

An HRA pays for eligible medical expenses that would otherwise come out of employees' own pockets. Each year my employer provides me with an HRA that I use to help defray the deductible under my health plan's family coverage.

Recognizing that health expenses can ebb and flow, employers may allow account balances to roll over from year to year to cover future costs, an incentive to employees to spend their money wisely.

I also like the flexibility I get with an FSA. FSAs let individuals and families save money on taxes and put aside savings to pay for eligible expenses that they will have to pay for out-of-pocket.

For instance, to monitor and treat my diabetes, I visit my endocrinologist every three months and purchase insulin as well as supplies for my insulin pump. At the beginning of each year, I plan ahead for these costs - which rarely vary from year to year - by calculating what will be covered by my plan and my HRA and then determining how much I should commit to an FSA.

Beyond dollars and cents, the CDHP has encouraged me to become far more engaged in managing my diabetes. Under my PPO plan, with its $20 copayment for doctor's visits, I paid little attention to costs. I was a passive health care consumer - following doctors' orders but not really taking the time to ask questions, discuss alternative treatments or otherwise take more control of my condition.

That has changed. For example, I recently engaged a telephonic health coach - a covered expense under my plan - to help me understand how the many years of taking insulin has affected me.

I also take advantage of my plan's wellness programs and read articles online about diabetes care. Today, when I visit my doctor for my periodic checkup, I usually come in with a long list of questions.

I'm no longer shy, for instance, about asking whether a less costly but just as effective alternative to an MRI is available. In addition, my family has come to realize that, unless there is a medical problem requiring immediate personal attention, a call to the nurse line covered under our plan can often resolve the situation or help us determine if a doctor's visit is necessary.

Benefits consultants and brokers play a key role in educating employers and employees about how CDHPs can benefit the chronically ill. Diabetes and other chronic conditions continue to take a staggering economic toll in the workplace. According to the American Diabetes Association, in 2007 the total annual economic cost of diabetes in medical expenses and lost productivity was estimated to be $174 billion, an increase of nearly one-third since 2002.

Of course, not everyone has a personal story like mine to share. Still, I find that brokers and employers that offer clear examples of how a CDH plan actually works - and make it easy to compare it with other plans - are well equipped to help drive successful adoption, allay concerns and help chronically ill people maintain their health.