Every year, I make sure that Direct Primary Care (DPC) makes the most financial sense for your healthcare dollars. It is that time again, open enrollment. This year, more than any other, it is important to have a doctor in your corner. Many choose Direct Osteopathic Primary Care (DOPC) as their DPC provider because of our relationship based, holistic and high quality primary care. With simple math, let me show you how pairing DOPC with a high deductible plan or health share makes the most financial sense too! COVID-19 is hard enough to handle, find a health care solution that is easy.
This year I am amazed…families can save $450-$715 a month by choosing Direct Primary Care partnered with a high deductible plan or a health share!
Check out the graph with rate comparisons from the 2020 Colorado Health Exchange. For a family of four, health care costs can add up. If you choose DOPC PLUS a high deductible plan can save your family of four $450 a month! If you want to get innovative, pair your DOPC membership with Sedera Medical Cost Sharing. With Sedera, an alternative to traditional insurance, your family of four saves $715 a month. That is $8,578 a year worth of savings!
Let’s review: WHY choose Direct Primary Care for you and your family to lower your out of pocket monthly costs?
- With DPC, no co-pay, co-insurance or deductibles apply to care. No charge on in office procedures. You pay $75 a month, that is it. We take care of you. Its simple.
- Cost transparency: no bewildering medical bills. We can tell you how much everything we do or recommend costs.
- Cost effective navigation of medical care: affordable labs, medications, referrals and imaging.
- Accessible options: welcome to having a provider you know and trust; care available when you need it. We have always offered phone and telemedicine visits, especially now during COVID-19.
We know many of our members know why DPC benefits are priceless, especially in 2020 during the COVID-19 pandemic. Having a provider you can call is essential. However, many of our members might not realize they can choose to have even more cost savings by looking at medical cost sharing. This is especially a good option to consider if you are uninsured.
Let’s talk for a moment on medical cost sharing.
The company Sedera has been working great for our clients. Here is the fine print on Sedera:
“MEDICAL COST SHARING (MCS) IS AN INNOVATIVE NON-INSURANCE SOLUTION TO MANAGE LARGE MEDICAL COSTS. OUR MEMBERS COMMIT TO LEADING A HEALTHY LIFESTYLE AND VOLUNTARILY CONTRIBUTING TO ONE ANOTHER’S LARGE AND UNEXPECTED MEDICAL EXPENSES. IN DOING SO, THEY ARE ABLE TO REDUCE ONE ANOTHER’S BURDENS AND BE IN CHARGE OF THEIR OWN HEALTH CARE DECISIONS.”
How does it work?
A health share is great for healthy, active adults and families that are willing to pay cash for health care services and negotiate to find the lowest cost option on their own. Having a community to share your larger medical costs helps when you encounter high cost care (like going to the hospital). You decide when Sedera costs are shareable – after you have paid $500 to $5000 out of pocket as your initial “unshareable” amount. This is not a deductible. Here is what Sedera says: “The Initial Unshareable Amount (IUA) is the amount you pay before your medical Need is eligible for sharing. A Need is defined as one or more medical expenses caused by a single accident or illness.”
What is interesting about this option: when you choose the IUA of $500 you have three health needs annually (5 for a family) before you can submit all of your larger medical expenses to share with Sedera’s cost sharing community at 100%. People will often think of that as a $1500 deductible, which it is not. Here’s why. In a traditional model, you can’t touch a penny of your insurance “coverage” until you have spent the exact $ amount of your deductible. Then insurance “kicks in” but there continue to be co-pays and “co-insurance” a great way of sending sneaky, bewildering medical bills. With a health share, first off YOU are paying the bills and negotiating directly to the lowest cash rate, so you know when costs are coming. When you have a DPC like us, we help you find the lowest rates. We are your cost conscious health care shoppers. We help you find the most affordable referrals, imaging and offer the best rates you could ever find on routine lab testing. Let’s look at an example:
Sally goes skiing and hurts her knee. She ends up at the clinic at the ski resort. They do xrays, and an evaluation, we will estimate this visit at $500. Then, Sally has to see a primary care doctor for her knee a few days later as it is still hurting. We estimate this office visit would be $200 (if she had DOPC, the visit is free with monthly membership of $75). Next, Sally has to have an MRI. Insurance might “discount” this with their negotiated rate to $600-$1000. (With DOPC’s help, we can find you an MRI for $300-$500!) Next, Sally has to see an orthopedic surgeon – yikes! Now the costs are soaring, $300-500 for the office visit and countless more if she needs surgery. Up to now she has paid ~$1300 out of pocket – finally her insurance might start kicking in! If Sally had Sedera and had chosen her initial unshareable amount to be $500 her out of pocket cost would be $500 for this health event and all other charges related to this health event would be shareable with the Sedera community at 100%. Even if she needed surgery, she would only pay the IUA of $500. Also, the shareable costs on the knee extend through the length of that medical concern – so if Sally hurt her knee in December, she does not have to start all over with out of pocket costs the very next month. How cool is that?!
What does that mean for you?
If you change your mindset and realize that healthcare is cheaper with cash, then Direct Osteopathic Primary Care + Sedera is for you. If you want to stay with traditional insurance, choose a high deductible plan. Pair this with Direct Osteopathic Primary Care to keep your out of pocket costs low. Save your insurance for a “collision” with the healthcare industry. For the rest, we are here to help!
Get on the direct primary care bandwagon, it just makes sense.
Our Vision at Direct Osteopathic Primary Care:
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