Health insurance is expensive and continues to get more so every year. Insurers are charging more and more while covering less and less. Physicians who accept health insurance have to rush patients in and out, spending only 15 minutes or so with each, to make any money in their practices. That’s why I’m such a big believer in our direct primary care (DPC) model.
With your direct primary care membership, you pay a monthly fee (usually between $30-$90) that covers all the healthcare services a primary care physician offers – annual checkups, physicals, medication management, and so much more. When you need access to your provider, you get it – and at no additional cost. Office visits and virtual visits (by phone, email, text, or video) are all included in your monthly membership.
Euphora Health also takes it further by providing no-cost electronic consults with specialists, helping coordinate with specialists for face-to-face visits, prescribing and directing you to low-cost prescriptions, and being there to consult during emergencies. We do this because we care about helping you get the best healthcare at the lowest cost.
We believe you should be in control of your healthcare investment, so we provide full transparency into costs. Patients relying only on traditional health insurance usually don’t know costs until they receive their bill, which is often full of obscure line items listed by code. There’s no transparency into what was provided for the listed charges. At Euphora Health, you’ll know the cost of every service before you incur it. In fact, we list prices on our website, which clinics that accept insurance could never do.
Covering What a Direct Primary Care Physician Doesn’t
Direct primary care physicians cover about 90% of healthcare services an individual will need in his or her lifetime. To cover healthcare needs that aren’t provided by a DPC physician, you can turn to high-deductible, low-premium health insurance (major medical) coverage, or a health sharing plan (also known as a medical cost-sharing plan).
Catastrophic Health Insurance
Many patients assume they can’t afford major medical insurance. While it’s true that plans with full coverage can be incredibly expensive, when you have direct primary care membership, you may be able to get by with less-than-full major medical coverage. Health insurers offer more affordable plans with high deductibles and lower premiums that can cover what DPC doesn’t. When you have one of these major medical plans and something catastrophic happens (think tragic accident or a major diagnosis), your out-of-pocket costs are capped after you pay up to the deductible dollar amount. Premiums are consistent and predictable, apart from annual adjustments; but out-of-pocket costs fluctuate as your healthcare needs change.
Today, many small and mid-sized companies have effectively said goodbye to bouncing around from one big insurance company to the other in search of lower rates.
Health Sharing Plan
Many organizations provide what’s called a health sharing plan, or medical cost-sharing plan. Although many have a religious affiliation, some health sharing plans don’t require a statement of faith, only an agreement to live a healthy lifestyle such as not using tobacco products or abuse alcohol and drugs. This type of plan is favored by cost-conscious patients who need more predictability in medical expenses than major medical coverage can provide. The organizations that offer these plans are called health sharing ministries, and they bring a community of members together to pool money to cover medical expenses. Unlike major medical health insurance, health sharing plans work on reimbursement and help members cover unforeseen medical costs.
Saving on Healthcare Costs with DPC Plus Major Medical
In my experience, combining direct primary care membership with one of the options discussed above saves patients on healthcare costs overall. This affordable solution provides all the coverage you need – a major medical catastrophe won’t bankrupt you – at a much lower cost than the health insurance plans in today’s market. Plus, you get a DPC doctor who is a true health partner for day-to-day healthcare concerns.
Some patients, especially those who are younger, opt not to get major medical coverage in addition to their DPC membership because they believe they won’t need it. We recommend all patients carry major medical for catastrophic events – which we all know are out of our control. With DPC, you CAN afford the healthcare you deserve.
If you’d like more information about supplementing your DPC membership, view our major medical coverage resources.
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