Health insurance plain and simple. Stripping away the crap you don’t need and don’t need to know so that you can take total control of your health insurance.
@JohnWebbMD@DrVDV@costplusdrugs@mcuban@markcuban@JohnWebbMD very good.
Then you understand legal assignment and differing adjudication between in/out network claims.
If I have not met OOP Max, any distribution is not in question.
If I have, I pay with checking/savings and receive 100% from plan.
Thanks for the discussion.
@JohnWebbMD@DrVDV@costplusdrugs@mcuban@markcuban@JohnWebbMD thanks for your reply. I appreciate the time you took to make the citation and provide extra context.
I do take exception to your characterization of fraud.
I think you know medicine well.
I am not certain that you follow the sequence of how insurance works.
@JohnWebbMD@DrVDV@costplusdrugs@mcuban@markcuban@JohnWebbMD thanks for the heads up. Can you tell me exactly where the Internal Revenue Code states “you can only use the HSA for UNREIMBURSED expenses”. IRC 213? 223? I look forward to your reply and learning more.
@DrVDV@JohnWebbMD@costplusdrugs@mcuban “Their coverage is” NOT “the expensive option”.
The PPO Network is!
The patient pays @costplusdrugs with cash from their HSA.
The patient then submits their claim to the plan administrator to directly receive payment.
Out of pocket is likely half of price @mcuban charges.
@EPotterMD You’re on the right path.
Patients need to be demanding….same as anything else they buy.
And doctors are selling a service whether they like it or not.
@mcuban@YouTube But what about the 55% of companies that self-fund….plus plans funded by federal taxpayers (Medicare/Medicaid/TriCare)? That’s 65% of the overall market.
How do denials help employers and federal taxpayers?
The fully insured market is only 25% of the total.
Thank you for your post. I increased prices in 2021, very reluctantly, as so many patients live on the margin. I don’t intend to increase them again any time soon. GKS
@LighthouseDPC “Health Insurance” as used here is generic, so difficult to say what the policy reads.
Pay the $750 with cash from HSA, submit claim to plan admin, get check directly for $375 (50% out of network). Insurance works the way it is supposed to…
PPO agreement is not insurance.
@LighthouseDPC Thanks for your reply.
Why is sickness so expensive to treat?
If the care costs $100K, $10K is a drop in the bucket.
If the care costs $1K, that’s an HDTV or a day with the family at Disney World. No insurance necessary.
Better insurance education is certainly necessary.
Are all of you CEOs paying attention?
Or are you asleep at the switch and deferring to CFO and HR Director who are:
chummy with broker and do as they’re told,
have “other things” to worry about and choose to ignore
fear waking employees only to face too many questions
I’m trying to actually start and run companies that cut the cost of healthcare.
https://t.co/xY30tRakLV
https://t.co/IjW3BsvfN1
https://t.co/zZPQ3lKHH7
Manufacturing pediatric cancer and other drugs that are in short supply, in dallas.
Talking to every politician, or group of politicians that wants to discuss HC
Trying to explain to CEOs of self insured companies , that the big conglomerates they work with are not only screwing their company over, their ignorance about HC benefits is why HC is so expensive in this country. If they stopped doing business with the conglomerates, prices would drop for more than the 160m employees they cover. They would drop for everyone
All day. Every. Day.
@ForestParkPharm Good
First step is pharmacy doesn’t sign a Preferred Provider Agreement
Second step is communicate prices - just like stuff on shelves
Third step is patient paying cash from their HSA and then submitting their claim to insurance carrier to directly receive payment per plan
@ForestParkPharm UNH is not an insurance company.
You perpetuate the charade with your characterization.
UNH is a very well run conglomerate that takes what it is given.
Insurance is very little of what they do and from less of where they profit.
Healthcare is not health insurance.
The market for honest pricing is growing, appealing to more individual and institutional buyers who realize they've been fleeced. As demand grows, I'll have MANY more competitors, a beautiful thing. GKS @FreeMarketMed
They’re all transparent, direct-pay/cash-pay (or bundled flat-rate) ambulatory surgery centers.
Doctor-owned or independent, they post real upfront prices, skip insurance middlemen, and deliver high-quality outpatient procedures often 50-80% cheaper than hospitals. Classic free-market healthcare in action—Surgery Center of Oklahoma style, spreading nationwide.