How to better use your health insurance by Dr. Q

Would you use your car insurance for oil changes or filling up gas? Probably not because oil changes and gas are inexpensive and routine. For every other industry, we know insurance is used for big, rare, expensive events such as car wrecks. But when it comes to health care, we treat health insurance not like insurance, but rather a credit card. Using health insurance like most people do nowadays is like drinking soup with a shovel. There is a way to receive better care and potentially spend less doing so.

Understanding the parts of an insurance plan can help understand its role. Here is an honest explanation of what the parts are

Copay: A fee to deter you from going to the doctor. This price has nothing to do with the value or price of the actual service. It is a purely made-up number by the insurance company to act as a barrier to care.

Deductible: The way insurance companies make you pay for their services while providing you with a bad product. For example, a $200/month plan with an $8,000 deductible means you have to spend $10,400 in the year ($2,400 + $8,000) before the insurance product does anything for you. If you don’t spend more than the deductible, the insurance company still pockets $2,400 from you and has provided you nothing. In the last decade, deductibles have risen sharply even while premiums increased (talk about some serious shrinkflation).

Co-insurance: Insurance company’s way of making sure you still have “skin in the game”. Also known as another barrier to care.

Car insurances reward you for driving safe and life insurances reward you for living healthier because, at the end of the day, the nature of insurance companies is to mitigate risk and reduce how much people actually use their products. Health insurance companies are no different, but having routine medical care is not only unavoidable, but also beneficial, so it makes little sense to use a product which sets up all these barriers to care to pay for your general medical needs.

Nobel prize winning economist Richard Thaler wrote a whole chapter in his groundbreaking book Nudge on how people spend too much on “good” health insurance, a scientifically proven observation. His advice was if you have no major illnesses that require routine, expensive treatment (like chemotherapy), a high deductible plan is almost always your best pick.

So, what about routine care? A few decades ago, some primary care doctors realized they no longer wanted to work for the insurance companies because of all the barriers insurance companies put up between them and their patients. They began a member subscription-based practice model dedicated to bringing cost effective, quality care to all called direct primary care which has now spread to include over 2,000 practices nationwide. EuDoc is the first direct primary care practice in Midlothian.

Our goal is to provide a comprehensive medical service for all issues which do not require insurance coverage. This includes chronic care management as well as urgent care. In addition to treating almost all common issues, we believe this care should be easily accessible and convenient. Because we are not incentivized to make our members come into the office, we happily use messaging and phone calls with our patients to handle the simple tasks and medical issues which do not require an office visit. We also value getting to know our patients and spending time with them, so our office visits are 30 or 60 minutes long to allow for as much time as needed.

Most people currently will spend hundreds and even over a thousand dollars a month for an insurance product which creates barriers to care and then also makes them pay more money when they see their doctor. EuDoc’s monthly membership fee is all inclusive. All visits and common urgent care procedures are included at no extra cost as is telemedicine with a doctor who you know and trust, and who knows you. Instead of creating barriers to care we encourage engagement and strive to be a high touch service. We want our members to ask us questions about things they hear from family or read in the news, and we want to hear about every strange pain or rash which they otherwise would have put off for the fear of cost or the usual unpleasant doctor’s office experience.

Health insurance plays a vital role in protecting from bankruptcy in the event of a catastrophic event, but it creates unnecessary problems when trying to cover common, routine problems. When you consider what plan works best for you and your family, consider a EuDoc membership for all your common medical needs and pairing it with an insurance plan which you save and use like you would any other insurance, for the big health event where insurance should be used.