In past years we have visited the Smith Family, a typical working family of three looking to reduce their healthcare expenses through a membership with our Direct Primary Care practice, Direct Doctors. We looked at how they were able to save $1350 during their first year as members of Direct Doctors just by switching to a higher-deductible, lower-premium health insurance and joining the practice for their primary care.
We eliminated costs for their family by helping them keep their care in the primary care office setting. We decreased (in fact, eliminated) their need for specialist visits and handled their urgent issues in our office or via text/email/cell phone when necessary.
In their second year as patients, they found additional savings benefits through reduced medication co-pays and laboratory co-pays. This is no mystery - labs and meds cost more when you use third parties.
The cost of a typical lab bill when sent through insurance has to be inflated to cover the contract-pricing. In other words, insurance companies have labs sign paperwork saying anyone with their type of insurance will be charged X amount. Let’s say for a thyroid panel that amount is $200. If the patient has not met their deductible, the lab is required to bill that patient the whole $200 fee. If the deductible is met, the insurance company often has a negotiated rate (i.e. they pay less than the patient would have to pay out of pocket). But, if that same patient went to a lab and did not use their insurance, but rather paid cash, they would often save at least 50% over the insurance rates.
When you think insurance helps you remain “covered,” often you may need to think again. That coverage comes at a price and especially with a high deductible plan, like the Smith family, you may have savings by paying out of pocket instead. In other states, DPC practices like ours are able to “client bill” - meaning they bill the patient directly for in-office lab draws - this costs only pennies on the dollar, but unfortunately is not allowed in RI.
To wrap it up, over the course of two years, the Smiths have saved nearly $3000 in health care expenses while simultaneously experiencing a level of access to their primary care doctors that they never had before.
If you are looking at your budget, and wondering where you can trim the fat next year, we strongly encourage you to consider the Direct Doctors’ Difference and how it can help you and your family save in healthcare expenses, including lab bills!
Lauren Hedde, DO; James Hedde, DO and Mark Turshen, MD are Family Physicians and Co- Founders of Direct Doctors, Inc. a Direct Primary Care Practice.