When your doctor says yes but your insurance plan says no

The health insurance industry has stripped the autonomy of doctors, patients and employers.

Routine office-based care is affordable. Sadly, both patients and employers are generally over insured and over pay because the health insurance industry is the only insurance industry that covers routine services..

How the health insurance industry practices medicine.

  • Created health plans of differing tiers and confusing by design.
  • Marketed health plans deceptively with so-called benefits you are “entitled to”.
  • Has limited choices by creating networks and “preferred” lists for doctors, hospitals, imaging centers, laboratories, drugs and anything else needed for medical care.
  • Created lists of non-covered services.
  • Created lists of pre-existing conditions that they won’t cover.
  • Has lifetime limits for coverage.
  • Requires authorizations before a physician can proceed with care (and often, preauthorizations before getting an authorization).
  • Has non-medical “gatekeepers” determining whether authorizations for care will be “approved”.
  • Requires copays for nearly every service.
  • Has you meet a deductible before payments are made.
  • Created endless barriers to delay, limit, ration and deny access to care.
  • Created processes that have nothing to do with health but everything to do with insurance company profits.

The endless self-serving insurance-based rules and pricing have shackled the ability of doctors to practice medicine and only raised healthcare costs into the stratosphere.

Self pay and direct pay medical care.

Routine office-based care is affordable and should be customer-directed and self-pay. Health insurance should be reserved for catastrophic care plans only.

Come see us at HEALTHdrum

HEALTHdrum.com – a cost-transparent healthcare marketplace product where self pay customers can connect with practitioners for as-needed, routine care needs. This product will be attractive to the 55 million gig workers, part time staff and independent operators who don’t have access to health benefits. As well, it presents an option for those who want to shift coverage to catastrophic plans and pay for affordable routine care.

Read more:-

https://www.commonwealthfund.org/publications/issue-briefs/2019/sep/small-business-owners-views-health-coverage-costs

https://www.theatlantic.com/business/archive/2017/06/medical-bills/530679/

https://www.consumerreports.org/health-insurance/high-deductible-health-plan/