Direct Primary Care and High Deductible Plans

*UPDATED 6/8/22*

While we obviously believe that DPC is the future of primary care in the United States, we do think that insurance plays a vital role in our health care system. Unfortunately, health insurance is so expensive that many folks think that spending more for a direct primary care membership is not something they can afford. This is often not the case, especially for patients who get insurance through an employer or buy it themselves directly from the insurance company or on the exchange.

As an example, take a family of three. For those who do not get reduced rates through a subsidy, a comprehensive “Cadillac” health plan through BCBS currently costs $1636 per month! This carries with it a deductible of $1,500. Now contrast this with the bronze high deductible plan that costs $789 per month and has a family deductible of $12,000. While both of these are way too much for health insurance in our minds, the high deductible plan costs $850 per month less or about $10,000 less every year! For young families, or patients without many expensive chronic conditions, moving toward a high deductible plan can save them a ton of money. However, if they continue to go to a traditional primary care practice that has limited access, high rates of specialist, urgent care and ER visits and does not take cost into account when prescribing meds or ordering labs and imaging, they will likely continue to pay a lot of out of pocket costs considering their deductible is so high. This is why many patients with high deductible plans put off medical visits.

Contrast that with a membership to a DPC practice like Direct Doctors. For $220 per month, the entire family can have unlimited access to a doctor who they know and trust while still saving $720 per month on their original insurance plan. Included in the membership is not only our time and expertise, but our availability on off hours to reduce expensive visits to an ER as well as up to 90% discounted lab and medication services. I wrote a previous blog on how we are able to get medications for much less than what most people find at the pharmacy

Dr. Hedde has written multiple blogs on the “Smith” family and how, even though they get health insurance through an employer, they are able to save money with a Direct Doctors membership. For some, there is even the option to join a health sharing ministry like Liberty Healthshare. We have many examples of patients who have saved money by joining our practice and talk with all of our new patients about how we can help them in this regard. If finances play a huge role in your medical decision making, do not hesitate to give us a call to see how we can help!