No deduction. No extra charge. No out-of-pocket costs. No cost for prescription drugs. All health insurance benefits.
That’s the idea behind a new health insurance option that healthcare company Curative is launching
The plan is for employers with 51 or more workers who live or work in
Curative established operations in
Healthcare “isn’t built for innovation,” said Curative’s CEO
The health insurance treatment plan is based on the idea that if people engage in preventive care in time, they can save money and so can their health insurance company. It’s also based on the idea that providers can simplify the process by not having to collect co-pays or co-pays.
When insurance companies raise copays and deductibles, people put off care, Turner said. “There is a short-term cost reduction because people stop getting care, but they don’t stop getting care. They stop doing preventative things – mammograms, colonoscopies. Health care costs are going up again with everything they put off … they end up in the emergency room and they don’t need to be there.”
Turner compares Curative’s health plan to Netflix. You pay one price every month and get access to everything. In insurance, this monthly expense is that the employer pays part and the employee pays the rest of the monthly premium. It is estimated that for a single person most monthly premiums for a single person will be between
Insurance industry experts in
To receive the benefits with no deductible, no out-of-pocket and no co-payment, people must have an annual baseline medical visit with Curative within 120 days of starting the plan. After this period, if they have not completed the primary visit, then they will have
“Design is one big financial incentive for preventive health,” Turner said.
The basic visit establishes that the person has a primary care physician and has been receiving regular preventive care. If they don’t, or haven’t been in a while, blood work will be done at the baseline visit and they’ll be connected to a primary care physician.
Even if they’ve recently seen a doctor, Curative will offer some pre-diagnoses to its members that look more in-depth at things like heart risks, as well as a whole-genome sequencing test to help a member and their doctor make more personalized healthcare solutions.
This test, Turner said, can help determine which drugs will work better for that person and what their genetic risks might be and what inherited traits they might pass on to future children. Genome sequencing is not required, but will be free to the patient and available for future use in medical decision making.
“It’s all part of the long-term investment in the patient,” Turner said.
Curative currently has a network of care that includes
If a member wants to see an out-of-network doctor, they will pay a co-pay and have a deductible for that office visit, just like any other PPO. However, if they can prove that there is no in-network option, or if their referring doctor can prove that another doctor is not medically appropriate for that patient, that specialist will be covered as in-network.
It’s the same with medication. Curative has its own pharmacy that delivers to your home as well as uses
If a person seeks emergency care outside of a network hospital, they will still be covered as a network hospital. If they have surgery scheduled, however, they’ll have to prove it’s medically necessary to be at that hospital instead of an in-network hospital in order to pay
Curative is currently negotiating with more healthcare providers and systems to reach agreements to expand its network roster with
At this primary visit, the health navigator the member meets with will also go over how to take advantage of everything in the treatment plan, as well as what is not covered, and connect them with services they may need.
The healing is also the opening of
Curative has invested the first three years of the expected cost of the healthcare program. He used his own funding to do this, Turner said. It added 70 positions to launch the health insurance program and expects to add more as it grows.
Curative expects to turn a profit on its health insurance business in two to three years, Turner said.
Editor’s note: This story appeared on Wednesday