JANUARY 26, 2015 – In an era of higher health insurance deductibles, rising out-of-pocket costs and shrinking provider networks, more people are taking matters into their own hands. Instead of using their health insurance for all of their care, they’re going off the grid and paying cash so that they can see the doctors they choose or get the drugs they prefer. Some are paying a fee to their primary care physician in exchange for longer office visits and 24/7 access.
Going off the grid doesn’t mean ditching your health insurance altogether. You’ll still need insurance for big-ticket medical care. But it usually makes sense to get a high-deductible policy to save on premiums. Payments you make in cash may count toward your deductible, and if you contribute to a health savings account or a flexible spending account, you can usually use that money tax-free to cover your out-of-pocket costs. The payoff: more control over your care, which may cost less than you’d pay with your health insurance policy.
Many providers are frustrated, too, by the lack of time they can spend with patients. So some primary care doctors are choosing to shrink their practices and charge for personalized attention and round-the-clock access. The typical fee ranges from $1,800 to $5,000 per year, but some physicians keep their practices a bit larger and offer access for as little as $40 to $75 per month.
Pamila Brar, an internal medicine physician in La Jolla, Calif., and president-elect of the American Academy of Private Physicians, a trade organization for concierge doctors, charges $3,300 per year and has just 200 patients. About half of them have been diagnosed with cancer or a complex condition. Brar helps them coordinate their care and assess their options. “I have had a number of patients whom I’ve taken care of in the last months of their lives,” she says.
Adult children who live far from their aging parents have also started hiring Brar. Nathan Myhrvold and his brother, Cameron, who live in Seattle, researched concierge doctors for their 87-year-old mother, Natalie, when she moved to a retirement community in San Diego. “We wanted someone to watch after her and give her extra care if required,” says Nathan.
Natalie goes to Brar for checkups, and she or her sons can contact the doctor anytime with questions about her health. Brar also coordinates Natalie’s specialists and prescriptions, and even went to the emergency room when Natalie was taken there after a fainting spell. “It’s great to have a point of contact who is completely plugged in with what’s going on,” says Nathan.
(Kimberly Lankford is a contributing editor to Kiplinger’s Personal Finance magazine. Send your questions and comments to firstname.lastname@example.org. And for more on this and similar money topics, visit Kiplinger.com.)
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