Will a Direct Pediatric Care Membership Actually Save Money?
While direct care subscription medical services are rapidly increasing in popularity, there is a frequent misconception that this care model is not affordable. However, using insurance for healthcare expenses does not always result in lower costs!
The membership model is actually more affordable for many families than a conventional office! The savings becomes clear when you consider the lower cost of a high deductible health plan, the avoided office visits for minor medical problems like some rashes and pink eye, the all-inclusive office testing for strep, flu, and COVID, and the likelihood that you will avoid at least one urgent care or ER visit every few years. In a traditional practice, all these visits would add up to several thousand dollars a year, not to mention time missed from work or school for the appointments.
According to the Kaiser Family Foundation report on health care spending, the average out-of-pocket medical expense is about $1,500 per year per person. For younger children, this certainly can be higher.
In the DPC model, health insurance is used just like your other types of insurances – for unforeseen situations that may occur. But every child needs a pediatrician – this is not an unforeseen need. And the price is right. The average membership costs about $5 per day. That’s right – about the same as you pay for a cup of coffee or a glass of wine.
Plus, with your membership you get additional services not found in a traditional pediatric office:
When considering membership, patients need to not only consider all those convenience and care advantages, but all consider the following list of avoided medical costs in the DPC model.
· Unlimited illness visits (and many do not even require an office visit).
· No facility fees
· In-office lab testing
· Avoided ER visits
· Avoided specialty visits
· Chronic disease management
· Discounted in-office medications
· Affordable diagnostics
Unlimited Illness Visits
It is estimated that 40% of all sick visits do not actually require an in-office appointment. So why do the doctors require you to come to the office? In the current model, your insurance often will not pay the doctor for their time unless a patient is actually seen in the office. In the DPC model, your membership covers unlimited access in a way that is most appropriate and also most convenient for you – email, text, video, phone, in your home, or even the parking lot or childcare location.
For example, imagine you have a four-year-old daughter who attends preschool. During the year, you have office visits for pinkeye, a rash, sinus infection, visit for fever and Flu test, strep throat, and ear infection. This is a pretty typical year for a four-year-old. Oh, and also, she falls once and gets a cut on her leg, and you go to the emergency department for stiches. You have a deductible, of course, and co-pays. Your out-of-pocket costs for the year are $1,400*:
You easily could have another $500 in facility fees from the health system and $200 for prescriptions making your total $2,100. All these visits would have been managed by your DPC doctor - all for your flat monthly subscription. You would have seen your own doctor each time and had some of these items managed without an office visit.
Additionally, for context, consider how much the average family spends on common monthly activities. The DPC membership is often more affordable than your monthly expenses for your dog, piano lessons for your son, sports team participation (hockey, ballet, soccer) or even a nice dinner out for the family.
If you feel the DPC model is right for you but that you cannot afford the membership, do some simple calculations of your out-of-pocket medical expenses last year. It will become clear that not only you can afford a membership, but it may save you money.
