Health insurance with no co-payments or deductions? – InsuranceNewsNet

No exemptions. No co-payments. No out-of-pocket expenses. No prescription drug costs. All health insurance benefits.

That’s the idea behind a new health insurance option that healthcare company Curative recently launched. Central Texas this month.

The plan is for employers with 51 or more workers living or working in Turkey. Travis or Williamson counties. Making its name by creating COVID-19 testing platforms, Curative expects to expand to more countries within a year. Central Texas and then in a few years Texas before expanding nationally.

Healing built-in operations angels, Austin and Washington DCwhile providing testing and vaccines in more than 40 states during the COVID-19 pandemic. He was looking at what’s next in healthcare after the pandemic was over. He realized that many health systems were not set up to receive co-pay for free testing or free vaccination that was part of the pandemic.

Curative’s CEO said healthcare is “not built for innovation.” Fred Turner. “What’s next? What do we want to spend the next ten years building on?”

The curative health insurance plan is based on the idea that people can save money if they enter preventative care early, and health insurance companies can, too. It is also based on the idea that providers can simplify the process without having to take downloadable or co-pay.

When insurance companies increase co-payments and deductions, people delay care, Turner said. “There’s a short-term drop in costs because people stop getting care, but they don’t stop getting care. They stop doing preventive things – mammograms, colonoscopies. Healthcare costs are rising again with everything they’ve put off…. They ended up in the ER and didn’t need to be there. “

Turner compares Curative’s health plan to Netflix. You pay one price each month and you have access to everything. In insurance, this monthly cost is that the employer pays part of it and the employee pays the rest of the monthly premium. For a single person, he estimates most of the monthly premiums for a single person will be among the following. 400 dollars with 800 dollarsComparable to other PPOs, as Turners said. Premium amounts are based on the number of previous insurance claims and risk factors each employer group has had. Family bonuses will vary more widely, Turner said, as some employer groups may have many employees with many children, and some may have very few children.

Insurance industry experts Texas and nationally declined to comment on definitive plans, but described Curative’s approach as unconventional in the industry.

To take advantage of non-stop, out-of-pocket and co-pay benefits, individuals must make an annual primary health care visit with Curative within 120 days of the start of the plan. After this period, if they have not made this base visit, then a $5,000 can be downloaded for one person or 10,000$ for a family. These numbers are doubled if the visit is with a non-network provider. As long as one of the parents does the basic visit, there is no deduction from the children.

“Design is a great financial incentive for preventive health,” Turner said. Said.

The baseline visit establishes that the person has their primary care physician and receives preventive care on a regular basis. If they are not present or have been absent for a while, they will be bled during the initial visit and connected to their primary care physician.

Even if they have recently seen a doctor, Curative will offer members some advanced diagnostics and a whole genome sequencing test that looks deeper into issues like cardiac risks to help a member and their doctor make more tailored healthcare decisions.

This test could help determine which drugs would work better for that person, what their genetic risks might be, and what inherited traits they might pass on to future children, Turner said. Genome sequencing is not required, but will be free for the patient and available for future use when making medical decisions.

“It’s all part of the long-term investment in the patient,” Turner said.

Currently, Curative has a maintenance network that includes: St David’s Health Care hospitals, Austin Diagnostic Clinic and Austin Regional Clinic. Members can also access a local physician via telehealth 24 hours a day, seven days a week.

Austin Regional Clinic He is excited to collaborate with his curative and innovative approach to health insurance.” Anas Dagestanpresident and CEO Austin Regional Clinic. “Providing access to high-quality, connected care has always been part of ARC’s commitment to our patients and communities, with a focus on keeping our patients healthy and helping them achieve their goals. Curative’s model is designed to do just that.”

If a member wishes to see a doctor outside the network, they will, like any other PPO, make co-payments and make a deduction for that office visit. However, if they can prove that there is no in-network option, or if the referring physician can claim that another doctor is medically unsuitable for that patient, that specialist will be covered as in-network.

The same is true for drugs. Curative has its own pharmacy that delivers to your home as well as uses. HEB pharmacies. Recipes are divided into tiers 1, 2 and 3. Tier 1 0 $ joint payment. Layer 2 50 Dollarsand Layer 3 $250. There is at least one Tier 1 drug for each type of medication, but members can take a Tier 2 or Tier 3 medication under Tier 1 if there is a medical reason why that medication will not work for the member.

If a person requests emergency care rather than an in-network hospital, they are still welcomed in-network. If they still have surgery scheduled, they must prove that it is medically necessary to be in that hospital rather than an in-network hospital to make the payment. 0 $ cost intranet rate.

Curative is currently negotiating with more healthcare providers and systems to reach agreements to expand its in-network staff. 1 January, when most people start new health plans. does not currently have Austin’s Level 1 trauma hospitals for adults or children yet in-network.

During this base visit, the health navigator the member meets will also review everything in the Healing plan as well as how to take advantage of everything not covered and link them to the services they may need.

The healer is also The Healing Commons in January 900 Congress Street. For its members there will be a fitness centre, classes and nutritional counseling.

Curative invested the first three years of expected costs for the wellness program. Turner said he used his own finances to do so. It has added 70 positions to launch its health insurance program and expects to add more as it grows.

Turner said Curative expects to make a profit from its health insurance in two to three years.

Editor’s note: This story was published on Wednesday. American-Statesmanbut we repeat it here because part of the story was skipped in some editions due to a manufacturing defect.

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