Monthly Archives: December 2011

Direct Primary Care

Direct primary care was designed to help American citizens save money on healthcare costs, and so far it has done just that. A broad definition of direct primary care includes several key attributes, such as doctors seeing fewer patients and patients having direct access to a doctor in person, by phone or email. In order to access these benefits, patients are charged an annual or monthly fee. Proven benefits that patients have reported consist of a better relationship with their doctor, access to more preventative medicine, as well as more and helpful advice on wellness and nutrition. The advantages that doctors have experienced from direct primary care include stability of income, improved hours of work, and an opportunity to simply be a physician.

While the price of entering a direct primary care contract can vary from as little a $1000 per year for each patient under direct primary care, there seems to be no upper end to what a doctor can charge to provide his services to individuals or to families.

In most cases, doctors will complete a process whereby their patient base is asked to join a direct primary care arrangement. In some practices, patients’ options are to either continue on with their current doctor under the new program, which allows them access day and night, or to find a new doctor. Patients may also benefit from getting better access to their doctor, being appointments the same or next day. Longer appointments allowing more advice to be offered in preventative measure supporting well-being, such as a nutritional diet being encouraged. Additionally, your doctor may decide to retain those patients who do not wish to convert to the new format.

Under direct primary care, patients are asked pay a combination of visit fees or fixed monthly fees (or a combination of both), which grant them access to a certain prearranged set of medical services.

These services typically include same and next-day appointments; these could be in the form of house calls or office visits. Access to a high deductible health plan (HDHP), a health savings account (HSA), and direct primary care also takes away the normal hassle of dealing with insurance companies, since direct primary care practices do not normally accept insurance payment.

Because physicians under a direct primary care plan are better compensated than they normally would be under an insurance billing scheme, they can afford to spend more time with their patient, which is something that may help to better assess the root problems and thus give better advice than they can under a traditional system.

The moral argument for direct primary care is that all patients are potentially equal and should not be discriminated against based on how much coverage their health insurance. This way, the problem of a doctor being obliged to spend time with one patient who has a non-life threatening problem, than with another who is more seriously ill, is avoided.

One of the main drawbacks of direct primary care is that it only goes so far in the treatment of patients and needs to be backed up and supported by other insurance plans. Additionally, it does not cover the many conditions that are too complex to be treated at the physician’s office.

Medical Underwriting – Health Insurance Underwriting

Medical underwriting is simply the process whereby an insurance carrier examines the medical history of a prospective client with the view of deciding what can be contained in their health insurance coverage and for what cost.  It is crucial for someone considering health insurance options to research medical underwriting and follow steps to lower their prospective health insurance costs.

The two ways in which an insurance providers assess applications for coverage are known as moratorium underwriting and full medical underwriting. Like anything else when you have a choice both have their advantages and disadvantages and depending on the specific needs of a client he may decide that one suits him more than the other.

Moratorium underwriting

When undertaking moratorium underwriting only three or four questions are asked about the client’s medical history. These can be as straightforward as, “Have you been to a doctor in a certain period?” Normally if you can state that you have been free of being given treatment and advice for a medical condition for a given period before the policy starts, you’ll receive coverage for it.

The main upside of moratorium underwriting is that there is no need to fill in a detailed health assessment questionnaire, and any pre-existing conditions for which you have received treatment or advice are automatically excluded although cover for these conditions can be reinstated after two continuous years from the start of the policy, should you remain symptom, treatment and advice-free in that time.

Another positive aspect of a moratorium underwriting is that it is fast to implement.  However, the main disadvantage is that the policyholder will continue to be underwritten every time they make a new claim.

The main purpose of any type of health insurance is to provide the insured peace of mind, allowing him or her to sleep easier knowing that they have done everything required of them at the time of purchase. Health insurance companies like to assure customers that if they require treatment, their insurance is ready to take care of it promptly and without raising any issue.

Full medical underwriting

Full medical underwriting may be the preferable option in for many people as, in this case, the insurance provider asks a number of detailed questions about the customer’s medical history at the time of your application. However, this process can take some time, averaging about a week in order that all information and files are gathered. They are then in a position to decide on what will and won’t be covered on the health insurance policy.  As you might have guessed, full medical underwriting may be preferable for those in good health and with good medical histories.

The upside of full medical underwriting is that you know exactly what you are and are not covered for. This, once again, helps with the “peace of mind” of anyone who has gone to the trouble of buying an insurance policy.

Full medical underwriting is not entirely free of problems. Just as the name suggests, it is comprehensive and for this reason it takes longer to create a working policy. It also means that the underwriter will want to know lots of intimate details about the applicants.

Full medical underwriting can be advantageous as well as being disadvantageous. It is important that everyone looking for the best health insurance plan carefully read the conditions of each plan they are offered, and be assured that they have found the best option that suits their own situation.