Health Insurance vs. Provider Office Plans: Which is Right for You?

Or better yet: which one is more beneficial?

Healthcare is astronomically expensive in the United States.

With impending inflation, it’s no wonder some Americans shy away from going to the doctor — even when they need to. I mean, this has always been a socioecomomic issue, but the point I’m trying to make is, it’s getting worse.

But why is the cost of healthcare so high? Between corporate greed, pharmaceutical greed, providers “over-treating” patients, technological advancements, and supply and demand, your guess is as good as mine.

Nonetheless, healthcare is essential to our wellbeing. Everyone deserves access and equitable care, but affordability seems to be the main barrier. Those with a low socioeconomic status can’t afford to be gouged by the medical industry, and having health coverage almost seems pointless. Even the middle-class is struggling to afford the care they need now-a-days.

One solution that providers have implented is the use of consumer “health plans.” Like insurance, these subscriptions cover the cost of specified health services that the office provides. For instance, America’s Best has an “Eyecare Club” that requires a tri-annual subscription fee and includes free eye exams along with discounts on contacts and eyeglasses.

So let’s do the math right quick.

The “most affordable” insurance plan with reasonable coverage may average $280 per month.

Office plans may charge $99-$250 for their customer plans per year.

So if you have insurance, you will pay $3360 in a single year for the same services that someone else is paying $99-$250 for. On top of that, provider office plans include service and product discounts, so while you’re at risk of paying full price, even if insured, the person with the office plan is saving more money.

Will medical office plans replace health insurance?

At this rate, probably so.

The cost of living is exponentially high, and unless you have “employer-sponsored” health insurance or somehow qualify for “free” coverage, there’s no way you can afford it. On top of that, a lot of plans have unreasonably high deductibles, and as a result, you have to pay for your medical services in full without copay, and if you don’t frequent the doctor’s office, you won’t meet that deductible in a timely fashion. Hell, you may never reach it. So what’s the point of having insurance anyway? Just to say you have it?

Even if the deductible isn’t high, the premium will be, and your plan probably won’t include everything you need. So again, what’s the point of having insurance anyway? What the hell are you paying for?

This isn’t like having life insurance, homeowner’s insurance, rental insurance, or car insurance; if nothing else, you definitely need those. Health insurance is so distinct from the rest because everyone’s health status is different and everyone has different medical needs. The more needs you have, the more healthcare is unaffordable, unless you’re prepared to go into debt. Having insurance doesn’t alleviate any of this because even if you have coverage and submit a claim, your health insurance company can deny you, even if you’re entitled to the benefit.

Which begs the question: what’s the point of having insurance anyway?

It’s a waste of money, if you ask me. The only people who can really advocate for health insurance are those who can afford it, or those who qualify for some sort of government subsidy. Everyone else just falls through the cracks. Or they give in and purchase a coverage plan only to visit the doctor and find out that everything is okay. They’re perfectly healthy and don’t need to keep coming in, so essentially, they’re paying for a $300+ service for nothing.