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.
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).
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!
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Special Thanks to Today’s Sponsors
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