Tuesday, April 19, 2016
How I'm Getting GREAT Health Care WITHOUT Traditional Insurance
When "affordable" healthcare went into play a couple years ago, our family of 6 quickly found that it was anything but affordable. We really struggled to find the best fit for our family, that didn't cause us to be completely broke. It took a while, but I've found a solution that works really well for our family. While it may not work for every family, I wanted to share what we've found in case it COULD help out another family in our same boat. Here's our story, and what we're doing now...
My husband has always had fabulous health care coverage at his work. But to get me and our four children added to the same plan, we were looking at over $1000. Not affordable. So we started looking around. We found some plans elsewhere for me and the kids for $750 (still not affordable). We finally tried the health exchange. We were looking, at the very minimum, at $350 for JUST me, not even the children (the minimum plan for us all was in the $700 range). We didn't qualify for any government subsidies. Now, $350 is not horrid, BUT the deductible was outrageously high (I remember thinking that I didn't even know they made deductibles that high). I'd still have to add all 4 children, AND would have co pays in office AND a huge deductible should anything catastrophic occur. So, we did the only sane and financially wise thing we could do in the situation, and took the medicaid/NV check-up that they offered our children (I hadn't even known we qualified prior to this). That is virtually free (only a small quarterly fee for NV check-up). But this still left me personally without many great options.
After lots of research, I feel that I have found the absolutely BEST solution for my healthcare needs, and I have the very BEST care I could ever have imagined. Better, even! To boot, I essentially have a deductible of $300, qualify for the Obamacare requirements (i.e. no penalty), have access to my doctor 24/7, and no co pays all year. For less than the cost of the awful, crappy, no good, very bad insurance I was offered through the health exchange, I have amazing care.
I've combined two resources to accomplish all of this.
#1. Health Care Sharing Ministry-Samaritan. While there are quite a few reputable companies out there, we settled on Samaritan Ministries as I had some personal friends who had been quite satisfied with their service. Health care cost sharing is simple...everyone pays a certain amount every month, but instead of paying a company, we pay directly to a person who needs it for medical expenses. If I need to go to the hospital, I cash pay and try to get my cost down as low as possible. Then I submit the claim to Samaritan. As long as it's a qualifying expense over $300, I will be reimbursed by other members for all but $300 of it. Some things, including pre-existing conditions, can be denied, but hey-insurance companies deny things too anyway.
Samaritan boasts more than 50,000 participating households, with about $15 million available each month to meet health care needs. Each month I receive a letter telling me who needs it and why (nothing too personal, just a quick "they had surgery on their knee" type note). I send my check directly to that person.
For just myself, my monthly share is $180. For an entire family of 3 or more people, the cost does not exceed $405.
Samaritan cost sharing ministry DOES QUALIFY for the Affordable Health Care Act laws mandating that everyone have insurance. There is an easy exemption form available right on their website for tax purposes.
I have had no big needs, and I hope not to have any, but at least I know that if I do, I will have coverage, with essentially, a very low deductible.
While Samaritan is the one I settled on, there are others out there. Be sure to do some research first to see if a cost-sharing ministry is right for you.
#2. Concierge Physician. Okay, this is THE coolest thing ever. Think old-school style doctoring, in a modern day approach. My doctor is available by email, Facebook, text, and phone. I have access to him 24/7, helping me avoid the need for those awful urgent care visits where you're just not sure if you should be seen or not. When my results came back from a test, he texted me my results right away (via a HIPPA approved texting app).
My first appointment was one and a half hours long. Just me and him. There is no office staff to deal with, which is VERY convenient and saves time, too. We talked about my health history, my family history, my personal life, etc. I felt as though my doctor wanted to know ME, not just see me for 5 minutes, write me a prescription and send me a bill. Then I had a full exam. Heart health, EKG, joints, full skin cancer check, full gynecological exam, eyes, ears, throat, etc. Everything all in one convenient and relaxed appointment.
I love that my doctor has joined the 21st century and uses technology, making it easy to get in touch with him. Should I need to be seen, I can typically be seen same day (or even just chat on the phone if that is sufficient).
My yearly fee (which I'm able to break into monthly payments), covers any check-ups that I need with him all year long. I do have to pay for any external stuff, like if he needed to refer me to a specialist or for blood work, but other than that, I don't have to pay any co pays or other fees in office. I have no risk of losing my doctor due to insurance changes, and he has a cap on how many patients he sees (he only takes on a fraction of patients compared to that of a typical/traditional doctor).
The yearly fee is really quite reasonable. And between this and my Samaritan coverage, I am STILL LESS per month than the crappy health exchange insurance. I can save the extra per month for any out of pocket expenses that may pop up!
Since these doctors are becoming more and more common, you should be able to find one where you live. If you happen to be a local follower of mine in the Reno area, and you're interested in talking with my doctor to see if he's a good fit for you, please contact Dr. Brown directly and he'd be more than happy to chat with you!
Even though my husband has great insurance through work, he will also be starting with Dr. Brown (hopefully sooner rather than later).
While these options may certainly not work for everyone, for me, it is the perfect blend. I've got great coverage, a very low deductible, an AMAZING doctor, and a reasonable financial expense each month. If you are looking for more options for your healthcare, be sure to think out of the box, do your research, and find something perfect for your family. Questions? I'm happy to answer whatever I can from our personal experience! Just leave me a note in the comments below!