Over the last few years the biggest conversation in healthcare has been in regards to health insurance and how so many people don’t have it. The Affordable Care Act was implemented in order to change that. Ultimately, it has helped to increase the number of insured individuals who otherwise would not be, but at what cost? Are we a healthier population because of it? The answer is no in case you were wondering. Just because someone has insurance doesn’t mean they are covered for services or have met their deductible to even have their insurance cover a service on their plan. This is an interesting time we are in where premium rates are sky-rocketing for the general population, but they aren’t receiving any greater care for it. Most families will shell out around $10,000-15,0000 a year in premiums (some more and some less), but they may not be able to use their insurance because they haven’t met their sometimes up to $5,000 deductible yet. So they ultimately pay about $20,000 each year for health care out of pocket, but their health expenses more than likely would barely break the surface of the $5,000 unless some sort of catastrophic event occurred, and it would have to be the case because most insurance plans don’t really cover things that are going to help us live a healthier life. They only cover band aid care to cover up symptoms. Some examples of services not normally covered by insurance providers that would affect you at WCW include acupuncture, pediatric adjustments, cupping, and some soft tissue therapies.
What does all this mean? It means that most people will pay an arm and a leg to have an insurance plan only to find out they will also have to give away some organs in the process just to have their health care paid for by their insurance carrier, and their health status could be worse than it was before. It also means that these individuals will not have the expendable income to afford higher quality foods or to live a healthier lifestyle. This will lead to them needing to spend more money on health care and thus perpetuating a cycle of unhealthy lifestyle and complete disease. Good thing there is a way to break this cycle and to actually take control of your own health!
I have been asked by friends and family alike who are in various health care professions why would I not accept insurance? The answer is simple. Insurance companies doesn’t care about the patient. Why would I spend more time fighting with an insurance company or pay someone else to do it in order to determine whether or not the patient’s insurance even covers the services provided? I could spend this time, money, and effort towards providing the best care I can to my patients so they can be healthy and well without the headache! It’s a simple concept really. Provide quality care at a reasonable rate, inform patients they can still use their insurance if they would like, and make the world a healthier place. You’re probably thinking, “Wait… did he just say I can use my insurance? Even after basically stating it is pointless to use it?” Yes, I did.
So the fun thing about not accepting and processing insurance in my office is I don’t have to worry about dealing with insurance representatives or having patient care dictated by what plan they have. This doesn’t mean you as the patient can’t submit the invoices from your care to your insurance company though. In fact, you can submit these invoices and claims yourself and you can be directly reimbursed! So let’s say you come to the office for an examination and adjustment which will change your life and health forever. That would be $55 out of pocket expense for great care (this amount would be less for any visit following until re-examination). Then, if requested, I would give you an invoice with some billing and diagnosis codes (ex. 99203-25 Dx-M54.5, and 98941 Dx-M99.05, M99.03, and M99.02), and you can then submit this invoice with a claim form to your insurance company. Depending on what your benefits are for out-of-network chiropractic care you will be reimbursed. Sometimes you can get between $20-25 back (sometimes more, sometimes less depending on your plan benefits), which would make your cost for this visit $30-35 out of pocket. When most co-payments are between $40-50 it makes sense to save you, the patient, more on out of pocket expense while also saving me, the provider of care, more time in order to give you the care you need to get back to full health! So save yourself some money and save me the time and sanity!
If you want to learn more about this process go to:
If you’re looking to decide on insurance though, my advice to you would be to purchase a high deductible plan for catastrophic coverage valued around $10,000. This will reduce your monthly premiums exponentially in some cases, and you can take the money you save from this and open a Health Savings Account. Ask your employer if they offer this as a benefit also because they may pay into it as well. You can use this HSA for any form of healthcare, including chiropractic services here at WCW! In the long run, you will be keeping more money in your pocket, receiving high quality of care, and improving the overall quality of your life in the process!
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