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80% of Americans are Paying Twice for Their Healthcare. This Houston Physician Has a Better Way…Learn More About High Deductible Health Insurance Alternatives.

Before we dive into some high deductible health plan alternatives, let’s first imagine you’re planning a nice, relaxing, tropical vacation. You’ve picked the island, you’ve chosen the resort, now it’s time to pick your package.

So what do you choose?

  • All inclusive?
  • Or pay as you go?

While you might be leaning towards that all inclusive (did you see the size of those pina coladas?) – the truth is, there’s only so much you can eat and drink.

If you tallied up the cost, 9 times out of 10, the all-inclusive isn’t the most cost effective option by a long shot. The same is true for health insurance.

In today’s world of the healthcare exchange, high deductibles, and the individual mandate, a LOT of us are paying for “full coverage” insurance that is anything but.

The truth is that only about 20% of Americans ever hit their insurance deductible in a given year.
That means most people are paying for their healthcare twice.

First in the form of bloated insurance premiums they’re unlikely to benefit from. And then again, when they head into their Doctor’s office, and pay out of pocket because their deductible isn’t met.

A lot of families make this mistake, thinking between everyone, they’ll have no problem hitting that deductible. Even still – only about 20% of them do.

In reality, the idea that you’ll pay less by choosing a high deductible plan is just that…ˆa nice idea. That’s why more and more people are looking for high deductible health insurance alternatives.

In essence, today’s “full coverage” health insurance plans are like our all-inclusive vacations. (Except way less fun)

We’re paying for all the “bells and whistles” without getting the benefits.

 

The irony in the whole thing is this: 80-90% of the average family’s healthcare costs are routine and predictable. They’re things like:

E

The bumps, bruises, and sprains at soccer practice

E

The blood pressure screenings and wellness check

E

The colds & flus at back to school time

And even worse than that all-inclusive resort package… You’re not only over-paying for them once (to have them included as “covered” in your insurance plan)…

You’re stuck over-paying for them again when you go to the doctor and have to pay out of pocket because you haven’t hit your deductible.

(Don’t tell the cruise lines *that* little trick!)

The good news is that there’s a MUCH better way to get coverage… And some savvy Houston families are already benefiting.

 

Healthcare is one of those topics where people often feel stuck between a rock and hard place.

Over the past 8 years, health insurance costs have risen at an unprecedented rate. In 2017, the average premium on a family health insurance plan was $1,021… with an $8,352 deductible.

(Individuals saw an average premium of $393 with a $4,328 deductible… no wonder no one is meeting them!)

 

For most people the options seem to be either:

A. “Take it on the chin” and accept the rising costs and shrinking coverage, or…
B. Forgo insurance all together.

While it might seem like those are the only options, there’s a third choice that is giving savvy patients in Houston and across the U.S. better coverage for less.

They can essentially “build their own” healthcare plan to get better coverage than many employer-sponsored health benefits for a fraction of what they’re paying now.

It’s what I’m encouraging most of my patients to do these days.

In order to build your own plan, there are two types of coverage you need to replace (and out-perform) your current health plan:

Catastrophic coverage

This coverage is for the infrequent but disastrous health events that insurance was created to handle. It’s fear of losing this type of coverage that keeps most people feeling tied to an insurance company.

Fortunately, a great alternative to traditional health insurance is a health cost-sharing plan. For most people, just like with your health insurance, you’ll rarely use these plans.

But unlike your health insurance, the cost of a family plan is normally in the $400/month range with a deductible (“unshared portion”) around $1,500. Essentially – 2008 insurance prices with better customer service.  

These health sharing plans meet the Affordable Care Act Individual Mandate requirements (although 2018 is the last year that the mandate will be in effect).

Everyday coverage (the 80-90% of healthcare needs)

This coverage is for the sick days, flus, aches, pains, sprains, and general health management and questions that come up throughout the course of everyday living. While these events aren’t normally top-of-mind when people are choosing a health plan, they should be. These are the issues that account for 80-90% of the average family’s doctor/urgent care visits (and out of pocket expenses…).

Many families across the country are switching to Direct Primary Care – concierge-like healthcare practices, where most routine healthcare is included in a low monthly cost. (My practice, First Primary Care, is one of them here in Houston)

While health sharing is fairly similar to insurance, direct primary care is unlike anything most patients have ever experienced. That’s because direct primary care practices are setup to give their patients unlimited access to their physician.

At First Primary Care, for example, we handle most appointments virtually via phone or video chat, have our patients text us directly with questions, and have completely eliminated wait times when it is necessary to come into the office. For most individuals and families, direct primary care completely replaces the piecemeal pediatrician, primary care physician, and urgent care trifecta that many patients are used to.

Instead, they have ONE physician and practice that supports the entire family, offering a modern approach to doctor-patient communication, low-cost prescriptions, personalized care, collaboration and coordination to improve outcomes with specialists – and virtually eliminating additional out of pocket expenses.

Most individuals can find a direct primary care plan for under $100/month and family memberships tend to average about $250/month.

Direct Primary Care plans can also be used to fill the gaps in traditional high-deductible insurance plans, limiting most out of pocket expenses to the monthly membership fee and reserving insurance for catastrophic emergencies.

The moral of the story

While that all-inclusive may be tempting, there are often much better options to be had when you build your own plan. In healthcare, that means better service, better care, and a healthier family.

Without breaking the bank.

About Dr. Goyal

Dr. Geetinder Goyal is the Founder and CEO of First Primary Care. After studying medicine for over a decade, he realized that our healthcare system really only takes care of the sick and no one is looking out for a patient’s overall health and well being. He started First Primary Care to turn the system upside down and provide patients with genuine “healthcare” and not just “sick care”.

In addition to his work at First Primary Care, Dr. Goyal serves as the Co-President of the Houston Chapter of the Free Market Medical Association.

Dr. Goyal is an avid runner and major Houston sports fan. When he is not caring for his patients, he can be found enjoying family time with his wife, Dr. Le Vo, and their two young daughters.

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