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Health Cost Sharing Header 2021

Health Cost Sharing 2021

The very concept for and purpose of insurance is to protect one against unpredictable and large expenses, such as damage to your vehicle from an accident, or to your home from a hurricane. In health care where there is virtually no transparency, most health care costs are purposedly unknown, falsely creating a need for insurance for even routine care. Charges are frequently inflated, and “discounts” off these inflated charges by health care facilities are advertised by insurance companies as evidence that they are working on your behalf to get your value and savings for your insurance plan.

The Direct Primary Care (Balanced Physician Care) membership model absolves the need for insurance for non-emergency care, from physician consultations to ancillary services, such as laboratory and radiology services. All costs are transparentaffordable and predictable with the all-inclusive monthly membership. Various private surgical groups are now publishing all-inclusive non-emergency surgical procedures so insurance is even not needed for them.

The Direct Primary Care model allows members to purchase insurance or other plans purely for catastrophic needs at a much lower cost by forgoing inclusion of routine care in their plans. Unless you have chronic medical conditions that truly require the care of a specialist physician and expensive medications (about 15% of you), a health cost sharing plan may be just what you need. These programs compliment a DPC membership perfectly, at a combined cost that is usually half of traditional insurance offerings

Thanks to Ochna Health for the chart below. They have revised it annually to reflect the changing marketplace. It is our hope that this updated version will guide you to a solution to your health care needs.

 

Health Cost Sharing 2021 Comparison Chart

Choosing a Christian Healthshare

Listen to the Pulling Curls Podcast above on choosing a Christian Healthshare.

What is covered.

  • What a healthshare is and how it basically works.
  • How they maneuver around the health insurance mandate
  • Their experience with CHM, Liberty and Zion Healthshare

Zion Healthshare

Liberty Healthshare

Christian Health Ministries

 

Local Covid-19 Vaccination Info

Local Phase 1 Covid-19 Vaccination Information

APPOINTMENTS ARE REQUIRED IN ORDER TO RECEIVE THE VACCINE.

Appointments are exclusively available for Phase1A prioritized groups which are as follows:

  • Residents age 65 and older
  • Health care workers

One person per appointment is permitted; individuals without appointment will be turned away.

What to bring to your appointment

  • Must present valid ID that show you are 65 and older
  • Health Care Worker, bring your employee badge

Make an Appointment Online

  • Check below for each County appointment links
  • Walk-in appointments WILL NOT be accepted.
  • Please note that the Moderna vaccine requires 2 doses that are 28 days apart.

Duval County
 

The Duval County Health Department announced new appointments will be added through the online system every Thursday at 5 p.m.

Appointments can no longer be made by phone. Only online appointments are available.

”The link will change each week and will be posted on the Department of Health -Duval website: duval.floridahealth.gov. Click on the yellow alert box.
 

St Johns County

Online registration to make a vaccination appointment will open at 9 a.m. on Thursday, January 7, for appointments on Friday, January 8,” a notification from the county’s Emergency Operations Center said. “A registration link will be announced Wednesday, January 6 at www.sjcfl.us/coronvirusvaccinations

St Johns County Covid Vaccination Text Alerts

Clay County

According to Clay County, all appointments to receive its initial allotment of 3,000 doses of the Moderna COVID-19 vaccine have been filled and there are no additional appointments at this time. Clay County said that as soon as the state provides an update on additional allotments, the county will open for additional appointments.

The county website to sign up is alert.claycountygov.com

For the latest updates please visit the following Balanced Physician Care social media pages

Facebook Link

Twitter Link

mad patient

Why Does My Primary Care Office Refer Me to an Urgent Care?

 

Your average physician’s office cannot accommodate the needs of the 2000+ patients that they have per doctor in the normal day.  If the doctor is full or not in the office that day, they will often either recommend that you come in and see a non-physician practitioner or go to the local urgent care where you can walk-in anytime you need it.

At Direct Primary Care practices, like Balanced Physician Care, we do our best to be available to our members when you need it.  24/7, 365 days a year we can be sure to get back to you when you have an urgent need.  Our members email or call our after-hours phone number when they have an urgent concern and they hear back from their doctor directly within hours (and usually within minutes!).  When scheduling allows and the need requires an in-person assessment or treatment, their doctor directly schedules them to come in for what they need. 

​Amid COVID, this has been super helpful for our members.  When a member has a cold and doesn’t know what to do, we can discuss remotely what the best course of action is, refer them to rapid testing, or schedule a COVID test fairly quickly to help guide next steps.  

We keep our panel of patients to under 600 patients with 2 providers, unlike the national average in a regular Fee-For-Service practice of 1000s per provider.  This lets us be sure we can offer what we’re recommending to patients without long wait times on hold with a receptionist.  We call, email, or message our members back directly and we arrange their urgent visit when needed.  We can also handle many urgent requests remotely (i.e. that annoying UTI is back and you need the antibiotic again - you don’t have to have a visit!).  

To find out more about how direct our care works and how Balanced Physician Care practices it, give us a call at 904-930-4774

 

end of pandemic

How Does a Pandemic End?

Several of you have asked me “How does an epidemic or pandemic end?” The answer, like most things in life, is – it depends. The metaphor of the forest fire is useful here. Consider that a forest fire can only get started when there is a spark (the virus) and enough fuel (people’s bodies) to accelerate. Like a forest fire, it starts small but with enough dry fuel, it can pick up momentum quickly. An epidemic, like a forest fire, can also jump to new locations. The wind can spread embers of a fire to new locations even as fire fighters are putting out the original location. Consider an infected person getting on an airplane and infecting other air travelers as well as people at a new location.

     The forest fire metaphor remains useful when we consider strategies for ending the epidemic. First of all, we can attempt to deprive the fire of fuel such as clearing brush from around structures. That would be similar to the stay at home orders that can help prevent people from getting in the virus’ path. Secondly, firefighters in towers can look out for flare ups and sequentially knock the flare-ups down. This is akin to testing for infection, tracing contacts and placing infected persons in quarantine. As with a forest fire, the strategy of testing, tracing and quarantining can only work if we adequately test to identify new hot spots, and then have the capability to isolate and treat those new cases. This strategy cannot work with a raging forest fire as there are simply too many burning areas to deal with at the same time. And, so with the epidemic, when the prevalence of the virus in the population gets too high – for example over 25% -- attempts at contact tracing and quarantine will be overwhelmed and ineffective. We are seeing this situation now in Miami-Dade county where the test positivity rate now exceeds 33%. At that point, the strategy as with a forest fire, is to retreat to safe lines and attempt to build a “fire-wall”. With the epidemic, this would be akin to preventing people from traveling from an endemic high prevalence area to a state with low prevalence of virus.

     The ultimate logical end of the metaphor would be the scorched earth situation wherein the fire burns everything in its path unimpeded and only the seeds left in the ground are there to repopulate the forest. That doomsday scenario might have occurred in pandemics past where very high percentages of the population were wiped out such as with the bubonic plague in the Middle Ages. That will not happen with us, but we should not be complacent as the virus is powerful and stealthy. Like a fire that can burn underground undetected, so the virus can spread via asymptomatic people and pop up in new locations.

 The current Covid-19 pandemic will end in any of the following ways:

  1.  We will develop a vaccine that is safe and adequately effective, and enough people will get it so that we develop societal herd immunity stopping the virus’ transmission. I have read that up to 1/3 of Americans might decline the vaccine which could prevent herd immunity.
  2. The virus will mutate to a less pathogenic form and peter out of its own accord.
  3. We will develop safe and effective drugs, or other treatments such as passive antibodies that will quickly treat infected persons and halt the transmission.
  4. We revert to severe shelter in place and travel ban protocols long enough to stop the virus from transmitting.

     Epidemics and pandemics end, one way or another. For reference, smallpox -- another airborne viral illness -- killed 400 million people in the 20th century before it was deemed eradicated by the World Health Organization in 1980. The good news is we have seen examples from many other countries where organized projection of tried and true public health strategies of testing, identification of cases, tracing, and quarantine can reduce the transmission of Covid-19 to almost zero. The bad news is that the United States has shown little appetite or capability to do the organized hard work of stamping out the virus. Therefore, we are stuck with waiting for one and/or the other modes of viral decline for the forest fire to end…

Article by Rich Parker - Chief Medical Officer at Arcadia.io. 

 

Zion Health – new medical cost sharing

HEALTHSHARING WITH Balanced Physician Care

Pair your Balanced Physician Care membership with a Zion Health Membership for full coverage, quality healthcare, and savings!

EVERYONE ACCEPTED

Zion does not decline anyone for prior medical conditions or religious beliefs.

SHARE MEDICAL COSTS

Zion shares each others medical costs as a community of like minded individuals.

HEALTHY LIVING

Zion encourages healthy living within their community which helps us all.

ATTENTIVE TO NEEDS

Zion processes medical needs quickly for their Members, often within 5 business days.

GAIN FREEDOM

Zion members can work with any provider without network restrictions.

NO ANNUAL CAPS

Zion's sharing program does not have annual or lifetime caps on your need requests.

MEMBERSHIP ACCESS

Contribute directly with your  Direct Primary Care practice.

WORLDWIDE

Share in a medical costs when on a vacation or serving a mission outside the USA.

Zion Health Rates

50% off new Membership enrollments for the first three (3) months when billed directly with Zion Health by using code “COVID19"

ZionHealth-COVID-Ad

Coronavirus

Sharyl Truty MD & Arlene Aquino APRN of Balanced Physician Care in Jacksonville, FL give you their medical perspective on the Coronavirus

The “NetFlix and CostCo” of Primary Care

How would you benefit if your relationship with your doctor was described as “Netflix meets Costco?”

Direct Primary Care, or DPC, is a new way of providing primary care that is making good on its promise to help people stay healthier and spend less on healthcare. Dr. Kirby Farnsworth, owner of Simply Direct Health, shares the story of what attracted him to choose DPC over traditional primary care models, how he can provide many medications at or near cost, and why referring physicians love it just as much as patients.

This conversation is brought to you by P3 Inbound

Health Cost Sharing 2020

The very concept for and purpose of insurance is to protect one against unpredictable and large expenses, such as damage to your vehicle from an accident, or to your home from a hurricane. In health care where there is no transparency, most health care costs are unknown. Health insurance gradually morphed to provide “coverage” for everything, from the routine care such as doctor’s visits, ancillary services (laboratory and radiology) and prescriptions to the catastrophic needs when one gets hospitalized or requires emergency surgeries.

Direct Primary Care solves the routine care dilemma by making the cost of health care and ancillary services all transparentaffordable and predictable with the all-inclusive monthly membership. In so doing, Direct Primary Care renders health insurance irrelevant for most routine needs. Then by removing the routine care from traditional health insurance, the cost for such is dramatically lower, as in the case of most health cost sharing plans. These plans perfectly pair with a Direct Primary Care membership to deliver you a health care solution that is better than most traditional insurance offerings, yet cost half as much.

Unless you have chronic medical conditions that truly require the care of a specialist physician and expensive medications, these health cost sharing plans will be just what you need. Most medical conditions that are currently managed by specialist physicians can be cared for by a Direct Primary Care physician who is not spending time running from room to room seeing 25-30 patients a day as in a traditional medical practice. That practice setting favors referrals for almost everything due to time constraints and network referral pressure.

When we could not find any solutions online comparing various health cost sharing plans, we decided to do it ourselves, and have revised it annually to reflect the changing marketplace. It is our hope that this updated 2020 version will help you find the perfect health cost sharing plans for you.
Health-Cost-Sharing-2020
Health-Cost-Sharing-2020 page 2
Click Link for Health Cost Sharing Pricing

-courtesy of ochna health

Open Enrollment

Open enrollment season is right around the corner and you may be making some important decisions for you, your family, or even your business. Here are some tips to think about when purchasing health insurance.

Whether you purchase your insurance through the state, government, employer or directly from vendors, this can be a daunting process. There are often many choices, with slight differences that are difficult to decipher. Beyond that, because price transparency is such an issue in healthcare, it is often hard to plan or budget for future costs when there is no way to find out how much these services actually cost! Below, I’ve tried to outline a couple tips while going through this process.  

Nothing is free!!:   Many patients get a large portion of their health insurance paid for by a third party (employer, government, etc). This creates the notion that health care is cheap or free in certain situations. Please remember that although you may not pay much in monthly premiums or out of pocket costs for your insurance, your employer is likely paying an exorbitant amount for health care services you may not even use. This cost has gone up considerably in the last few years

Know your family:  Unfortunately, because this can be so complicated, many patients simply select the most inclusive insurance options, which are also the most expensive. Sit down and review what medical services you and your family have used over the past few years. What medications do you require monthly, if any? Do you see specialists, and why? Do you know of any bigger health expenses that may come up next year (like planning for a child or an elective surgery)?  Or do you just really need a good primary care physician who has time to address all of your medical needs? (Hint: the answer for almost everyone is yes!)
 
Understand premiums and deductibles:   Just to review, a premium is the amount that you (or a third party) pay monthly for the privilege of being insured. The deductible is the total amount of out of pocket costs you and your family can incur during the year on top of the monthly premium you already pay. The lower your monthly premiums, the higher your out of pocket costs may be… though you still might save money this way! For instance, for a young family of 4 buying insurance from BCBS, the monthly premium for a $2,800 deductible plan is about $500 more a month than the $12,000 deductible plan… that’s $6,000 extra in monthly premiums over the course of the year!!! Why would anyone pay that much extra when good primary care can cover 85-90% of issues that will ever come up?  Even the $2,800 deductible plan listed above leaves a family paying out of pocket for much of their costs in a year. Those costs are often inflated because of insurance and the amount is completely unknown to the patient prior to utilizing the service (try to think of another purchase you make where you do not know the cost prior to buying?!?).
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Consider Medical Cost Sharing or Healthshare:  Healthcare Sharing, or Groups, are non-profit organizations of like-minded individuals that pool their money together every month to help each other with serious medical costs. They are NOT considered insurance. They work great with Direct Primary Care.The majority are Christian based ministries except for Sedera Health (sedera.com). The Christian based Ministry groups usually require members to adhere to moral and ethical principles that result in lower healthcare costs; such as not smoking, avoiding excessive alcohol, no extra marital sex, and no illicit drugs. Since these plans are not insurance, they can restrict or refuse Approval, i.e. exclude for pre-existing conditions. Sedera Health is different. It does not require you to adhere to moral or ethical principals and is not a Christian based. These health sharing plans can provide catastrophic healthcare protection (like health insurance should be doing) for significantly lower monthly costs.
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So, if you have a relatively healthy family, ask yourself why you (or your employer) pay so much more in premiums for, what should be, cheap and comprehensive primary care services. And wouldn’t you want an affordable, budgetable, transparent monthly fee that will cover most everything that will come up during a given year including keeping you out of an expensive urgent care and or even worse, the emergency room.

 

  •  If you do have some chronic medical concerns, think about the specialists you are seeing and the different medications you're on.  Is YOUR Primary Care Doctor putting all the pieces together?

 

  • Is you current doctors taking your finances into consideration when prescribing and ordering expensive medications/tests without thinking about it?

 

  • Is you current doctor part of a hospital system and only recommending specialists "in the system"?

 

  • Does your doctor expedite changes in your treatment plan and save you trips to the office?
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If the answer is a No to the questions above or you're just unsure, it’s probably worth making a 15-20 minute, Meet & Greet appointment here at Balanced Physician Care so we can discuss how our practice will work with your medical and insurance needs. The best part is, the consultation is free!  (Schedule your visit here or give us a call at 904-930-4774
BPC Logo

115 Professional Drive Suite 104

Ponte Vedra Beach, FL 32082

904-930-4774

www.BalancedPhysicianCare.com

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