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Healthcare
Consumer Information |
Information
About
Medical Discount Plans
Definition
Many
individuals are without health insurance or are underinsured for
a variety of reasons. Medical discount plans have emerged as an
attempt to meet the needs of these individuals. Medical
Discount Plans are not health insurance. Most regulated
health insurance companies do not offer the discount plans, except
for specialized services such as prescription discounts. The companies
that do offer the discount plans are businesses formed to market
discounted health services for a monthly or yearly fee to the member.
The services for which they offer discounts range from medical,
dental, vision, prescriptions, vitamins, as well as other health
services. And most companies who offer these services state it clearly
on the policy that it is not comprehensive insurance.
How
the program works
Again, medical discount plans are not health insurance plans. The
plans do not, nor are they intended to, provide comprehensive healthcare
coverage. You, as a consumer, agree to pay the medical discount
company a certain amount of money each month or year. For payment
of this fee you are enrolled in a plan that will provide you access
to discounts for health care services or prescriptions if you go
to the doctor, medical care facility, hospital, or pharmacy (provider)
that has a contract with the discount plan. The provider has agreed
to accept a lower payment from the medical discount member. The
discount is usually a percentage of the provider’s regular
fee.
For
example, a person will pay XYZ Care Plan $10.00 per month for access
to discounted dental services. The particular dentist visited has
agreed to treat XYZ’s members and to charge them 20% less
for certain services than the amount charged to other patients.
If you, as a member, go to the dentist for a regular cleaning, then
you will receive the discount for the service. However, if the regular
fee is $60.00, and the dentist has agreed to accept 20% less, then
you, not the medical discount plan, still must pay that discounted
fee of $48.00. The plan does not reimburse the dentist the difference
between the regular fee and the discounted amount that you paid.
The provider has usually agreed to participate with the plan to
increase patient numbers and because they hope to increase their
cash flow in return for giving a discount to the plan member.
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Advantages
-
Some individuals sign up for these plans to help augment
a high deductible insurance policy. If your health
insurance policy has large deductibles you must pay before the
insurance company will pay, you can buy a membership in one
of these discount plans to get more services for your out of
pocket expenses.
-
If
you have no insurance, either because you don’t qualify,
your employer doesn't offer coverage, or the coverage is too
expensive, you can decrease what you pay for necessary health
services through the medical discount plan.
In this way, you can increase the amount of services you can
purchase with a limited amount of money.
-
Some
medical discount plans do not have a pre-existing condition
exclusion. Often when you have had a recent health
problem and try to purchase health insurance, you are turned
down because you have been previously treated for a health condition
or still have the problem. You are unable to buy health insurance.
Some of the discount programs do not care if you already have
a health problem or have been treated for one in the past. They
will still let you enroll in the plan, since they are not paying
for any of the services, only guaranteeing discounts for their
member’s services.
Disadvantages
- Most
plans require a credit card payment for the membership fee or
an electronic funds transfer. If you do not have or do
not want to use either of these methods, they may not accept you
as a member.
- Some
plans require that the patient have had no healthcare expenses
for a previously determined amount of time. For example,
the plan may require that the person, either you or a family member,
enrolling in the discount plan not have seen a doctor for at least
a year. Plans vary widely on this particular form of requirement.
- It
is difficult to determine if the providers in the discount health
plan network are truly offering discounts. For example,
if you price prescriptions at various pharmacies, you may be able
to buy the prescription at a nonparticipating pharmacy cheaper
than the discounted rate at the participating pharmacy. You should
still compare services and prices in order to determine if you
truly are getting a discount.
- You
must be sure you are saving in provider fees more than you are
paying for the annual membership fee for the plan to give you
any true savings. If you are paying more for the annual
membership fee than you save in discounts from providers, then
this is not a good deal for you. For example, if your annual fee
is $500 and you have two visits to the doctor over the course
of the year, and the doctor discounts 20% off his office visit
fee of $60.00, the annual savings is $24.00. You have paid $500
to save $24.00. Unless you are fairly sure you will save at least,
if not more, than the fee charged for the discount plan, you should
not sign up for a medical discount program.
- If
you enroll in the discount plan, you may not be able to continue
seeing your current physician in order to receive the discount.
The physician, pharmacist, optometrist, hospital, etc. must have
signed an agreement with the discount plan in order for you to
get the discount.
- You
need to thoroughly check the background of the provider that has
agreed to accept the discount. Providers join the plan
to increase their business. Perhaps they are just new to the area
or are just starting their own practice and want to have access
to a large client base. However, you, the consumer, need to be
vigilant on your own behalf since the medical discount plan is
not required by law to prescreen the providers they have participating
in their plan.
- REMEMBER
THESE MEDICAL DISCOUNT PLANS DO NOT TAKE THE PLACE OF COMPREHENSIVE
HEALTH INSURANCE PLANS.
Consumer
Advice: We encourage consumers to
purchase health insurance plans through our partners. They only
provide quotes from the best licensed health insurance companies.
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health insurance quote
However,
if you are just unable to afford regular health insurance, medical
plans are a reasonable alternative to paying the high costs
of healthcare services. If interested ...get
FREE MEDICAL DISCOUNT QUOTES
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