My primary care physician is leaving her current practice and starting a direct care practice. No insurance involved, just a monthly "subscription" (my term, not hers)fee for all the doctor's office access I need. This is new to me, but she says it more popular in the south and on the west coast.Could this save me any significant amount on my PPO Plus insurance? I'll be Medicare age next year anyway, but my wife won't. Any experience with this from the hive?
Go look at your EOBs & insurance info for the past few years. How many visits did you make to that doctor or to equivalent primary care doctors? What did the insurance company actually pay her office for those visits, and how does that total compare to the subscription fee?
Consider that a PPO covers a lot more than office visits with your PCP. AFAIK you can't really buy insurance that covers everything except PCP visits, so if you want to be covered for prescription drugs, specialists, ER visits, surgeries, etc then you'll be paying twice for the PCP coverage.
If you're generally healthy and only taking drugs for which generics are available, then maybe a high deductible plan combined with that subscription might be cheaper. This is what spreadsheets are for. :)
Doctors have so much trouble getting paid by insurance that they are trying this to avoid them. Usually gives you a deeply reduced cost, reflecting what ins. reimbursement would cover. I would think Doc Hess might chime in on this.
Also called "Concierge Medical". You pay an up front fee and then can see the doctor, the real doctor, not the PA that thinks he is a doctor or the NP that thinks she is a doctor. The real doctor, anytime you want. Sometimes they even give you their personal cell phone number.
Note that thanks to Obamacare, you still must have an official medical insurance policy, approved by the feds, or you will have to pay a penalty, sorry, a "tax." So look into that before you decide.
Man, we should dig up the old posts by skappes it over from '08 and '12. What a riot it would be to read those today.
In reply to codrus:
Oh, I understand my insurance covers a whole lot of other stuff, I've had bypass surgery and saw those bills. I just wondered if anyone had firsthand experience with seeing their insurance costs reduced.The monthly fee for the service would probably cost my wife and I about $120, but my insurance bill is almost $1100, so a 10% reduction would be break even. I can't think of a good reason for it to drop significantly because the big costs to the insurance company are the catastrophic things, like bypass surgery.I just wondered if anyone had actually made the switch and had seen a drop in premiums.
This sounds like it might make sense for those who can't afford Cadillac plans like mine and currently live with a high out-of-pocket expense.
In reply to Dr. Hess :
I wouldn't even consider being without insurance for all the out of office coverage, just wondered if this might have merit as a way to reduce my annual medical expenses which are typically $15-18K .
In reply to cwh:
My PCP claims that dealing with the insurance companies is a huge cost to her and the other physicians. That's why she's making the switch. She said they'll have an in-house pharmacy which would significantly reduce the drug co-pay and they've got negotiated costs for outside tests that are much cheaper than the current system provides.
I didn't realize this kind of medical service even existed as an alternative.
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