Health insurers in several big cities will take some pain out of doctor visits this year — the financial kind.
They’ll offer free visits to primary care doctors in their networks.
You read that right. Doctor visits without copays. Or coinsurance. And no expensive deductible to pay off first. Free.
In Atlanta, Chicago, Dallas, Miami and more than a dozen other markets, individuals seeking coverage from the insurance exchanges can choose health plans providing free doctor visits, an insurance benefit once considered unthinkable. The improvements are rolling out in a limited number of plans following reports that high copays and deductibles have discouraged many Americans who signed up for private coverage the past two years from using their new insurance under the Affordable Care Act.
Insurers say they hope encouraging visits to doctors will benefit members and their bottom lines by catching illnesses early before they become harder and more expensive to treat.
For example, prescribing antibiotics promptly to a patient with pneumonia could avoid a lengthy hospitalization costing tens of thousands of dollars. In addition, the policy could also cut down on the use of more expensive urgent care centers and emergency rooms.
Jan. 31 is the final deadline for consumers to sign up for 2016 coverage.
Two new health insurers, Harken Health, an independently operated affiliate of UnitedHealthcare, and Zoom+ are offering unlimited free primary care visits at their company-owned clinics. Harken operates in Chicago and Atlanta. Zoom+ is based in Portland, Ore.
Florida Blue, the state’s largest insurer, has health plans in Miami-Dade and nine other counties where low-income members buying plans can also get two free primary care visits per year.
California-based Molina Healthcare is offering not only free primary care visits in some plans, but also free visits to specialists in Florida, Texas and five other states.
The no-fee visits go beyond the many preventive services, such as immunizations and screenings that all insurers must provide under Obamacare without charging a copay, even when a deductible hasn’t been met.
Health policy experts say the new approach sets the insurers apart in crowded insurance markets and may attract younger, healthier people who don’t have relationships with doctors.
“This is a great development…and shows how the market is trying to innovate,” said Katherine Hempstead, director of coverage for the Robert Wood Johnson Foundation. “It’s a very exciting idea.”
“Consumers should find this very appealing…it might be like a ‘spoonful sugar to make the medicine go down,'” she said, quoting a line from a song in Mary Poppins.
“People are not going to grouse as much about cost sharing later if they are getting something free first.”
Consumer advocates applaud the trend, which they say underscores why people need to look beyond the monthly premium when shopping for a plan. “It’s a smart move to reduce financial barriers to basic outpatient care to help patients manage their health,” said Lydia Mitts, a senior policy analyst at Families USA. “I hope other health plans will realize removing financial barriers to primary care doctors is a smart direction for patients and for the plans.”
The health plans offering free doctor visits are typically among the lowest-priced plans in many markets, according to a KHN review of plans sold on the exchanges.
Some insurers can offer free visits because they operate health clinics staffed by salaried physicians. That’s the case at Harken Health, which has four primary care clinics in Chicago and six in Atlanta for its members to use for unlimited visits. Harken also offers members access to a doctor by telephone and Internet. “We are creating unfettered access between the care team and the patients,” said Tom Vanderheyden, CEO of Harken Health. “We think it’s a significant differentiation.” Harken also offers free yoga and cooking classes.