Texas Doctor Going Her Own Way, Fine, Good Riddance!

There was a story in the Fort Worth Star Telegram by reporter Dave Lieber on Friday discussing a new concept called concierge medical services. According to the Lieber’s article some doctors are charging patients a yearly membership fee of $1500. Based on my research some doctors are charging as much as $5000 per person per year. This new assessment of course would not be covered by your Texashealth insurance company. In my opinion this is just doctors attempting to milk more money out of the system. The Lieber article attempts to paint this “I’m a doctor, oh poor me” scenario. The doctor goes on to preach about how Texashealth insurance companies are to blame for the “gouging” of patients. Now, what I see as the truth, is it’s all about money. It’s just plain and simple. Oh, and reducing the doctors workload to possibly spend more time at the local tea club or country club. Dr. Michele Burzynski from Arlington Texas, as well as several other medical providers across the metroplex have hopped on board with this new concept, boutique or concierge medical practices. Dr. Burzynski indicates in the article that her reason for the abuse of her patients is about being a better doctor. A better doctor for whom? I bet for her bank account and family.

 

Let’s just look at this from a business standpoint. Dr. Burzynski indicates she will reduce her patient base from 3000 patients down to 600. The good doctor goes on to say that she will cut her workload to about 9 patients a day, down from 25. In return she will charge a $1500 yearly “usage fee”, this fee also provides a little annual physical that if I had my guess will be processed through the health insurance company. The story also indicates Burzunski presently sees 25 patients a day. If we use an average billed amount after PPO repricing of $150 that computes out to $938,000 a year in gross revenue in a 50 week year. Now, lets look at how the new concierge service would work from a financial perspective. Under the new “boutique” system the good doctor will cut her patient base to 600 and charge 1500 bucks per patient per year, we are at $900,000 before she sees even one patient! The doctor also indicates that she will see 9 patients a day, that calculates out to almost $340,000 in additional revenue. The total you ask? 1.2 million per year in revenue over the $938,000 under the old system. Another advantage of this new system for the doctors is having less workload. If workloads are cut could staff be next?

 

Now, think about this for a moment. You are a current patient of her practice, your spouse and children have been visiting her for several years, she knows everything there is about your medical history and the next thing you know is that in order to be blessed with her presence you must fork out $1500 a pop per family member. What do you do? Well, obviously the doctor doesn’t care, pay up or get out. I thought doctors got into medicine to serve the people. That’s what we always hear them say. Doctors always preach that they are committed to service and at the drop of a hat will blame the big bad Texas health insurance companies for all their problems. This is nothing but a load of bunk. I feel this system only benefits one group, doctors. Period.

 

Have doctors forgotten we are in the midst of the worst economy since 1929? Do they still think money grows on trees? Doctors, I have a question. Why are some of you gouging us? Why are you holding us hostage?

Again, doctors have squalled for years that health care and the Texas health insurance system needs to be fixed. Doctors have went on and on about how Texas health insurance companies are tying their hands behind their backs and preventing them from properly treating their patients. Doctors, I think it’s time for that talk to stop! Your new practice is not only tying patients hands behind their backs, but you have a gun pointed at their heads.  

 

Work less, make more, it’s the American dream!

 

Keep in mind this is only my opinion as a veteran Texas health insurance broker.

 

Texas Health Insurance is Exploding With New Options

As we start moving through the new year I am finding several individual health insurance companies introducing new and exciting health plans that are truly benefiting the Texas consumer. For several years I felt we were just running in place or taking a step back in quality of products that were being offered to the Texas consumer. Now there is exciting news, companies like World Insurance, United Healthcare and Cigna have exploded with excellent new policies that have one thing in mind, providing quality products at affordable monthly cost. Individual health insurance in Texas is now something we can be proud of, unlike the past few years where clients were either dissatisfied with the benefits being offered or unhappy with the cost to secure a quality product.

World Insurance Premier Series Plus has just hit the streets for Texas health insurance clients. This new and exciting product offers an unbelievable amount of first dollar outpatient benefits. Procedures like MRI’s and CAT scans are offered up before the deductible has to be met, this is a first in my recent memory. Also, your first two doctor co-pays are waived and lab and x-rays are covered with a co-pay. Of course this plan offers the traditional major medical coverage with high life time maximums so consumers can rest assured that any major claim should be paid. From a monthly price standpoint I am finding the Premier Plus Series falling right in line with the other insurance companies in Texas.

Another fabulous offering to the purchaser of individual health insurance is from Cigna Texas. This product resembles the products offered from Aetna Texas which in past writings I have discussed Aetna’s more than adequate portfolio. The major benefit that Cigna brings to the table? Price. Period. Their products will more than handle the needs of most consumers in the Texas individual health insurance  market however, their monthly cost in most cases fall well below market. The only drawback with Cigna is their underwriting guidelines are some of the most difficult. Texans with health conditions may find that Cigna will deny coverage where a company like Aetna or Humana will have no problem with the consumers past medical history. The old adage of you get what you pay for does NOT hold true with Cigna, they offer great coverage at the lowest rate, you just need to be in above average health to qualify.

These offering from World Insurance and Cigna are not the only new products being introduced in the Texas health insurance market, just the ones that are catching the most attention. I encourage every Texan in the individual health insurance in Texas market to ask your broker or agent for information and a Texas health insurance quote on these products. I think you will be shocked at the savings and benefits. It’s about time!

How to keep the sour Texas economy from stealing your health insurance policy

There has not been a time in recent history that the economy has been this pitiful. Families across the great state of Texas are seeing their savings get hammered, investments vanishing and expendable income dwindling. What should we do? Well, for starters, don’t cancel your individual health insurance in Texas policy, having quality health insurance is critical to receiving major medical treatment, more so in these times when credit availiabilty has all but dried up. One thought is you should entertain making some modifications to your Texas health insurance coverage in order to to keep it in the framework of your current budget.

Over the past few months I have noticed an influx of Texas health insurance consumers that have been active clients for years calling me to discuss their options. Each and every time we have been able to find other solutions to bring their premiums down slightly until such time as the economic ship has been righted. How should you do it? Simple, rework the configuration of benefits.

Now keep in mind, all these recommendations should only be for the short term, until financially things have straightened out. If you are lucky and you are not experiencing negative effects of the economy, please don’t alter your individual health insurance coverage as these changes do have their drawbacks. Texas health insurance companies will allow you to do things like raise a deductible or eliminate doctor visit co-pays, but when you attempt to put them back on a policy your family will be forced to go back through the underwriting process and any new health conditions could preclude you from getting your old policy design back. So think long and hard about this or discuss it with a qualified broker before doing it. The main thing here is just don’t cancel the coverage outright, things can get very messy if you do that. Being uninsured for a period greater than 63 days is the kiss of death in the health insurance world, you loose any and all pre-existing credit you have gained and would have to start back at square one when you get a new policy.

Most of the health insurance policies that are being purchased in Texas are known as the PPO doctor co-pay plans. Also, most policies have a major deductible of somewhere around $2500 per year. Some solutions would be to raise the deductible up one level, either to a $3500 or $5000 deductible. You would still have the doctor visit option on your policy for things like preventive care and  the common colds we all get, you would also keep any additional outpatient benefits like urgent care or drug prescription coverage. Most times raising the deductible will cure a families budget crunch.

Another option is to eliminate the doctor visit co-pay feature on your health insurance policy. I don’t like to see this done, but if it will save your policy from cancellation then you have to look at it closely. Another option is to look at policies with higher doctor co-pays. Several of the policies we market offer 20 and 25 dollar co-pays, you could explore companies that offer 40 and 45 dollar co-pays for the time being until brighter days shine.

One thing I will warn you about as I have in other articles I have written. Do not scrap the policy to sign up for some type of limited benefit policy. Every recommendation I have talked about still keeps the Texas health insurance consumer in the major medical family of coverages. My advised changes are only altering the policy, not making radical benefit changes like limiting the amount of coverage for inpatient or outpatient procedures. The last thing in the world you, the Texas health insurance consumer wants is to be stuck on a smoke and mirrors policy that leaves you bankrupt at claim time.

Although these recommended changes could potential expose you to a tad bit more out of pocket in the event of a major claim, or you may experience a wee bit higher co-pay, these changes will at least save the policy. The number one goal if you are experiencing limited dollars is to keep your family moving forward, by altering your Texas health insurance policy for the short term it can not only save you a few bucks, but allow you to not be forced to cancel important medical coverage. If these ideas make sense, please find a responsible, experienced health insurance broker or allow me to review your choices. This economic mess will be over soon, we all just have to get through it the best we can, I can help you do that.