Could Direct Primary Care Control Your Health Care Benefit Costs?

Affordable Care Act marketplaces are closing at an alarming rate. Health care benefit costs are soaring. Some Republicans are trying to repeal and replace the current Affordable Care Act and others in Congress just want to make changes before it implodes. Meanwhile, coverage isn’t getting any cheaper, and many Americans are left wondering what options they have for affordable health care coverage. A new health care model called direct primary care is being touted as an alternative to traditional health insurance.

Combined with supplemental insurance, it’s proving tube an appealing alternative for employers who are looking for reasonably priced benefit plans and great benefits for their employees. Automobile, home and life insurance policies typically cover the costs of catastrophic events like accidents. Health insurance is different. Although it was originally designed to cover expensive health issues, such as heart attacks or cancer, it’s now used to help with the cost of routine doctor visits. Primary care has become so expensive, few people can afford it without financial assistance. What DPC Is and How it Works Direct Primary Care practitioners don’t accept insurance for routine care.

Instead, members of a DPC pay the practice a monthly fee. In return for that fee, they have access to routine physicals, acute care, chronic condition management, prescription refills and basic lab work. The cost is usually less than $90per month for an individual. To cover the catastrophic expenses, like broken leg or a stroke, DPC arrangements often are paired with health insurance. Wholesome insurers might provide a plan that duplicates the primary care coverage, other insurers are now providing coverage that strips out the primary care coverage and just focuses on catastrophic services. Remember that the Affordable Care Act still requires individuals to have health insurance. If the plan that’s paired with the DPC doesn’t provide the minimum essential benefits, the DPC member might have to pay a penalty to the government.

Experts say that a DPC arrangement can save employers up to 40 percent on healthcare costs because the practitioner’s practice has less overhead — fewer staff members need to be hired to file insurance claims. Therefore, DPC can save employers double digits over traditional group plans. Employees save on their out-of-pocket expenses. More importantly, most DPCs are known for prompt appointments, exceptional care and direct phone and email access because they see fewer patients.

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