US Healthcare Resources and Shopping Services:
Whether you buy individual health insurance, get coverage through an employer group plan or from the government, healthcare in the US is EXPENSIVE. It takes a little effort on your part to make sure you are getting the care that you need at a reasonable (fair) price.
To help you with that effort I have put together the following list of online healthcare shopping tools and resources. They include sites to help you shop for the best price (or fair price) on all different types of healthcare. There are also providers offering deeply discounted prices on multiple different types of care.
You will find multiple different services in the following categories:
- General Shopping and Pricing Services
- Outpatient Physician Visit Services
- Urgent Care and Walk In Clinics
- Surgery Resources and Shopping Services
- Prescription Drug Savings Tools
- Lab & Blood Work Savings Tools and Resources
- Imaging (e.g. MRI and CT) Savings Tools and Resources
- Outpatient Mental Health Services
- Bill Review/Negotiation Services
- Patient Advocacy Tools and Resources
- Air Ambulance Subscription Services
Please take some time to read through this document. Then keep it handy with your other plan documents. Pay specific attention to my Personally Recommended resources. Also check out those services that are listed as NEW.
I believe that if you refer to the resources listed below prior to receiving care, you can save time and money.
There are two “general rules” to keep in mind when looking to get the best care at the lowest possible price:
1. Hospitals are the MOST expensive place to receive certain types of care – While hospitalization is necessary for certain types of care, there are several services where receiving care on an “outpatient” basis will save you BIG money. Some examples include: Elective Surgery, Imaging Services (X-Ray, CT, MRI, etc.), Lab/Blood work.
2. Avoid the Emergency Room if at all possible – Again, sometimes the ER is unavoidable, but far too often people go to the ER for treatment that is NOT a true emergency. The ER is far and away the MOST expensive place to get treated! Two articles that back this up are here and here. You should utilize ALL resources available to you before going to the ER. If possible, consider Urgent Care or your primary care doctor first.
Keep the above rules in mind as you review the following tools and resources. Also, in all the following service categories I try to provide the most recommended website at the top. However, I always recommend that you do comparisons from several of the sites for each specific care situation:
General Shopping and Pricing Services:
Healthcare Bluebook – Healthcare Bluebook helps patients determine what a fair price should look like for most types of healthcare services. You can see how they breakdown the fair price and what it includes. Then you can print an agreement to take to a provider to see if they will accept the fair price. Simply enter the type of healthcare service in the search bar to see the results.
IMPORTANT NOTE: I encourage you to look up costs in advance for hospital and emergency room treatment. Type “hospitalization” in the search bar to see pricing for many different care situations. Also, type “emergency room” in the search bar and note the range of fair prices from minor to major types of situations.
State of Washington Only - All-Payer Claims Database - Washington State's All Payer Claims Database gives the public access to accurate cost predictions for a selection of health care procedures by combining the actual costs from more than 55 health insurance companies.
MDSave Personally Recommended – MDSave runs an online marketplace where people can buy the healthcare services they need for a pre-negotiated price. Anyone can use MDsave. The price is the same with insurance or not. MDSave shoppers can self-file the service with their insurer to have the payment count toward their deductible.
The marketplace is searchable by procedure and location. It shows the average MDSave price versus a national average as well as the range that MDSave shoppers can expect to see. MDSave contracts with the providers on pricing so there’s no balance bill or surprise down the road and all of the clinicians involved in the procedure are included in the price.
NOTE: Right now MDSave is in about half the country with a concentration in the Southeast and Texas, where it rolled out its platform. Here is a map with a list of providers by state. On their website they have a brochure that you can download and forward to providers in your area. Doing this can help them expand their program across the country.
Healthcost NEW – HealthCost allows any consumer to understand the components that typically make up common healthcare services and show what these components will cost in an itemized manner. They will show who performs the service you are looking for in your search area and how the total cost varies by location of service, facility type, and doctor selection. Their focus is to provide transparent cost and quality tools to empower you during your healthcare decision making process.
Providers must agree to post HealthCost Rates that they would be willing to accept from any private pay patient who wants to utilize your services.
Shopping Comparison Tip: When you drill down to the prices for the services and providers on this site, they also give you the current Medicare reimbursement rate. This can help you in negotiating “cash pay” rates for specialist doctor visits of all types. Also on the surgical procedures you can see how much above Medicare rates that they charge. This information can be especially helpful if you have a Fixed Benefit plan and/or high deductible Short Term Medical plan as part of our alternative health plan packages.
Pratter Personally Recommended – Pratter is a medical-cost savings and transparency company that aims to empower consumers to save thousands of dollars per year by searching and comparing prices for 600 of the most common outpatient medical cost items…including 1) blood work, 2) imaging studies, such as x-rays, MRIs and CTs, 3) elective medical procedures, such as a colonoscopy or carpal tunnel surgery, and 4) doctor visits.
Pratter’s recently updated Money Map now lists the better priced Urgent Care, Imaging, Blood Work and Outpatient Surgery centers from all major insurers and PPO networks nationwide.
***IMPORTANT NOTE: Pratter is NOT a free service. They charge a very low $5/month for a one year minimum or $52/year up front. I have used their services and I think this is a tool worth having. If you are interested in signing up, let me know and I can provide you with a code for 10% off the prices listed here.
Pricing Healthcare- Pricing Healthcare is a completely open, independent, online marketplace for direct-pay healthcare. Their aim is to bring visibility to healthcare prices and make paying for healthcare simpler and more direct. Providers of all types can advertise bundled, cash-pay procedures, without putting contracted or government relationships at risk. They believe this will do more to lower costs and improve the quality of U.S. healthcare than anything else.
Personally Recommended - Sign up for a FREE account and explore providers and charges in your area and all around the country.
Free Market Medical Association - The FMMA is dedicated to bringing together BUYERS and SELLERS. Matching a willing buyer with a willing seller of valuable healthcare services is the goal of everyone involved in this movement. They help identify patients willing to pay cash, doctors willing to list their prices, businesses attempting to provide affordable quality insurance, and providers/services/and patient advocates that are helping make everything work.
SEARCH TIP: To search for all member providers and the services they provide, click here: https://fmma.org/shophealth/. Leave the search box blank and click “Search.”
New Choice Health– NewChoiceHealth.com is a free, consumer-focused healthcare marketplace where consumers can shop for common medical procedures. Users can obtain medical provider specific pricing, service, and quality data for common medical procedures and connect with their network of Certified Medical Providers to compete for their business.
FAIR Health – Fair Health is a national independent, not-for-profit corporation whose mission is to bring transparency to healthcare costs and health insurance information through comprehensive data products and consumer resources. FAIR Health uses its database of billions of billed medical and dental services to power a free website that enables consumers to estimate and plan their medical and dental expenditures.
Guroo – Guroo.com was created by the Health Care Cost Institute (HCCI), an independent, nonprofit research organization. Guroo is powered by claims data contributed by some of the nation's key health insurance providers. Consumers can identify the low, average and high prices within each market, including all services to treat certain conditions, which they call “Care Bundles.” You can search by body part or by condition.
MediBid – Medibid is an online marketplace which is about quality, choice and value. Patients can post the medical services they need, and providers bid for their business. The cost is $100 per bid. By getting doctors and facilities to name their prices in advance, providers know they must be price competitive or the patient will go elsewhere.
Medibid’s Cost Calculator gives a sampling of some of the savings they have been able to provide for various procedures and surgeries.
Clear Health Costs – They are a journalism company from New York City bringing transparency to the health care marketplace by telling people what stuff costs. With data from different sources – from their independent reporting, from health-care providers, from participating consumers and from databases – they are working to shed light on health care pricing.
The easiest way to use this site is by entering information (by name or code) for a healthcare procedure in the “FIND PRICES” search tool at the top of all pages on their website. If they don’t have specific costs in your area, they will provide the Medicare reimbursement price, which you can use to determine fair pricing.
There is also a HUGE amount of great information and resources by state and at the federal level under the Useful Links page on their website.
Outpatient Physician Visit Services
When you need to see a Primary Care Physician or Specialist, you can use several of the services in the General Shopping and Pricing Services section (above) such as MDSave, Pricing Healthcare, HealthCost and others to help you find a doctor. In addition, where available in your area, you can use the following alternatives:
HEAL NEW - Heal believes in making healthcare a more personal and convenient experience by creating a more efficient doctor’s office in your home, that inevitably improves healthcare outcomes. Through the touch of an app or a click on their site, a highly-vetted, qualified medical doctor will arrive at your door, twelve hours a day, 365 days a year. The cost of a visit is $159 without insurance. If you have insurance, depending on your specific plan, the cost could be less.
Heal is in-network with many PPO insurance companies (including Aetna, Cigna, Humana, United Healthcare, Anthem Blue Cross of CA, Blue Shield of CA, Regence Blue Shield and others) as well as Medicare.
Heal continues to grow with service in multiple markets in California. They also offer services in Atlanta, GA, New Jersey, New York, NY, Washington D.C./Northern Virginia, Seattle and Spokane, WA. Here is a link to the most current list of locations.
Urgent Care and Walk In Clinics
Urgent Care centers and walk in clinics are another good lower cost option to treat certain healthcare issues. As noted above, an urgent care center is a much more affordable option than the emergency room for care that is NOT life/limb threatening. Similarly, walk in clinics can be a good, affordable alternative to going to your primary care doctor for certain minor issues.
IMPORTANT NOTE: In a recent email from my friends at Pratter (see Personally Recommendedabove) point out that some urgent care centers are owned by hospitals. They often charge a “facility fee” of about $150, in addition to the doctor fee of $150. Also, some urgent care centers use emergency room (ER) billing codes instead of regular doctor visit codes, making your visit way too expensive. Pratter has interviewed every urgent care center and reviewed their websites across the USA. So, their money map will only list those that will charge a fair price.
CVS Minute Clinic – MinuteClinic, the walk-in medical clinic inside select CVS/pharmacy® stores, is the largest provider of retail health care in the United States.
Their family nurse practitioners and physician assistants provide convenient, quality medical care to adults and children. They are open every day, evenings and weekends, with no appointment needed. They accept most insurance plans as well as offering cash pay pricing.
Concentra Urgent Care – Concentra, a division of Select Medical, is a national health care company focused on improving the health of America’s workforce, one patient at a time. Through its affiliated clinicians, the company provides occupational medicine, urgent care, physical therapy, and wellness services from more than 520 medical centers in 44 states. In addition to these medical center locations, Concentra serves employers by providing a broad range of health services and operating more than 140 onsite medical facilities.
State of Washington Only - Care Clinics – In Western Washington Kaiser Permanente and Bartell Drugs have teamed up to operate these walk in clinics inside 15 Bartell Drug stores. They accept most major insurance or you can have a visit for $89 as a self-pay patient.
DispatchHealth – DispatchHealth is bringing back the house call with a modern technology twist. DispatchHealth gives patients ways to access convenient, high-quality acute care in the comfort of their home, office or in the location of need. DispatchHealth’s providers are board-certified physicians, physician assistants and nurse practitioners with significant experience evaluating acute injuries and illness in the emergency department.
DispatchHealth can treat just about anything that can be seen in an urgent care center and a few more things. Examples include respiratory infections (such as bronchitis, croup), sinusitis, sore throat (strep, mono), urine and skin infections, minor trauma (sprains, minor breaks), lacerations, nosebleeds, asthma attacks, allergic reactions, vomiting/diarrhea, inability to urinate, constipation and dehydration.
DispatchHealth visits typically run between $150-$300 and the percentage of the total bill you’re responsible for is determined by your insurance plan. If patients are uninsured, DispatchHealth accepts a flat rate of $275 at the time of treatment via credit card. This flat rate is for everything that we do, which includes medications delivered, procedures performed, and any lab tests obtained.
DispatchHealth offers their services in multiple states. Here is a link to the most current list of locations.
The following are a couple other sites that I found which list multiple locations for urgent care and/or walk in clinics:
NeedyMeds – NeedyMeds is a national non-profit organization that maintains a website of free information on programs that help people who can't afford medications and healthcare costs. We regularly update data on over 9,000 assistance programs, 15,000 free/low-cost/sliding scale clinics and nearly 1,500 drug discount coupons.
SolvHealth – Solv helps you find nearby convenient care in a way that fits your life. Whether you're seeing your doctor, pediatrician, dermatologist or chiropractor, their practice will be equipped with the latest in technology that not only improves the quality of your health, but also the quality of your service.
Surgery Shopping Services:
As noted in the General Rules at the top of this document, for most non-emergency (elective) surgeries you can save BIG by having the surgery done on an outpatient basis. The bulk of that savings is from having the surgery performed at an Ambulatory Surgery Center (ASC). ASCs focus on outpatient surgeries. The patient must be ambulatory and released within 24 hours.
NOTE: Claims data indicate that services provided through an ASC average $6,700 LESS per procedure (or about 81% less) for outpatient surgical services when compared to the same services provided through a hospital outpatient setting.
CMS Medicare Price Tool - Procedure Price Lookup provides Medicare patients with price differences for some surgical procedures in hospital outpatient and ambulatory surgery center care venues.
SEARCH TIP: This website can be an important tool in your search for the most affordable outpatient procedures, because knowing the Medicare reimbursement rate for the treatment/service(s) you need gives you a starting dollar amount when negotiating a cash/private pay rate with a provider.
Surgery Center of Oklahoma – The Surgery Center of Oklahoma is the original and still a leader in providing fully transparent pricing on a wide range of surgical procedures.
NOTE: In addition to the resources in this section, there are resources under the General Shopping and Pricing Services section (above) such as MDSave, Pricing Healthcare, HealthCost, Pratter and others which provide locations and pricing for specific providers offering various surgical procedures.
IMPORTANT NOTE: Please go to: Ambulatory Surgery Centers (ASC) That Post Prices Online for a list of ASCs that I have found around the US which offer all-inclusive “cash pay” pricing posted right on their website.
Prescription Drug Savings Tools
Drug Mart DirectBest Prices– DrugMartDirect.com™ is not itself a pharmacy, but a prescription referral service that provides you with direct access to affordable prescription drugs. Our order processing center is located in central Canada and serves both American and international customers.
PharmStore Next Best– Whether your needs are for prescription or nonprescription medication, PharmStore provides its customers with the opportunity to purchase a large range of safe, affordable medication from pharmacies all over the world. Pharmstore.com™ is not itself a pharmacy, but a prescription referral service that provides you with direct access to cost effective prescription drugs. Their order processing center is in central Canada and serves both American and international customers.
GoodRx – Every week GoodRx collects millions of prices and discounts from pharmacies, drug manufacturers and other sources. Use GoodRx's drug price search to compare prices (just like you do for travel or electronics on other sites) for your prescription at pharmacies near you. They don't sell the medications, they tell you where you can get the best deal on them. GoodRx will show you prices, coupons, discounts and savings tips for your prescription at pharmacies near you.
CleverRx NEW – CleverRx is an invite only app with the prescription drug savings built in. CleverRx is aiming to compete directly with GoodRx and offer better pricing than GoodRx at least 50% of the time. Therefore, if you need a prescription filled, check the website and/or download the mobile app so you can compare their prices with GoodRx and others. If the Clever Rx price is best on your prescription at one of the local pharmacies they work with, go with them.
Personally Recommended From your mobile device Download the Clever Rx app!
Pharmacy Checker NEW – PharmacyChecker helps people find the lowest prices on prescription medication among licensed U.S. and international pharmacies. We are the only independent company monitoring and verifying the credentials of international online pharmacies and comparing prices of the prescription drugs available from these licensed pharmacies.
Total Care Mart NEW – TotalCareMart.com™ is not itself a pharmacy, but a prescription referral service that provides you with direct access to affordable prescription drugs. Our order processing center is located in central Canada and serves both American and international customers.
Blue Sky Drugs NEW – BlueSkyDrugs.com is a leading British Columbia, Canada based online generic pharmacy which provides generic prescription drugs and over-the-counter medications to customers around the world. BlueSkyDrugs.com has fulfillment partners in a number of countries around the world. These include Singapore, Turkey, Mauritius, India, the United States and the United Kingdom.
WellRx – ScriptSave WellRx is brought to you by Medical Security Card Company, LLC, the trusted prescription discount leader at more than 62,000 pharmacies nationwide. You can use ScriptSave WellRx to shop for discount pricing on any brand name or generic prescriptions.
OneRx – We are on a mission to reduce health care costs for Americans by putting real-time prescription savings at everyone’s fingertips. How? We make it easy for the almost 70% of Americans who take prescription drugs to access comprehensive information on drug-specific co-pays, and accurately compare costs & money-saving options.
Blink Health – Their mission is to make prescription medications available at lower prices to millions of people across America. They have developed a proprietary technology to group millions of patients together, creating the strength to negotiate the lowest drug prices possible. They allow patients to purchase their medications online and pick them up at their local pharmacy.
RxCut – This pharmacy price search is tightly integrated with Google Maps making it faster and easier to find the lowest price and pharmacy information. You can easily search across multiple pharmacies and medications to find the lowest prices in your area!
Rx ‘n Go – Rx ‘n Go™ is a prescription medication savings program that delivers up to a 90-day supply of your generic maintenance medications right to your doorstep.1 The Rx 'n Go covered drug list contains more than 1,100 generic medications across four flat-fee pricing tiers, and nearly all major chronic conditions are covered. If you are looking to save money on your monthly prescription costs, compare us to your current prescription costs. Rx 'n Go is available to anyone with a valid prescription. There are no enrollment or membership fees, no income restrictions, and no pre-qualifications or lengthy applications.
Honeybee Health NEW – Honeybee Health is an online pharmacy based in California. They sell primarily generic medications. They have a subscription model for $10.99/month, with a FREE 30-day trial.
Supplemental Prescription Benefit Plan:
For those people who take high cost generics and/or specialty maintenance medications that cost several hundred up to many thousands of dollars per month, Shared Health Alliance (SHA) has very affordable supplemental benefits.
Please refer to the US Supplemental Coverage page for information on the SHA plans that include prescription drug coverage.
Lab & Blood Work Savings:
Lab and Blood work (aka blood tests) are an area where you can get hit with a BIG out of pocket expense, if you aren’t careful. In addition to avoiding the hospital, you also need to be aware that often your doctor will want to do a blood test as part of an office visit. They will then take your blood sample and send it to whichever lab service they prefer without regard for what it could cost you. If your health plan doesn't cover lab/blood work with just a copay and you have to pay your annual deductible first, you could be hit with a BIG bill.
Savings Tip: If your doctor wants you to have ANY type of blood test, DON’T let them draw your blood at that visit. Instead, ask them to write down the names of the specific test(s) that they want done. Then, go to one (or more) of the following resource sites and find the best price for the test(s). Go have the test done and have the results sent to your doctor for their review.
Direct Labs Personally Recommended –DirectLabs®is the leader in direct access laboratory testing. They offer a wide variety of important health and wellness blood chemistry tests directly to you online at extremely discounted prices. They use Quest Diagnostics labs. Confidential results are available online in as little as 24 hours for most tests.
The easiest way to search for and order tests is to go to the Order Tests link under “How It Works” on the home page. Search for the test(s) you need. Click “Add to Cart.” The first time you will register to create your account and complete check out and payment. For future tests login to your account and order directly.
If you don’t want to order online, the other option is to call the number on the home page and provide the code R-USIN.
Savings Example 1: I recently talked to a woman that told me she gets two lab tests twice a year for hormone related issues. Those tests cost her a total of $2,600 and are not covered by her high deductible health plan. I looked her tests up on Direct Labs and the total cost for both is $300. I was able to save her $2,000 per year on these tests!
Savings Example 2: Another client told me that they were billed over $1,100 for “preventive” lab work for their daughter. A complete Wellness Panel test with Direct Labs is $97!
Savings Example 3: A Client in FL who was looking at alternative plans was told by their doctor that preventive visit blood work could run around $600. Again, compared to the Complete Wellness Panel test with Direct Labs for $97!
Walk In Lab – Walk-In Lab's mission is to provide affordable direct-to-consumer testing, the convenient solution for all medical laboratory needs. Committed to operational excellence with an innovative approach, Walk-In Lab offers a wide array of lab tests with or without a physician's referral, empowering individuals to take control of health care costs while monitoring their overall health.
Discounted Labs – DiscountedLabs.com was founded by frustrated self-reliant health advocates that needed more economical access to lab tests. They provide you with a doctor's prescription for your blood tests (every order is reviewed by a clinician). They are also committed to educating people about what blood tests mean via our blog and education pages. They also keep their blood test menu concise and simple so that you can find what you need faster. To make it easy for you, they have also created common blood test panels ordered by physicians for different conditions.
Grassroots Labs - Grassroots Labs is a health care technology company that connects individuals, employers, nonprofits and other health care consumers to affordable clinical laboratory testing (a.k.a. blood tests needed when seeing the doctor). The Grassroots Labs platform allows customers to purchase blood tests from major clinical laboratories at a steep discount. Their mission is to bring transparency, convenience, and cost savings to purchasing blood tests, all the while maintaining standards of care.
Every order placed on the Grassroots Labs store is assessed a processing fee of $28. This fee covers the online infrastructure and processing time needed to complete your order and get your test results to you quickly and securely.
***Can’t provide services to anyone under 18 at this time
Any Lab Test Now – ANY LAB TEST NOW® is an alternative lab testing provider for those who are conscious about the cost of their lab tests due to high deductible insurance or their health savings accounts, as well as those who have no insurance.
Fair Price Labs – Fair Price Labs is another alternative lab testing service provider. Their goal is to provide you with “fair prices” on your lab/blood work. They offer several individual tests for $15.
EverlyWell – EverlyWell is placing the lab testing process into your hands. With their convenient at-home sample collection process and your results delivered to you on their secure platform in just days.
Pratter – See the information above under the General Shopping and Pricing Services about this shopping and price comparison tool for lab and blood work.
MDSave - See the information above under the General Shopping and Pricing Services about this shopping and price comparison tool for lab and blood work.
Supplemental Lab & Blood Work Benefit Option:
Please refer to the US Supplemental Coverage page for information on the WellMEC SelectMed Pro plan that provides 5 combined X-rays and lab/blood tests for just a $25 copay at providers in the First Health PPO network. Of course, this plan also includes 100% preventive care coverage (per ACA guidelines) AND 5 combined primary care, specialist and urgent care visits for just a $25 copay each.
Imaging (e.g. MRI and CT) Savings Tools
Savings Tip: As noted in the General Rules at the top of this document, you can save big on Imaging services by staying OUT of the hospital! Going to a “free standing” Imaging center is a much more affordable place to get this work done. Claims data indicate that services provided through a freestanding imaging center average $1,600 less per procedure for imaging services.
Resource Usage Tip: I received an email from a client about a claim for a routine mammogram screening. She sent me a copy of the bill for a Digital Bilateral Mammogram Screening. The place she went charged $904! Here is how this client could have received the same service and saved 60-80%:
1. Start at Healthcarebluebook.com (above). Here she could see that a fair price range would be $218 to $306 for a 2D or 3D screening mammogram
2. Go to MDSave (above). Here she could find a provider that was only an extra 10 miles from where she went that quoted $264 (2D) and $320 (3D) for screening mammograms.
3. For a second quote go to Green Imaging (below). Green Imaging has a facility that is an 13 miles from where she went. She could request a specific quote, but they offer rates for screening mammograms starting at $125!
Those 3 easy steps could have saved this client $600-700 or more!
Please review the following resources if you ever need any type of imaging done:
MDSave - See the information above under the General Shopping and Pricing Services about this shopping and price comparison tool for lab and blood work.
Green Imaging Personally Recommended – Green Imaging is a group of board-certified radiologists who help patients make the most informed decisions about a wide range of imaging services. With Green Imaging you can save 50% to 80% on out of pocket costs for MRI, CT, ultrasound and other imaging services. They have locations around the country. Check their website to see if there is one near you.
Savings Tip: If you go to Green Imaging and let them know you are a Philadelphia American Life policyholder, they will give you a cash pay price that is discounted 30% off their already low prices!
Supporting Article: Buyer Beware: Overpriced Diagnostic Imaging Centers
Radiology Assist NEW – Radiology Assist is a nationwide program committed to making healthcare affordable and transparent. They specialize in providing affordable diagnostic imaging such as MRI, CT scans, Ultrasound, Mammograms and X-rays to self-pay patients.
Magnetic Imaging Services – Magnetic Imaging Services is one of the largest radiology services companies in the United States. The management team at MIS has been involved in medical imaging since 1963. This expertise has shown MIS can save you, the consumer 40-70% on MRI, CAT Scans, X-Rays and Most other Imaging Procedures. Their network of affiliated PPO physicians and providers has over 1200 locations Covering 42 states. To get a quote, find a location and schedule an appointment, just call 1-800-894-4674.
Colonoscopy Assist – The Colonoscopy Assist program promotes colon cancer screening among the uninsured (and cash paying) communities. The program focuses on removing financial barriers to CRC screening. They work with board certified doctors and accredited surgery centers. Financial assistance is provided to patients unable to afford the tests The following tests are provided at heavily discounted all-inclusive rates:
1. Colonoscopy - $1075 - $1275 (depending on location)
2. Upper (GI) Endoscopy - $975 - $1275 (depending on location)
3. Cologuard - $599
IMPORTANT NOTE: For those who have the Philadelphia American Life or Manhattan Life Fixed Benefit plans and have chosen NOT to add either the Enrollment 1st SelectMed Base or SHA Preventive plans to their health plan package, this service can help ensure that you get the best price and care for routine colonoscopies.
Pratter – See the information above under the General Shopping and Pricing Services about this shopping and price comparison tool for Imaging services.
MDSave- See the information above under the General Shopping and Pricing Services about this shopping and price comparison tool for lab and blood work.
Telemedicine services are now included in most health insurance plans. You should check the details of your current health insurance plan to see if you have a telemedicine benefit, and whether there is any cost to use it. The following are telemedicine options that are available.
Teladoc – Teladoc is included in both of our fixed benefit plans from Philadelphia American Life and Manhattan Life at no additional cost. There is no cost to use this service that is included in the fixed benefit plans. It can save you time and money not having to go to the doctor’s office when you have a simple illness like cold or flu. Physicians are available by phone or Skype 24/7/365.
Additional programs that offer more advanced services are available for a small additional cost as follows:
United Concierge Medicine NEW – United Concierge Medicine provides virtual emergency medicine with a personal touch. 24/7/365. UCM provides virtual treatment and triage with ER experts via phone, video and picture to employees and dependents. They can diagnose, prescribe medication, order labs and imaging, make referrals and triage any and all conditions. They also follow up with 100% of their patients. They accept all patients, not just a select few conditions. Simply download the UCMnow app for your iOS or Android device and one touch gets you access to a health care provider.
Whether you have a minor medical problem like cough or cold, a serious concern like an injury, or just need some compassionate medical advice, we can help.
· Emergency Medicine Treatment and Triage Expertise
· Phone, Video and Picture Consults with our emergency medicine team
· Diagnosis, treatment, triage, prescriptions, order labs, imaging, make referrals and follow up with our patients to track recovery.
The Cost to join is $12/month for individuals and $14/month for a family. Groups of 2 or more can join for $8 per employee per month. Individuals can sign up directly at the link above. If you are interested in signing up a group, please contact me directly for instructions?
Check out this short animated video about our services
Freshbenies – Telemedicine services is one benefit included. Please refer to the US Supplemental Coverage page for detailed information on all services provided by Freshbenies.
Outpatient Mental Health Services:
One of the coverage areas where alternative health plans are NOT required to comply with ACA/Obamacare mandates is for outpatient mental health services.
Even though these services are NOT covered under non-Obamacare alternative health plans, I have found a few telehealth providers for outpatient mental health counseling services as follows:
TalkSpace - TalkSpace is a behavioral telehealth provider. Talkspace offers:
- A comprehensive behavioral health solution including outpatient therapy and psychiatry
- National network of approximately 4,000 behavioral health providers across all 50 states
- Live video appointments with in-app scheduling
- Personalized provider match with a dedicated therapist relationship
- Text messaging with providers – anytime, anywhere
Breakthrough by MDLive – Breakthrough is an online/telemedicine service for counseling and mental health treatment. With Breakthrough a person can search for a therapist or psychiatrist by location, provider type, insurance or specialty. The person can message any therapist initially to see if that therapist fits with the person’s needs. Once an acceptable therapist is found, the person can sign up, book an appointment and talk to the therapist.
Remedy.me – Board Certified Primary Care Physicians. Licensed Mental Health Therapists. Available to you 24/7/365, Nationwide. Cost is $29/month for an individual.
Bill Review/Negotiation Services:
Experts estimate that between 30% and 80% of medical bills contain errors that increase costs. There are many different causes of these errors, including the use of the incorrect billing codes and use of out-of-network healthcare providers. Therefore, the following services are provided to help you with reviewing bills for high cost services.
Karis360 – Karis Bill Negotiator serviceis included in both of our fixed benefit plans from Philadelphia American Life and Manhattan Life at no additional cost.
The following are provided as additional resources:
Medical Cost Advocate – Medical Cost Advocate provides health care cost reduction solutions to benefit consumers. Medical Cost Advocate is the expert source to validate billing accuracy, negotiate medical bills and regain control over your health care costs. They can reduce your medical bills after services are performed or reduce your procedure price before services are performed.
· Before Treatment - Let professionals handle the finances so you can focus on your health. MCA experts will negotiate the best possible price and payment terms for a procedure, UPFRONT. They will help you understand how much you will owe. Solidify price, terms and scheduling.
· After treatment - Medical Cost Advocate will negotiate medical bills as long they exceed the $300 minimum. Medical Cost Advocate will charge no upfront fee for medical bills assistance. If there are no savings on medical bills, you pay nothing. If there are savings, Medical Cost Advocate will charge 35% of such savings to your credit card or debit card.
MedBill-IQ – MedBill-IQ helps people reduce their out-of-pocket healthcare expenses through reviewing and negotiating medical bills. The services are free if they cannot help save you money. If they can save you money, their fee is 30% of the amount that they are able to save.
CoPatient – CoPatient helps people reduce their out-of-pocket healthcare expenses through reviewing and negotiating medical bills. For most everyone, the Basic – service is free to submit bills for review and if they can save you money, their fee is 35% of the amount that they are able to save.
Patient Advocacy Tools and Resources
Karis360 - Karis Healthcare Navigator service is included in both of our fixed benefit plans from Philadelphia American Life and Manhattan Life at no additional cost.
The following are provided as additional resources:
Patient Advocate Foundation – A national 501 (c)(3) non-profit charity that provides direct services to patients with chronic, life threatening and debilitating diseases to help access care and treatment recommended by their doctor.
National Association of Healthcare Advocacy Consultants – The NAHAC is a non-profit that dedicated to the development of healthcare advocacy as a profession. For the consumer, they offer a search engine for all of their patient advocate members that you can use to find an advocate in your local area.
Related Articles: WHERE EMPLOYER HEALTH BENEFITS ARE HEADED
Air Ambulance Subscription Services:
This is an area of healthcare services that seems to be completely overlooked and even people covered by the “best” employer group plans can be left with huge bills.
NOTE: I have personal experience with this when an employee of one of my group clients had an accident that required him to be taken by air ambulance to a specialty provider. The air ambulance company billed him $66,499!
If you ever have an emergency that requires you to need an air ambulance transportation, having one or more of the following programs could save you BIG money and hassles!
Domestic and International Option:
Medjet Assist – MedjetAssist® is the premier air medical transport membership program for business or personal travel for both domestic and international travelers. They have two plan options and you can choose to purchase either option for a short-term trip or an annual membership. The plan options are as follows:
· MedJetAssist plan - If you are hospitalized 150 miles or more from home, Medjet will arrange air medical transport to the hospital of your choice — regardless of medical necessity. Short-term travel up to 8 days is $99/individual, $199/family. If you travel more than 15 days/year, an annual membership is a better value. Individual annual memberships start at $189 for domestic travel and $295 for domestic + international travel. Family annual memberships start at $325 for domestic travel and $399 for domestic + international travel.
· MedJetHorizon plan – Offers all benefits of the MedJetAssist plan, PLUS: Emergency Medical Cash Advance, Ground Ambulance & Specialty Hospital Transfer under 150 miles and 24/7 Travel Security and Crisis Response benefits. Short-term travel up to 8 days is $184/individual, $314/family. If you travel more than 15 days/year, an annual membership is a better value. Individual annual memberships start at $338 for domestic travel and $444 for domestic + international travel. Family annual memberships start at $504 for domestic travel and $578 for domestic + international travel
Domestic Only Options:
AirMedCare Network – The AirMedCare Network is an alliance of affiliated air ambulance providers (Air Evac Lifeteam, Guardian Flight, Med-Trans Corporation, and REACHSM Air Medical Services) – the largest of its kind in the United States. An AirMedCare Network membership automatically enrolls you in all the participating provider’s membership programs, giving you membership coverage across a combined 38+ state service area. Base local transport service is $85/year. They also have an option for transport over 150 miles that is $149/year.
Life Flight Network – Life Flight Network is a nationally recognized air medical transport service covering a large part of Oregon, Idaho, and Washington. They also have reciprocal partnerships with other air ambulance providers that cover Wyoming, western Montana, northern Nevada, or northern California. They provide critical care transportation to ill or injured patients in a safe, compassionate, efficient, and expeditious manner. When you’re a member, there’s absolutely no cost for medically necessary emergent flights. Membership covers you, your spouse or domestic partner, and dependents you claim on your income tax return. Elderly and disabled family members living in the same household can also be covered. An annual membership is only $65 for air ambulance service in WA, OR, and ID.
Schedule a Call to Discuss This Information
If you have questions about any of the above resources as it relates to your existing health plan or you want to see how they work as part of our alternative health plan solutions, please go to the link above with the image that says CALL ME and schedule a call with me on a day and time that works for you, and I will call you to review your options