Direct Primary Care(DPC) involves cutting out the middle man–insurance companies. As health insurance becomes increasingly confusing, expensive, and frustrating, Direct Primary Care removes it from the equation.
At Direct Medical Care, you have the option of obtaining a membership, which includes the cost of provider visits along with other perks. However, a membership is not required, and you can pay for waht you need as you go.
With this type of healthcare in place you should expect:
To spend more time with your healthcare provider as they are spending less time filling and billing for insurance
Affordable wholesale medications, labs, imaging, and procedures
Transparent pricing
Accessibility and convenience such as same day appointments, virtual visits, and so much more
Flexibility! You still have the option to submit to insurance. We will provide you the necessary information at the end of your visit to do so.
When the pandemic hit in early spring, I commented that you should assume you will get the coronavirus. It is not a matter of if you get the virus, but when you will get it. If you happen to not get it, count yourself lucky.
So what have you been doing the last six months to prepare? I am not talking about wearing a mask. I am not talking about staying six feet apart. I am talking about what have you done to better your health to better prepare your body to fight the coronavirus?
What should you have been doing these past six months to prepare?
Eating Healthy
Achieving/Maintaining a Healthy Weight
Getting Good Sleep
Exercising
Managing Stress
Managing Medical Issues
Building your Immune System–zinc, vitamin C, vitamin D, elderberry
If you have not engaged in your health there is no better time to start–not just for the coronavirus but for life.
My traditional high deductible healthcare insurance plan I carried in 2016 was increasing from $820.00per month to $2100.00 per month with an even higher deductible.
I was looking at an annual premium cost of $25,200.00
Year One(2017)
When we made the transition to the cost sharing program with Liberty HealthShare in 2017 it made sense as long as we were healthy. The cost savings were profound. We opted for their top coverage: Liberty Complete
With the Liberty HealthShare option we chose we have an annual registration fee of $75.00 and pay $449.00/month for our family of four.
I was now looking at an annual “premium” of $5,463.00
Now we had a few medical bills in 2017:
an MRI for my husband’s shoulder $240.00
a screening mammogram for me $200.00
remember I am a family practitioner so some minor coughs/colds etc. would be handled by me that we will account for $500.00
Our general out-of-pocket expenses for the year were around $940.00. Let’s round that number up for a few other incidentals and we are at $1000.00 for the year.
So our first year savings came out to almost $19,000.00
Year Two(2018)
So year two brings on a different twist as we have a medical need arise. Craig’s MRI and poor response to conservative therapy leads to major surgery. We researched our options and chose the Surgery Center of Oklahoma.
Our annual “premium” is still $5,463.00
Craig’s Surgery and Rehabilitation Costs:
Surgical Consultation: $200.00
Surgery Center of Oklahoma: $5,749.00*
Continuous Passive Motion(CPM) Chair: $775.00
Physical Therapy: $540.00
*includes surgeon fee, facility fee, and anesthesia fee
Liberty HealthShare Shared Amounts(reimbursements):
Surgical Consultation: $200
Surgery Center of Oklahoma: $4,249.00
CPM Chair: $0
Physical Therapy: $0
Our final unshared(out-of-pocket) amount we were responsible for was only $2,815.00
So in two years after leaving traditional health insurance we will have saved about $35,000 with a major event occurring
If I still haven’t convinced you…
Now let’s go back to the traditional insurance world…the national average projected cost for arthroscopic shoulder surgery with one of the major insurance carriers in the United States is:
Facility and Anesthesia Fee: $16,150.00*
Surgeon fee: $8,985.00
Total: $25,135.00
*based on outpatient surgery, national average for inpatient surgery increases that fee by $11,000
I had blogged about them and had seriously considered them–cost sharing plans.
I resisted giving up my traditional health insurance because of the beauty of the triple tax savings with the Health Savings Account(HSA) that I married to my high deductible plan. I saw such value in that piece that I lost out on the bigger picture–saving money without sacrificing care.
What changed?
I paid for my daughter’s surgery out of pocket in 2016 when the cost for the negotiated insurance pricing was higher than actually just paying cash.