188: Saunacast: How We Took Control of Our Healthcare and Insurance (& Saved Money)

188: Saunacast: How We Took Control of Our Healthcare and Insurance (& Saved Money)

 
 
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Saunacast: How we Took Control of Our Healthcare and Insurance (& Saved Money)

It is no secret that we live in a world where we face a lot of potentially harmful things on a daily basis. From plastic exposure to all of the additives in our food system and even over-exposure to blue-light, our bodies face a lot each day.

These, and many other factors, may help explain why we’re seeing such a drastic rise in so many challenging health conditions that don’t respond to a simple cause>symptom>treatment medical model. In this Saunacast, Katie and Heather Dessinger share how they (and their families) have both faced unconventional health problems and the great lengths (and expense) it took to find results.

The Two Factors That Changed Everything

Katie’s struggle with Hashimoto’s and Heather’s family struggles with other health issues led them to a lot of research. This also set in motion a long process of trying to find doctors and practitioners within the traditional insurance model who understood the complexities of these conditions.

Eventually, frustrated by the inability to work within the system, they both considered an unconventional approach that finally led to answers (and to saving a lot of money in the long run!) Today, they share the system that has worked for both of them and how to customize this system to work for your family.

Concierge Medicine

Using a concierge model for a primary care doctor, both Katie and Heather were able to find a doctor who had the time and expertise to help with their health challenges. The benefits are that these doctors know their entire medical history and have fewer patients and more time for each patient. Having more time means these doctors actually have the bandwidth to research and specialize in specific conditions and challenges.

Thanks to technology, these doctors are available whenever they are needed via email, text, or video chat and can work with specialists in their local area when needed.

They each now pay a small monthly fee to have their doctor available whenever needed, and there are no additional copays, charges for talking to the doctors, or other unusual fees (other than external fees like labs, which are done through inexpensive local options).

Healthcare Sharing

The other piece that made their plan work was switching to health care sharing instead of traditional insurance. If you’re unfamiliar with the concept, here’s the basic gist:

Instead of paying money to an insurance company each month, they each now send money directly to a person or family who has a medical need that month. In the event that one of their families has a medical event or bill that meets the criteria, they submit the bill and other members send them checks to cover the bills. This has been really beneficial for several reasons:

  • This makes them technically “self-pay” in the eyes of most medical establishments. Many places offer a steep self-pay discount (80% in some locations) with an additional discount for paying that day.
  • Since health care sharing is substantially cheaper than insurance, they put the extra money in a savings account and use it if needed to pay a bill the day the charge is incurred to get the discount.
  • The entire amount is then reimbursed.

Katie and Heather both use Samaritan Ministries which is a Christian organization (though there are many different options that are reviewed in depth here). If you decide to check out Samaritan Ministries, let them know Wellness Mama referred you! A new organization called Knew Health is opening soon and is not faith-based but focused on those interested in being healthy (which also reduces health care costs).

But, What About the Costs?

Glad you asked. This was one of the biggest benefits of switching, besides the better health care and actually finding answers. Here’s an example…

Before switching to this system, Katie and her family were paying over $800/mo for insurance. This is when they were newly married and this amount was a large part of their monthly income, but since they were in the phase of life of having kids, they saw it as their only option. But it had a deductible of $5,000 and only covered 80% after that, so in any year with a medical event or a baby born, they came out of pocket over $15,000 (insurance monthly premiums + deductible + percentage they paid). And the insurance often didn’t cover the doctors they wanted to see, the type of birth Katie wanted to have, or many basic labs.

Comparatively, they now pay just under $500/mo for Samaritan, plus about $200/mo for them all to have access to SteadyMD. This works out to around $8,000 a year and they don’t end up paying any more out of pocket when someone breaks a bone, has a baby, or even has major surgery.

As an example, when Katie’s husband’s appendix ruptured years ago, leading to surgery and a long hospital stay the initial bill was over $132,000. The self-pay discount + paying up front got it down to around $12,000 which was entirely reimbursed by Samaritan and they didn’t end up paying out of pocket for it.

Will It Work for Everyone?

Short answer… no. But this combination may be a great option especially for certain types of people:

  • Entrepreneurs who will pay huge monthly premiums for independent insurance
  • Those who tend to focus on wellness and preventative care vs. visiting the doctor for everything
  • Anyone who prefers home birth but it isn’t covered by traditional insurance
  • Those who don’t use medical care often and prefer to save money

This is definitely an outside-the-box solution though options like this are becoming more available and more common. Anyone considering these should do their research, call, and ask questions and make sure that any plan or program is truly a good fit.

How about you? Do you have any experience with directing your own healthcare in this way? Ever used a healthcare sharing organization or concierge medicine? Please share your tips and experience in the comments!

Please take two minutes to leave a review on iTunes. I value knowing what you think and this helps other moms find the podcast as well!

Special Thanks to Today’s Sponsors

This episode is brought to you by Perfect Keto. I have heard from a lot of you who are trying the keto diet right now. And Perfect Keto has several products that make it so much easier and tastier. They have keto-friendly sports drinks with zero additives, zero carbs, and only high-quality ingredients. And I’ve gotten so many questions about this. They also have exogenous ketones that raise blood ketone levels up to 1.5 millimoles per liter. So that would be simulating a fast. A lot of people use these exogenous ketones to increase mental performance, and energy production, and fat burning without the need to do extended fasting. And Perfect Keto really just helps make ketosis available to everyone, everywhere, all the time without the need to do extended fasting, like I said. You can check out these and all of their other products at perfectketo.com/wellnessmama. And if you use the code HEALTHYMOMS, all uppercase, you can save 20% on any order.

This podcast is brought to you by Joovv. This is a super bright red light that I have in my bathroom and that I use daily to help my skin, hair and brain all be their best. Here’s the deal… we’re exposed every day to cellular stressors like blue light, environmental toxins and EMFs that can reduce how efficiently our cells work. Joovv combines red and near infrared light (without the heat of a sauna) in a single product that lets me combat the negative effects of the modern world (and combat wrinkles) in just a few minutes a day. I’ve talked to a ton of people who love this light as much as I do and say it has helped improve their skin and hair, tighten skin and even lead to better sleep and libido. It has a lifespan of 50,000+ hours so it will truly last a lifetime and it is one of the easiest things I do for my health. Joovv is third party tested and FDA approved and you can Check out the many benefits at joovv.com/wellnessmama and get a special gift with any purchase just for being a Wellness Mama podcast listener!

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Reader Comments

  1. Thanks for the great info! Your podcasts are always great! One question with health sharing–what about prescription medication coverage? Do the plans offer any assistance with prescriptions or reimbursement for that? Thank you and keep up the amazing work!

    • It will probably depend on what it is and the cost associated with it. Reach out to any of the companies mentioned to find out!

    • @Jen look into Good Rx. They have online coupons for just about any prescription. We have insurance, good insurance actually, and we found Good Rx when they wouldn’t pay for a prescription anymore. With insurance we paid $30. Without insurance we paid $116. Then we found Good Rx and paid $40. Same prescription, same dosage, same everything. I called them directly and asked all kinds of questions. They were super helpful.

  2. Great podcast and great timing! We have been paying so much money this year out of pocket – my husband’s company switched to a high deductible plan and it’s crazy. We’re starting to research other options and see if we can find something better suited for our family.

    I’m curious – what do you do for annual visits for your kids? Is that just part of the out of pocket expense you plan for?

    • We have a nurse practitioner in the family so we don’t do annual visits, but well-child visits or regular visits are not sharable so they are out of pocket. Only things over $300 can be shared, so annual visits would be things that we’d plan for as out of pocket expenses.

  3. I have appreciated your website and podcast for years— thanks so much for what you do. I know that insurance coverage can be painfully high and most of us feel like something has to change but my concern with an organization like Samaritan is that it doesn’t cover pre-existing conditions. I think we need to support healthcare that will include everyone. I totally understand how an organization like Samaritan would make so much sense for your family, and I love how you talked about the community aspect. What are your thought?

    • It will probably depend on what the condition is. Reach out to them and see…

      • At the moment we have good health insurance through my husband’s employer. I did look at their website and it says that pre-existing conditions are not covered, although there may be exceptions if someone hasn’t had symptoms for an extended period of time. My main concern is that I want to support health care models that are accessible to everyone— like my friend’s son who was born with a congenital heart condition for instance. It sounds like Samaritan is an insurance pool for healthy people, which unfortunately leaves a lot of people out.

  4. I am apart of Samaritan Ministries. Because of Samaritan, we’ve been able to publish in full, the home births of our 5 children. They’ve allowed us to use the healthcare we’ve decided is best for us. So pleased to be able to share with fellow Christians.

  5. That picture of Mommypotamus and the wellness mama in the sauna is so Cute! You guys are beautiful. And God bless you and your families. Thank you for making a difference in this world. I love you guys and wish I could jump right in one of those.

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