Open Enrollment San Antonio - Salveo Direct Care

Open Enrollment San Antonio

January 6, 2022
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Open enrollment is a time for Individuals and Businesses to re-evaluate their health insurance needs for the upcoming year and Direct Primary Care should be part of the conversation.

If you have an employer-sponsored health plan, most will use a period in the Fall that usually runs through November 1 to December 15 to elect for coverage. This can vary from employer to employer, some only allowing 15-30 day periods to sign up. Compare to Direct Primary Care where enrollment in our memberships is on a rolling basis, when you are ready, and our Employer rates are deeply discounted.

For those looking into an individual health plan, not sponsored by a group or employer, then open enrollment usually also starts November 1 to December 15, with variations based on your state’s health exchanges.

If you qualify for Medicare, your open enrollment usually begins October 15 to December 7 each year.

Keep in mind that there is a separate open enrollment period from January 1 to March 31 for people who already have Medicare Advantage plans.

One additional point to consider when deciding what to do for your health care needs, is to look into Direct Primary Care. Direct primary care is not insurance but instead is a way to pay for your primary care every month, at rates much lower than an insurance premium. This gives you access to your personal physician as many times as you need it without worrying about co-pays, insurance denials for health visits or restrictions to your primary care.

Health exchange plans can be more affordable, or sometimes even free if you qualify for subsidies, but look at the fine print. Those plans usually have many restrictions for care, restrict you to only a handful of primary doctors, specialists and hospitals, won’t cover many of the lab work you may need and still has copays, high deductibles and plenty of red tape.

Direct Primary Care removes the red tape and gives you access to discounted prices for labs, imaging and specialists when needed. When you pay for your basic services in cash, healthcare businesses will offer you reduced prices compared to what they bill your insurance, which ultimately you are paying for part of that anyway.

For example, if you need a CT scan, the imaging facility may bill your insurance company $800, but the insurance company may have a contract with that facility for $500. Since you have a health plan that only pays out once you hit a $10,000 deductible, you get stuck with that $500 bill on top of your monthly insurance premiums.

However, if you were to pay cash directly to the imaging facility, they actually only charge you $275 like Green Imaging right then and there because you saved them the hassle of dealing with your insurance company, saved time printing invoices and explaining to you that you are responsible for the bill because you have to meet a deductible, thus delaying their payment for 30-90+ days. Even they srill make a profit at that rate when you pay cash!

This is only one example but the same principle applies across the field from lab work to surgery: cash prices for labs start at $3 cash vs $100’s per test with insurance; surgery for your gallbladder as a package may cost $5865 at the Surgery Center of Oklahoma where people fly from all over the country for their prices and customer service vs $64,000 with insurance! (minus any contracted price the hospital may have with your insurance company, which you will likely pay for anyway until you meet a deductible).

Our job as Direct Primary Care doctors is to care for your health but also help you navigate the complicated health system. This includes finding more affordable ways to help pay for your health, try to keep you out of the hospital by focusing on prevention of disease, treat current disease promptly to slow its progression or even better, to reverse it, or how to save on prescription medications and many other cost saving efforts.

The relationship with your primary doctor can be lifelong when you find the right doctor for you.

Have a question about your health care options? Give us a call and schedule your free 15 minute personalized call to help answer your questions about Direct Primary Care as part of your health planning and to learn more about us and what we can do for you as your Personal Physicians.

Dr. Prisiliano Salas

with Salveo Direct Care

Our Doctors

We are Primary Care Doctors with a combined over 20 years of experience in Family Medicine and are additionally board-certified in Lifestyle Medicine. Our focus is on evidence based treatments in both traditional and integrative medicine practices to find what best fits your needs and health goals. Crafting your path to wellness and renewed vitality is our passion.

Drs. Monica Salas and Prisiliano Salas with Salveo Direct Care