Premiums, deductibles, and co-pays, oh my! The first recorded insurance clause was transcribed around the same time as the Hammurabi Code (eye for an eye, anyone?), but the concept has been a boil on society’s face ever since. The theory checks out, of course – save for a rainy day, and you’ll have a better shot at weathering the storm when the inevitable bad luck hits – but health insurance often causes far more harm than good when put into practice.
If “an eye for an eye” seems like a high price to pay, you’ll be shocked to learn what the REAL cost of health insurance is. Keep reading to find out just how primitive the system still is, how the hidden costs affect you and your family, and how ZüpMed’s health insurance alternative may be the solution for you.
The REAL Cost Breakdown
Health insurance costs more than just your premium. Here’s what they don’t put on your statement.
The Real Dollar Cost: Premiums, Deductibles, & Co-Pays
You would think that paying into a system every month for years would pay off when the time came, but with modern health insurance companies at the helm of your health care, your total bill is always a moving target.
First, there’s your monthly premium. The average cost of health insurance for an individual in the U.S. is $560 per month. For a family of four in Tennessee? The partner and kids up that cost to $1,705 per month – that’s more than the average cost of rent for a two-bedroom apartment in the U.S.
So now that you know you’re paying more on risk protection than the roof over your head, there’s the deductible to account for. Even though you’re insured, most policies require that you pay out of pocket up to a certain threshold before your insurance benefits kick in.
But even when your benefits take effect, you may still have to pay a co-pay at your next doctor’s appointment. And that’s not to mention tests or procedures your insurance may decide aren’t medically necessary and won’t pay for. Or surprise bills that you didn’t know were coming. That’s a high price for a policy intended to save you money.
The Real Price of Fear: Delayed Care & Changing Risk Profiles
The real dollar cost of health insurance often leads to fear, which leads to delayed treatment and a reluctance to get diagnosed for the fear of a changing risk profile. And within this cycle of fear, patients get lost.
Fear Discourages Patients from Seeking Medical Care
Without knowing what your health insurance will or won’t pay for or how much your total bill will be after treatment, you may cut back on the number of appointments you schedule when you need care. This fear of the unknown billing cycle often discourages patients from seeking needed treatment, even when their symptoms are serious or potentially life-threatening.
That means the patient who notices blood in their stool or the patient who has steadily been losing weight without trying may create alternative explanations for these symptoms and delay going to the doctor, sometimes until it’s too late. And serious preventable illness, disease, or even death is a disturbingly high price to pay on top of the real dollar cost.
Fear Discourages Patients from Getting Diagnoses That Might Change Their Risk Profiles
When purchasing health insurance on an individual basis, higher risk can mean higher premiums and fewer benefits. Patients often tell us that they have avoided going to the doctor in the past because they were “afraid to find out” not that they have a terrible disease but that the diagnosis of diabetes, high blood pressure, or even depression might alert their insurance company to raise their risk profile – and their cost of insurance along with it.
The Complications of Insurance Approval
Insurance is a middleman that tends to complicate the normal pathways doctors use to diagnose and treat patients. When every step along the way needs to be approved by an insurance representative with very little medical knowledge and experience, clinicians and patients alike become frustrated.
Insurance barriers (or the absolute denial of needed exams) lead to the need for shortcuts or inadequate alternative tests that could result in wrong or missed diagnoses or impaired health care.
The Rising Costs of Insurance
Does it seem reasonable to be charged $53 for a pair of non-sterile nitrile gloves? How about $15 for a single Tylenol tablet? Even the little plastic cup your nurse brought your medicine in is listed as $10 because of the nature of the health insurance pricing process.
That’s due to the fact that hospital charges are referred to as “allowable” because they represent the maximum that an insurance company has agreed to reimburse for that particular item. However, even though the insurance company has over-valued these items on your behalf, they still may decide on the back end that these items weren’t medically necessary and, you guessed it, make you pay for them at the inflated rate instead.
That means you could end up paying a $500 bill for six Tylenol tablets and six medicine cups over a short hospital stay. Just let that one sink in.
ZüpMed Membership: A Better Way to Pay for Care
At ZüpMed, we believe that health care payments shouldn’t bankrupt you (a novel concept, we know). Loosely based on the Direct Primary Care model, our Membership allows you to pay a modest monthly fee in exchange for unlimited urgent and primary care medical visits. Paired with our in-house pharmacy, ZüpMed is better able to control prices and the course of treatment without the insurance middleman getting in the way.
Relieved of the concern for cost, Members seek the treatment they need when they need it, without delays, shortcut diagnoses, or $8 tissues.
For Intentionally Different Medical Care, Call ZüpMed
In a perfect world, routine medical care would be treated (and paid out of pocket) the same as the routine oil changes in your car. And, like car wrecks, insurance would be reserved for the big problems: necessary surgeries, cancer, heart attacks, and the like. Created intelligently, such a program would drastically reduce premiums and provide equal access to quality medical care for all Americans.
ZüpMed’s Membership brings Memphis patients a step closer to that vision. Call our office to join the program today!