No out-of-pocket cost health care

[cordex]

My insurance coverage is just not very good.  Coverage is meager and all visits result in a significant out of pocket expense.  This, combined with my natural skinflint tendencies, has caused me to avoid medical interactions where possible.  Of course, I still pay for my wife and kids and their various visits, but I'm pretty healthy and stay active so why add to the load if I can avoid it?

Last year my business added a new coverage I've never had before.  It gives our employees access to a network of doctors and nurse practitioners with offices located in or adjacent to large organizations (major manufacturers, school districts, etc).  I take it they're basically just using excess capacity that these offices have.  Care covers most of the stuff a PCP would cover and they can refer to specialists as needed.  The kicker is that there is no cost to the patient for any in-office exams, procedures, or medications (prescription or OTC).  I'm sure they bill insurance somehow, and I'm sure there is an extra cost for the company, but from the patient perspective you make your appointment, get the care, and walk out.  As far as I can tell you're not limited to one visit per year or anything either.

Yesterday I got a biopsy for a spot on my face and a tetanus booster.  Lab work for the cancer testing is covered as well - instead of only being partially covered if cancer is found and totally out of pocket if not.

The office - a single story building next to a middle school a town over from where I live - isn't as pretty as my kids' or wife's PCP, but the price is right and the care was great.  The provider wasn't rushed and I was the only patient in the building at the time.

If this model of care is sustainable I'd love to see it expanded.  The fact that it is privately delivered is heartening.

[230RN]

Who?  I've wanted to look more closely at "Oak Street Health."

Would you have to copay for high-tier Rxs?

[cordex]

Who?  I've wanted to look more closely at "Oak Street Health."

Would you have to copay for high-tier Rxs?

Everside Health.

If you want what they have available there is no charge.  If you don't then they'll send a prescription to the pharmacy of your choice and at that point it is whatever insurance makes you pay for a given prescription.

[JTHunter]

Who?  I've wanted to look more closely at "Oak Street Health."

Would you have to copay for high-tier Rxs?

After seeing one of their commercials on TV recently, I called to see where the closest was to me.
Unfortunately, the nearest location is about 15 miles away in the heart of East St. Louis.

I don't fit the "demographics". 

[230RN]

^

I have trouble traveling for reasons and that's my primary grump about my insurance.  It seems like whenever they make a referral it's too far away.  Kinda ticks me off, because I'm reasonably close to one of the biggest hospitals in Colorado and all the the ancillary MD offices which collect around a hospital.  Maybe I'll check out their 20 and what their usual referral area is when I get a chance.

"Demographics" don't matter to me any more since it's getting difficult to keep away from the "demos."

[JTHunter]

^

I have trouble traveling for reasons and that's my primary grump about my insurance.  It seems like whenever they make a referral it's too far away.  Kinda ticks me off, because I'm reasonably close to one of the biggest hospitals in Colorado and all the the ancillary MD offices which collect around a hospital.  Maybe I'll check out their 20 and what their usual referral area is when I get a chance.

"Demographics" don't matter to me any more since it's getting difficult to keep away from the "demos."

Don't get me started on health insurance companies !! 
After 3 years with United Healthcare (UHC), I switched to Aetna this year because UHC was "yo-yoing" their OTC benefits.  In '22, the OTC benefits were $50/qtr.  In '23, that went up to $85/qtr.  BUT dropped back to $50 this year.
So I shopped around and chose Aetna as their quarterly benefits were $120.  Unfortunately, I didn't find out until late January that those benefits were ONLY available through their catalog OR at CVS stores - nowhere else ! 
Then, in late January, I got a letter from them (dated 1/8/24) that I was being "disenrolled" from the PPO program I had signed up for and was being switched to an HMO instead !
To date, NOBODY has been able to explain to me WHY they switched me. 
NOW, as of 7/1/24, the hospital and doctors that I have been going to for at least 8 years will no longer be "in network" !! 
If I survive to "open enrollment" this fall, I'M SWITCHING !!

[230RN]

UHC has changed ownership a couple of times in the last 2 or 3 years, so I exercised my celebrated patience about it. In the meantime, my old company has been dunning me for two years to rejoin them.

I remember when you called a Medic, made an appointment, and paid him directly.  Seems like it's more expensive nowadays with monthly payments.  Illustrates my long-standing and oft-verified opinion that insurance ALWAYS increases the cost of the services insured against.