Patients like the short appointment wait times, cost savings of not having to pay deductibles, copays, or coinsurance charges, and the greater facetime with their primary care physicians that DPC practices offer.
And doctors like the much lower overhead, reduced administrative costs, and smaller patient loads.
All these factors translate into a better healthcare experience for patients, higher professional satisfaction ratings for doctors, and improved health outcomes.
But DPC plans aren’t intended to be stand-alone healthcare solutions. For all their advantages, DPC plans don’t include things like specialist care, ER visits, urgent care, hospitalizations, imaging services, and many other healthcare procedures.
To pay for these costs, while avoiding double-paying for primary care services under an overpriced traditional health insurance policy, most people need a health sharing plan.
In the health sharing world, two programs from Zion Health, the CARE+ plan and DPC DIRECT, have emerged as frontrunners for those seeking a health sharing plan that works well with their DPC memberships.
Both of these complement DCP plans seamlessly dovetail with DPC plans. Both are extremely affordable compared to the unsubsidized cost of a traditional health insurance policy.
But which one is the right fit for you? This article will help you narrow down your options, so you can make the right choice from among these two excellent plans.
Understanding Direct Primary Care (DPC)
Direct Primary Care (DPC) is an innovative healthcare model that eliminates traditional health insurance from primary care, and instead prioritizes a direct patient-doctor relationship.
Instead of navigating the complex world of insurance claims and copays, DPC members pay a flat fee for unrestricted access to routine primary care services. Here’s how it works:
- You select a Direct Primary Care physician’s practice nearby and enroll in a membership. Costs usually range from $75 to $110. You pay this directly to the DPC practice. There is no insurance intermediary to add costs and bureaucracy.
- You receive unlimited appointments with your DPC physician. Much like a gym membership, a DPC membership allows you to access primary care services as often as you need them. There are no additional charges other than the monthly or quarterly membership fee. Members have unlimited access to routine primary care and preventive services that are covered in the plan.
- Add a supplemental plan to address areas not covered by the DPC. These services include ER visits, hospital stays, and prescription medications. Since the DPC membership takes care of routine care, the patient can opt for more cost-effective alternatives like a high deductible health plan, a health sharing program, or accident coverage.
Supplementary plans like the CARE+ plan and DPC DIRECT are designed to help members customize additional coverage according to their needs. The right plan can help cover ER and urgent care visits, hospitalizations, surgeries, specialist care, and advanced imaging.
Why Health Sharing Pairs Better With DPC Than Traditional Health Insurance
Combining a DCP membership with health sharing is usually much more cost efficient than using a traditional health insurance plan – especially for those who don’t qualify for ACA subsidies.
There are two reasons for this.
- Healthshare costs much lower than unsubsidized Affordable Care Act-style health insurance premiums.
- When you combine DPC with a traditional health insurance policy, you essentially pay twice for the same primary care coverage. But since most health sharing plans don’t share costs for routine primary care services – at least until you spend a few thousand dollars out of your own resources – you only need to pay for primary care services once: via your DPC subscription.
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The CARE+ Plan and DPC DIRECT: A Closer Look
Both the CARE+ plan and DPC DIRECT are health sharing plans designed to supplement DPC members.
They both offer an affordable alternative to traditional health insurance, potentially saving members up to 50% of the unsubsidized monthly cost of health insurance premiums.
Both are secular health sharing organizations open to all regardless of faith background or practice.
But how do they differ? Let’s take a close look at each of these fine plans.
The CARE+ Plan
The CARE+ plan is an affordable health sharing program designed for W2 employees or people who are not working.
It is one of the lowest cost health sharing plans available, and is a wonderful option for those looking for major medical coverage.
CARE+ Plan Features
- Cost-Effective. The monthly costs are significantly lower than a comparable health insurance policy.
- More Inclusive. There are no height-weight restrictions with the CARE+ plan as long as there are no pre-existing medical conditions, and smokers can join for an additional monthly cost.
- No cap on benefits. In most cases, there is no limit to the amount that can be shared to cover necessary medical expenses.
- Telehealth access. All plan members can access unlimited telephone or video visits with medical providers for free.
- Mental health services. The CARE+ plan includes a variety of mental health and counseling benefits.
- Alternative Medical Treatments. The CARE+ plan shares costs for approved alternative treatments, provided they are deemed safe and effective by the CARE+ plan administrators.
DPC DIRECT is a health sharing program tailored for DPC members that is designed to provide more comprehensive overall health coverage.
This program provides a blend of traditional and alternative care benefits and is open to everyone.
Features of DPC DIRECT:
- Health Sharing for Emergencies. While your DPC doctor handles routine care, DPC DIRECT covers unexpected medical bills.
- Affordable Costs. Monthly fees start as low as $170 for individuals.
- Telemedicine Services. 24/7 access with no additional fees.
- Prescription Discount Program. Optional access to discounted medications.
- Preventative Screenings. Covers costs for screenings like mammograms and colonoscopies, which the CARE+ plan doesn’t.
- Comprehensive Coverage. While priced slightly higher than the CARE+ plan, DPC Direct offers more features, especially for those aged 40 and above. Specifically, DPC Direct includes mammograms and colonoscopies with all tiers in the plan’s membership.
- If you want these in the CARE+ plan you’ll have to pay for them out of pocket.
Choosing Between The CARE+ Plan and DPC DIRECT
Aside from DPC DIRECT memberships requiring enrollees to also be enrolled in a DPC plan, these two outstanding health share plans are nearly identical.
The difference is that DPC DIRECT includes free preventative care screenings (mammograms and colonoscopies), while the CARE+ plan does not.
So the choice between these two plans largely hinges on age and individual healthcare needs:
- Younger Individuals. The CARE+ plan might be a better value for those who don’t yet need the preventative care features of DPC DIRECT.
- Aged 40 and Above. DPC DIRECT becomes more appealing due to its preventative care benefits.
How to Enroll in DPC DIRECT
Enrolling in DPC DIRECT is very easy. The process just takes minutes.
Just click here, select the “ENROLL” button under DPC DIRECT, and follow the prompts.
How To Enroll in the CARE+ Plan
You can enroll yourself and your family online.
It’s easy, and takes just minutes. Click here, select the CARE+ plan from the menu, and follow the instructions:
- On the first page, enter your name and date of birth.
- Next, Below your name and DOB fields, you’ll see an option to add dependents. Click the “add spouse” or “add children” buttons on the screen and add their names and dates of birth as appropriate.
- Scroll down to the bottom of the page and click “UPDATE.”
- Select your desired IUA from the drop-down menu. The higher your IUA, the lower your monthly pricing. You’ll be able to see the different monthly costs just by clicking each of the three options. Select the one you want, and click “continue.”
- On the next page, fill in your address, contact, and Social Security number information. To complete the form for all your dependents, click the “pencil” icon next to each name. After you’re done, click “Save dependent” and repeat the process until you have entered all your dependents on the plan.
- Scroll down and review the CARE+ plan’s Statement of Principles. Click “Yes” or “No” on each one as appropriate.
- Review the Health History section. Make sure you understand the CARE+ plan limitations on sharing for pre-existing conditions, pregnancies, and other exclusions. Click “Yes” or “No” on each paragraph as appropriate.
- Select your payment method. You can pay by bank ACH draft or by major credit or debit card.
- Check the “I’m not a robot.” box.
- Click and drag your mouse or touchpad to digitally sign the document.
- Type out your name in the box below.
- Click “Submit.”
- Check for error messages. If you skipped an entry, you’ll be prompted to go back and fix the error.
- Confirm your application went through.
Tip: If you enroll by the 20th of the month, your membership will be effective as of the 1st of the following month. If you apply after the 20th, your membership will be effective the first day of the month after that.
Once you’re enrolled, you should schedule a 30-minute orientation phone call with the CARE+ plan’s healthcare concierge.
Make sure to take advantage of this orientation opportunity, as it can help prevent a lot of confusion and help keep the process as smooth and seamless as possible.
You’ll also be hearing from us. HSA for America is here to be your resource and advocate for as long as you are a member of the CARE+ plan.
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Both the CARE+ plan and DPC DIRECT offer unique advantages for DPC plan members. Your choice should align with your healthcare priorities, budget, and long-term goals.
Need any help? Want to look at all your options? That’s what we’re here for!
Make an appointment for a FREE, no-obligation consult with one of our experienced Personal Benefits Managers.
Here are some additional blogs for further reading: How to Combine a DPC Membership With a Health Sharing Plan | Everything You Need to Know About Direct Primary Care (DPC)