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Hi - Mark here - I'm curious to know what you get for your $500 monthly premium. Do you get anything else of value, any incentive programs, knowledge support,

Hi - Mark here - I'm curious to know what you get for your $500 monthly premium. Do you get anything else of value, any incentive programs, knowledge support, coaching, etc. I am assuming you get free access to telehealth. I would like to know if you use any of these other things

mgkimsal 5y ago
I'm not the OP, but my insurance program (BCBSNC) offers some things. I get * a 'wellness portal' (which... doesn't open anything when I click on it) - nope - goes to 'werally.com' * a 'nurse support program' - which seems to be a bullet point list of things they say they help me with, but... no call to action, or phone number, or.. anything actionable. * 'Behavioral Health Support' - which takes me to quartethealth.com, which says their service is free, but it's just the matching portion - services still cost something (and I've got... $7000 in deductibles to hit first, only for 'in-network' - out of network, it's... $35k) * a 'blog' where I can 'explore articles and videos on fitness, nutrition and more to help keep you healthy.' * 'nutritional counseling' - 'Simply make an appointment for nutritional counseling with a registered dietitian. If you see an in-network dietitian in an office setting, your copayment can be waived...' - except if you have a high-deductible plan, which is the only thing I can remotely afford. "Telehealth" services are from 'Teledoc', and are 0% for me once I hit my deductible. Yay. What I would value is being able to go visit a doctor more than once a year. If I'm physically ill (bad cough, aches, headaches, etc) I would like to be able to go see someone for some basic inspection without it costing hundreds of dollars or more. My wife broke a bone in her foot years ago - this was at least a couple of thousand dollars out of pocket on top of the (at the time)... $7k year in insurance premiums. But... it's my own fault because I 'chose' "high deductible". If I'd just have been willing years ago to commit to paying $12k/year for the two of us, perhaps we might have gotten away with 'out of pocket' for her foot of under $1k. Essentially, between 'premiums', and 'deductibles' and 'copays', I have to be willing to commit to ... $15k-$20k up front before I see any 'benefit' from a health care encounter. I don't see how this is sustainable, but... I've been saying that for years, and... I'm hanging in there - I don't know how other people do it. 5 years ago a friend's insurance was $1900/month for him, wife and a kid. And.. yes, high deductible.
- mjamilkowski 5y ago
  Sounds like each one of those "integrated" components are actually separate things and each has an expense to you. And theres noone at the plan to help you navigate or coordinate what you access or why you should. All up to you. Our approach is to make these types of things to be inside the benefit plan (e.g. no copays, no deductibles for telemedicine solutions), and support you with care guides and incentives. I hear your pain though - its why we are trying to do this. Better access, easy as well as affordable.
qgin 5y ago
They do have free teleheath and I do appreciate that. If I don’t absolutely need to be seen in person, I use the telehealth option. No other features, tbh. It’s a bronze ACA plan in the NY State exchange. The yearly out of pocket maximum is about $7000 so it’s essentially only for catastrophic situations. I just wish there were a cheaper option. At this point, I’d take a plan with a much higher deductible/ out of pocket limit if the premiums could be half of what they are.
- mjamilkowski 5y ago
  Now I am curious why you buy health insurance. Are you insuring against the risk of a high cost claim, like a heart attack or premature baby, cancer or transplant? Is it just something you think you should have (but from your comments, dont really use the healthcare system very often)?
  - qgin 5y ago
    I actually didn’t have health insurance a few years ago and signed up for one of the non religious “health shares”. But I ended up in the hospital for a few days with a condition that was never fully diagnosed before I was discharged and the health share refused to pay anything and I was left with a $45k bill. For just 3 days of inpatient. Imagine cancer or a car accident. If you have no income or assets, you can often get that written off by the hospital, but if you have income or assets, they will absolutely bill you for everything and a major health event like that could easily rack up $500k or more in bills.
    - mjamilkowski 5y ago
      Oh yeah it can get crazy expensive. I was just asking to gauge your sense of risk aversion. One of the things I think is missing is being able to bring value to you even if you do not have claims. Kind of like how we have responded to others in this conversation, we are trying to get a membership card in your wallet that provides you with a sense of value even if you only go to the pharmacy for Slim Jims. We think theres an opportunity to engage with people in a way that encourages maintenance, or sustaining, your health, or if you think, improve your health. All too often we wait for someone to get sick before offering care - we want to get in front of that. Identify and manage emerging issues. and so on.

mgkimsal 5y ago

I'm not the OP, but my insurance program (BCBSNC) offers some things. I get * a 'wellness portal' (which... doesn't open anything when I click on it) - nope - goes to 'werally.com' * a 'nurse support program' - which seems to be a bullet point list of things they say they help me with, but... no call to action, or phone number, or.. anything actionable. * 'Behavioral Health Support' - which takes me to quartethealth.com, which says their service is free, but it's just the matching portion - services still cost something (and I've got... $7000 in deductibles to hit first, only for 'in-network' - out of network, it's... $35k) * a 'blog' where I can 'explore articles and videos on fitness, nutrition and more to help keep you healthy.' * 'nutritional counseling' - 'Simply make an appointment for nutritional counseling with a registered dietitian. If you see an in-network dietitian in an office setting, your copayment can be waived...' - except if you have a high-deductible plan, which is the only thing I can remotely afford. "Telehealth" services are from 'Teledoc', and are 0% for me once I hit my deductible. Yay. What I would value is being able to go visit a doctor more than once a year. If I'm physically ill (bad cough, aches, headaches, etc) I would like to be able to go see someone for some basic inspection without it costing hundreds of dollars or more. My wife broke a bone in her foot years ago - this was at least a couple of thousand dollars out of pocket on top of the (at the time)... $7k year in insurance premiums. But... it's my own fault because I 'chose' "high deductible". If I'd just have been willing years ago to commit to paying $12k/year for the two of us, perhaps we might have gotten away with 'out of pocket' for her foot of under $1k. Essentially, between 'premiums', and 'deductibles' and 'copays', I have to be willing to commit to ... $15k-$20k up front before I see any 'benefit' from a health care encounter. I don't see how this is sustainable, but... I've been saying that for years, and... I'm hanging in there - I don't know how other people do it. 5 years ago a friend's insurance was $1900/month for him, wife and a kid. And.. yes, high deductible.

mjamilkowski 5y ago
Sounds like each one of those "integrated" components are actually separate things and each has an expense to you. And theres noone at the plan to help you navigate or coordinate what you access or why you should. All up to you. Our approach is to make these types of things to be inside the benefit plan (e.g. no copays, no deductibles for telemedicine solutions), and support you with care guides and incentives. I hear your pain though - its why we are trying to do this. Better access, easy as well as affordable.

qgin 5y ago

They do have free teleheath and I do appreciate that. If I don’t absolutely need to be seen in person, I use the telehealth option. No other features, tbh. It’s a bronze ACA plan in the NY State exchange. The yearly out of pocket maximum is about $7000 so it’s essentially only for catastrophic situations. I just wish there were a cheaper option. At this point, I’d take a plan with a much higher deductible/ out of pocket limit if the premiums could be half of what they are.

mjamilkowski 5y ago
Now I am curious why you buy health insurance. Are you insuring against the risk of a high cost claim, like a heart attack or premature baby, cancer or transplant? Is it just something you think you should have (but from your comments, dont really use the healthcare system very often)?
- qgin 5y ago
  I actually didn’t have health insurance a few years ago and signed up for one of the non religious “health shares”. But I ended up in the hospital for a few days with a condition that was never fully diagnosed before I was discharged and the health share refused to pay anything and I was left with a $45k bill. For just 3 days of inpatient. Imagine cancer or a car accident. If you have no income or assets, you can often get that written off by the hospital, but if you have income or assets, they will absolutely bill you for everything and a major health event like that could easily rack up $500k or more in bills.
  - mjamilkowski 5y ago
    Oh yeah it can get crazy expensive. I was just asking to gauge your sense of risk aversion. One of the things I think is missing is being able to bring value to you even if you do not have claims. Kind of like how we have responded to others in this conversation, we are trying to get a membership card in your wallet that provides you with a sense of value even if you only go to the pharmacy for Slim Jims. We think theres an opportunity to engage with people in a way that encourages maintenance, or sustaining, your health, or if you think, improve your health. All too often we wait for someone to get sick before offering care - we want to get in front of that. Identify and manage emerging issues. and so on.