Insurance Math: Part 1
Whoa, 25% increases. That is hurting homes and businesses across America. While there is plenty of blame to go around, there is something that we the people can do to help change the tide . . . Sign up with a DPCP — a Direct Primary Care Physician. At Health Studio KC, in our DPC model, a simple, upfront fee provides you access to a personalized physician who came meet the majority of your health care wants and needs. — without the hassle and fickle changes of insurance.
Health Insurance is useful and important . . . for risk management and, as insurance should, it provides coverage for when bad things happen. So,once a year, you make the confusing and expensive decision to sign up for insurance — but when you need a Doctor, who do you call? If you have some one to call, how quickly can they see you? Oh, and there is that pesky deductible . . . So, how much do you actually pay before health insurance starts paying for care?
We are poor consumers of our insurance -- signing up for all the bells and whistles most of us do not need and are paying dearly for.
Here is the first Insurance Math scenario I would like to run by you:
Scenario 1: I recently looked at the available gold plan options for BCBSKC for healthy 40y/o male and there were two plans with identical $2000 deductibles — the only difference in the plans was the network of providers. One plan was $450/mo and the other was $380/mo.
In the $450/mo PPO plan you are going to pay a total annual premium of $5400 — add the $2000 deductible and you are going to pay $7400 out of your own pocket before insurance starts paying. AND, you still don’t have a Doctor you can call when you need something (so you choose not to see the Doctor until “it is really bad” — another conversation to be had).
What if you took the $380/mo plan — same risk, fewer offices to select from — at an annual premium of $4,560. Now add an annual DPC membership with Health Studio KC, $600. You are now at $5160 out your pocket — a savings of 2,240 annually — AND you have a Doctor your can see/text/call today — a Dr who knows you.
Review: PPO: $450/mo ($5400 annual) + $2000 deductible = $7400 before covering whatever
Dr you find on the plan
non-PPO: $380/mo ($4560 annual) + $600 annual DPC = $5160 and you have Your Dr
Total Savings $2240 + having a Dr you know and trust and can see today . . . Priceless
We have been convinced that insurance is care and have settled for an experience that is miserable and reactive — only going to the Dr when we are out of options, and settling for whatever that visit brings. This is the most expensive way to engage our health and feeds the cycle. We are poor consumers of insurance, and we are too disengaged from the responsibility of our health. Insurance is expensive and going to the Dr is awful — and that is what we sign up for. However, there is another way. We can rewrite this story. Health Studio KC and other DPC clinics are working hard to provide an alternative.