It is that time of year when businesses, families and individuals need to re-enroll in healthcare coverage. Given the current economic climate, many people will be looking for the most cost-effective options for coverage. Direct Primary Care is an option to keep in mind as we make our decisions regarding coverage.

Direct Primary Care is a model of care where individuals or business owners pay a low monthly fee to have themselves, their families and/or their employees become members of a Direct Primary Care practice. This allows them to receive unlimited access to primary care with no copays.  All visits, procedures, and in-office testing are included in the membership and medications administered in-office are heavily discounted.  Labs and imaging are also deeply discounted. If patients require additional or specialized care that the practice is not able to provide, Direct Primary Care doctors work to help their members find the least expensive options for the care. The Direct Primary Care model also has the additional benefits of being able to provide timely and personalized care when compared to traditional models of care. This is because by separating patient care from traditional insurance, Direct Primary Care eliminates insurance red tape and allows doctors to focus solely on taking care of their patients.

For individuals and families who do not have healthcare coverage through their employers, the first step in their search for affordable healthcare coverage will be to find out if they qualify for subsidies through the Affordable Care Act (ACA).  To qualify for subsidies, their income must be at or below certain levels. Most people who qualify for subsidies will be able to find affordable, cost-effective options for their health coverage through the Affordable Care Act on Healthcare.Gov.

However, many individuals and families will not qualify for subsidies through the ACA due to their income being too high to qualify. In these cases, they will likely find that the only affordable plans available to them will be very-high deductible health plans. With very-high deductible plans, patients are unlikely to meet the deductibles unless they have a major illness or hospitalization. This means that individuals and families who purchase these plans can easily end with a lot of unplanned out-of pocket healthcare expenses just for routine care.  By combining  membership in a Direct Primary Care Practice with a very-high deductible health insurance plan, individuals or families can attain a wide range of healthcare coverage at an affordable cost and greatly reduce the risk of ending up with large unplanned out of pocket healthcare expenses at the same time.

Similarly, business owners can save money on healthcare coverage for their families and employees by combining Direct Primary Care with high deductible health plans. Even small business owners who have chosen to self-insure their primary care expenses will find that a Direct Primary Care membership will save them money on their Primary care healthcare expenses. Employers that have 50 or more employees and are required by law to provide health insurance coverage can combine any health insurance plan with a Direct Primary Care Membership as long as the health plan meets the minimum value standard.

To learn more about Direct Primary Care, contact Katy Premier Primary Care  at (281) 978-2624 or by email at [email protected].

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