4 ms·

We considered trying OneMedical, which opened an office close to where we live. But when I looked into it, it seemed like you have to buy a subscription up-fron

We considered trying OneMedical, which opened an office close to where we live. But when I looked into it, it seemed like you have to buy a subscription up-front, with no other way to try it out. We might have made the switch by now if they had made it easier to try.

dylan604 3y ago
I was on a gig interviewing a doctor co-op. It was similar in that it was an upfront subscription plus co-pays per visit. They had a staff of MDs, more nurse practioners, and a staff of nurses. They also had a couple of psychiatrists on staff as well. The upfront subscription was still lower than an actual insurance plan. The only downside for me that I could see in the idea was it was not available in my city.
- malfist 3y ago
  Even if it's cheaper than insurance, your insurance pays for was more than just doctor visits
  - dylan604 3y ago
    the vast majority of people's medical needs are typical office visits. emergencies or more serious things do occur, and they mentioned something about those situations but I was not part of that interview so I didn't get that part of the details.
imbusy111 3y ago
The costs after you susbcribe are also insane: $420 for a 15min online chat. I got the same type of appointment for something around $20 directly from Cigna. And that's with a high deductible account.
- tekno45 3y ago
  Is it supposed to be cheaper? I doubt they're better. The Amazon of Healthcare doesn't seem like the best place for high quality doctors. but then it should be cheaper than your regular premiums and stuff. I really don't know what they're offering.
- chimeracoder 3y ago
  > The costs after you susbcribe are also insane: $420 for a 15min online chat. > > I got the same type of appointment for something around $20 directly from Cigna. And that's with a high deductible account. Cigna (and any insurer) is always going to charge you way more for services that they don't provide themselves, because their direct incentive is to encourage (or force) you to use the services that they provide directly instead of using independent in-network providers. Their profit margins are way higher on those (compared to in-network providers), and furthermore they have way more control to use those as a mechanism to gatekeep further specialized care. You can sort of think of it like a loss leader, but in reverse: providing those services "at-cost"[0] allows the insurer to save way more by using that virtual visit to deny you a referral to a specialist, or denying you a particular procedure, based on some clinical guideline that the insurer has decreed, when an in-network independent provider would have come to a different judgement. Remember that, for in-network coverage, the amount that you have to pay is a somewhat arbitrary number that is entirely decided by your insurer, and has very little (if anything) to do with how much the providers on the other end are actually making. Cigna makes you pay more for independent providers because it benefits them to charge you more for those. I'm using Cigna here because you mentioned Cigna, but to be honest, all the insurers operate like this. [0] "cost" is a fuzzy term here; I'm being figurative
- filoleg 3y ago
  Oh, that’s interesting. The one time I had to use OneMedical services was when I was on a work trip to another state and was afraid I broke my hand after falling on the street and scraping off the entirety of my knee skin. Scheduled a quick appt for the same day, they checked up and did the first aid stuff on the knee, and then redirected me to a radiology clinic a few blocks away for an x-ray. I just checked the billing portal, and the visit to OneMedical ended up costing me $8, while the x-ray at a radiology clinic afterwards cost me $5. So yeah, that’s just anecdotal, but your cost of $400+ for a short online appt just doesn’t feel right. Not doubting you, but I doubt that this is a typical experience.
chimeracoder 3y ago
> We considered trying OneMedical, which opened an office close to where we live. But when I looked into it, it seemed like you have to buy a subscription up-front, with no other way to try it out. We might have made the switch by now if they had made it easier to try. In many (most?) states, they are actually legally required to offer services to you without a subscription, but you won't be able to use the app. In other words, you have to call them like a normal doctor's office and book an appointment, and when you do, they will have to provide you the same medical care and services that they would for any other patient. This is not specific to One Medical; it's due to laws that prohibit additional fees for medical services. In a similar vein: in many states you can use the Costco pharmacy even without a Costco membership, although you can't buy anything else while you're there. That said, you're not really missing out. One Medical's entire shtick is that they have a slick UX and "appointments start on time" (in theory). In practice, their medical care is... let's say variable, at best. You're paying for a slick UI and convenience slapped on top of a care delivery system that's no better than what you might get elsewhere.
- sadfsdafklj 3y ago
  > In many (most?) states, they are actually legally required to offer services to you without a subscription For emergency services from hospitals that provide emergency services, that's true. But for virtually anything else I don't think it is.
  - chimeracoder 3y ago
    > For emergency services from hospitals that provide emergency services, that's true. But for virtually anything else I don't think it is. You're thinking of a separate law, which requires emergency rooms to provide emergency medical services to all patients if they accept Medicare or are attached to a hospital which accepts Medicare. (This is one of the reasons that there's been a proliferation of standalone for-profit emergency rooms in the last several years - it's a way to bypass this requirement and serve only the most profitable patients). That's separate from what we're talking about here.
    - 3y ago
sonicanatidae 3y ago
I've had enough horse shit from the parent company. I sure af ain't trusting them with my healthcare.

dylan604 3y ago

I was on a gig interviewing a doctor co-op. It was similar in that it was an upfront subscription plus co-pays per visit. They had a staff of MDs, more nurse practioners, and a staff of nurses. They also had a couple of psychiatrists on staff as well. The upfront subscription was still lower than an actual insurance plan. The only downside for me that I could see in the idea was it was not available in my city.

malfist 3y ago
Even if it's cheaper than insurance, your insurance pays for was more than just doctor visits
- dylan604 3y ago
  the vast majority of people's medical needs are typical office visits. emergencies or more serious things do occur, and they mentioned something about those situations but I was not part of that interview so I didn't get that part of the details.

imbusy111 3y ago

The costs after you susbcribe are also insane: $420 for a 15min online chat. I got the same type of appointment for something around $20 directly from Cigna. And that's with a high deductible account.

tekno45 3y ago
Is it supposed to be cheaper? I doubt they're better. The Amazon of Healthcare doesn't seem like the best place for high quality doctors. but then it should be cheaper than your regular premiums and stuff. I really don't know what they're offering.
chimeracoder 3y ago
> The costs after you susbcribe are also insane: $420 for a 15min online chat. > > I got the same type of appointment for something around $20 directly from Cigna. And that's with a high deductible account. Cigna (and any insurer) is always going to charge you way more for services that they don't provide themselves, because their direct incentive is to encourage (or force) you to use the services that they provide directly instead of using independent in-network providers. Their profit margins are way higher on those (compared to in-network providers), and furthermore they have way more control to use those as a mechanism to gatekeep further specialized care. You can sort of think of it like a loss leader, but in reverse: providing those services "at-cost"[0] allows the insurer to save way more by using that virtual visit to deny you a referral to a specialist, or denying you a particular procedure, based on some clinical guideline that the insurer has decreed, when an in-network independent provider would have come to a different judgement. Remember that, for in-network coverage, the amount that you have to pay is a somewhat arbitrary number that is entirely decided by your insurer, and has very little (if anything) to do with how much the providers on the other end are actually making. Cigna makes you pay more for independent providers because it benefits them to charge you more for those. I'm using Cigna here because you mentioned Cigna, but to be honest, all the insurers operate like this. [0] "cost" is a fuzzy term here; I'm being figurative
filoleg 3y ago
Oh, that’s interesting. The one time I had to use OneMedical services was when I was on a work trip to another state and was afraid I broke my hand after falling on the street and scraping off the entirety of my knee skin. Scheduled a quick appt for the same day, they checked up and did the first aid stuff on the knee, and then redirected me to a radiology clinic a few blocks away for an x-ray. I just checked the billing portal, and the visit to OneMedical ended up costing me $8, while the x-ray at a radiology clinic afterwards cost me $5. So yeah, that’s just anecdotal, but your cost of $400+ for a short online appt just doesn’t feel right. Not doubting you, but I doubt that this is a typical experience.

chimeracoder 3y ago

> We considered trying OneMedical, which opened an office close to where we live. But when I looked into it, it seemed like you have to buy a subscription up-front, with no other way to try it out. We might have made the switch by now if they had made it easier to try. In many (most?) states, they are actually legally required to offer services to you without a subscription, but you won't be able to use the app. In other words, you have to call them like a normal doctor's office and book an appointment, and when you do, they will have to provide you the same medical care and services that they would for any other patient. This is not specific to One Medical; it's due to laws that prohibit additional fees for medical services. In a similar vein: in many states you can use the Costco pharmacy even without a Costco membership, although you can't buy anything else while you're there. That said, you're not really missing out. One Medical's entire shtick is that they have a slick UX and "appointments start on time" (in theory). In practice, their medical care is... let's say variable, at best. You're paying for a slick UI and convenience slapped on top of a care delivery system that's no better than what you might get elsewhere.

sadfsdafklj 3y ago
> In many (most?) states, they are actually legally required to offer services to you without a subscription For emergency services from hospitals that provide emergency services, that's true. But for virtually anything else I don't think it is.
- chimeracoder 3y ago
  > For emergency services from hospitals that provide emergency services, that's true. But for virtually anything else I don't think it is. You're thinking of a separate law, which requires emergency rooms to provide emergency medical services to all patients if they accept Medicare or are attached to a hospital which accepts Medicare. (This is one of the reasons that there's been a proliferation of standalone for-profit emergency rooms in the last several years - it's a way to bypass this requirement and serve only the most profitable patients). That's separate from what we're talking about here.
  - 3y ago

sonicanatidae 3y ago

I've had enough horse shit from the parent company. I sure af ain't trusting them with my healthcare.