DPC vs Insurance

 
 

High deductible/HSA

For those who are able to afford insurance premiums, but want to pay less. High deductible plans minimize the costs built into the premiums that are essentially "pre-paid health benefits" that can be provided through Ascent Internal Medicine "directly". It is very expensive to have your insurer cover all healthcare related expenses, due to the added costs from insurers and providers contracting with insurers. For example a $2/month medication that we can provide may cost you $10 or more per month using insurance. This applies even more so to labs, excessive diagnostic testing, and delayed medical care. What if face to face appointments can be sometimes replaced by using text, email, phone or video?  This also saves time and schedule interruptions.

Health Savings Accounts work very well for those who are at both ends of the health extremes and have high deductibles. The contributions are never taxed. If you spend your deductible every year, you get full tax deduction. Without the HSA, you are paying your share of medical expenses with after tax dollars. If you are healthy and the account grows, especially if invested, can be used for retirement. Expenses have to be health related as defined by the IRS. Even expenses like building a ramp for wheelchair access into your home is a qualified cost. 

Indemnity Insurance

Indemnity insurance pays specified amounts for healthcare services, without contracting with the provider so you are able to go wherever you want. The premiums are much less as these plans are much easier to administer.  I accept the amounts reimbursed. However, there are several exceptions compared to the monthly memberships. First, this requires 3 appointments for new patients and follow up appointments are 20 minutes each. Second, services provided are paid directly to the clinic and then you submit the bill to the insurer for direct reimbursement to you. Third, since there is no monthly membership fee, appointments may not be as immediately available as for members. For more detailed information, contact Gary at Bend Health Insurance below. Click on the "Health Saver Plus III" or request a quote. 

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Medical Cost Sharing

These work efficiently with Ascent Internal Medicine as they are more cost effective than high deductible health insurance plans described above: costs can be less than $200 for young singles or around $500-$600 for a family. The savings compared to insurance premiums more than cover membership costs primarily because "pre-paid health benefits" are not included in the prices. Also, overhead for these companies approximately 10% instead of a minimum 20% for insurers. They are better for those who are relatively healthy, only want catastrophic coverage, and agree to be modestly responsible for their medical expenses and health. They cover catastrophic expenses like hospitalization, traumas, heart attack, cancer diagnosis, etc., but don't cover ongoing chronic problems that can be paid out of pocket.  You can sign up directly or through the sign up process if becoming a member (each company returns a small fee if you sign up through membership process). 

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a la Carte

If all you need is rare to occasional medical care, there are straightforward prices for an in person exam. You pay for the time you need, no more, no less. Some patients will need longer than 30 minutes to establish care and will need an additional 20 minute follow up which can be done via telemedicine. You can still get the medications, labs and imaging at cash prices and can always join later. Telemedicine can be used only if directly related to the face to face visit, at my discretion. There are additional charges for in clinic testing. The initial visit will be charged through Hint Health, but afterwards all charges will need to be paid at the time of the visit. Payment plans can't be accepted. 

 

Cost

Plans

Employer

Ind/Family

a la Carte

 

Ascent Internal Medicine

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Contact

Phone: 541 771-2932

Address: 354 NE Greenwood Ave., #113

Bend, OR 97701

Email: contact@ascentinternalmedicine.com

This practice does not constitute insurance, and billing occurs at the end of the month. This practice provides only the limited scope of primary care as specified in the retainer medical agreement. Specialty and/or hospital care, pharmaceuticals, vision, dental and testing (labs that are not included, X-ray, Ultrasound, etc.) are not covered by your fee and are your financial responsibility. Labs ordered through Quest are billed at my cost and are paid to Ascent Internal Medicine. You can contact consumer advocates at the Department of Consumer and Business Services at (888) 977-4894, dcbs.insmail@state.or.us, or Oregon Insurance Division.

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