Group Health Medical Cost Sharing Small Business

How to better access medical services with this innovative program

A Health Access Solutions membership can provide easier access to medical services and providers for individuals and families.

One of the things I often hear from just about anyone I talk to is how frustrated they are with their health insurance plan and how difficult it can be to access medical services. As I’ve mentioned in another post, these folks also look forward to their annual health insurance renewal about as much as they look forward to tax time and root canals. (Read: Not at all.) Every year they’re hit with the same decision—pay even more for the same plan, or take away benefits (and pay the same). None of the folks I talk to want to do either of those things—who does?

Unfortunately, with the way our healthcare system is currently set up, there isn’t a long list of viable options when it comes to offering coverage. And, if I’m being honest, way too many health insurance brokers and reps just toe the line and come to renewal meetings armed with the same cookie-cutter options—ultimately giving you the choice to pay more or get less. So much for the forward-thinking…

Even if you don’t hear it from your current broker, the truth is that there are innovations available that utilize recent legislative changes and groundbreaking ideas to come up with fresh solutions that can actually move the needle when it comes to taming health care costs.

Paying more for the same or getting fewer benefits are no longer your only two options.

How A Health Access Membership Helps You Access Medical Services

The groundbreaking Health Access Solutions membership is available as a stand-alone solution for individuals, as well as an employee assistance program for businesses. It provides access to medical services such as free preventive services, low-cost prescription drugs, direct primary care, and coverage for vision screening and/or dental cleanings. It’s an excellent way to help reduce your health care costs while giving you 24/7 virtual access to licensed primary care physicians.

The Health Access solution is a comprehensive program that’s designed to piggyback with either a traditional health insurance plan or even better, a medical cost-sharing plan. This combination gives you access to a range of high-quality health care options at a reasonable, predictable cost.

The following components are what make this solution work so well.

Virtual Direct Primary Care (VDPC)

The Health Access Solutions membership includes 24/7 access to a personal care team of doctors, nurses, and health advisors. Best of all, there are no co-pays or hidden fees. Members can see the same VDPC physician each time via video, phone, and text visits. Their physician can prescribe medication, send orders for labs/imaging, and do follow-ups. They can also do referrals to local medical providers when necessary.

Common health issues supported by virtual direct primary care include:

  • Chronic conditions such as asthma, diabetes, high blood pressure, high cholesterol and thyroid disorders.
  • Prescription medications & refills.
  • Lab & imaging tests.
  • Mental health issues.
  • Common ailments and infections such as cold, fever, bladder infections, sinus problems, and skin infections.
  • Men’s health issues like erectile dysfunction, hair loss, and low testosterone.
  • Women’s health issues like bacterial vaginosis, birth control refills, breast lumps, and UTIs.
  • Preventive wellness such as diet, nutrition & fitness counseling, smoking cessation, and weight management.

Preventive Care, Dental, and Vision

As a Health Access Solutions member, you simply submit and receive reimbursement for evidence-based screenings and preventive services including annual wellness exams, women’s annual exams, mammograms, routine vaccinations, and flu shots. Physician-recommended wellness lab services such as cholesterol, comprehensive metabolic panel, complete blood count, thyroid panel, vitamin D, PSA, CRP, and HbA1C also fall under this benefit. Dental cleaning and/or vision exam services are also eligible for reimbursement.

There are no provider network restrictions with these benefits, so you can see any dentist and use whatever lab you want. This lets you take advantage of some of the more cost-effective at-home labs that are available which can help you save time and money. There are limits to how much you can be reimbursed each year, so be sure to check with them to find out what the current reimbursement limits on preventive care and dental/vision are.

* Refer to Health Access Solutions Digital Membership Packet for a current, complete list of eligible expenses and benefit limits.

Discount Prescriptions

Through a partnership with America’s Pharmacy Source, Health Access members have access to a nationwide network of pharmacies with a combined 65,000+ locations, including access to manufacturer savings and patient assistance programs, as well as international pharmacies. With predictable pricing starting at just $5 on over 80 acute medications and 100+ maintenance medications, this program aims to help individuals taking prescriptions save money. Pharmacy coaching with experienced, licensed pharmacists is also available in an effort to help further educate members.

Out-of-Pocket Assistance

This particular benefit is only for members who join the Sedera medical cost-sharing community. For those individuals, this out-of-pocket assistance benefit helps ease the strain of unexpected medical costs by reimbursing a member’s 3rd (if an individual member) or 5th (if a family membership) Initial Unshareable Amount as a preventive expense, up to $2,500!

The Health Access Membership In Action

Each of these Health Access membership benefits helps to support improved access to medical services. Examples of the membership in action include:

  • Using the preventive care benefit to reimburse $250 of the costs associated with quitting smoking.
  • Being reimbused for “well child” exams for kids.
  • Having a video appointment with a licensed physician at any hour of the day or night at no cost.
  • Getting reimbursed up to $250 for routine dental cleaning and/or an annual eye exam.
  • Using Cologuard for colon cancer screening and being reimbursed for 100% of the costs.

Affordable Assistance To Access Medical Services

Health Access Solutions is leading the way and putting a fresh spin on what it means to control healthcare costs—giving individuals and employees better access to health care, at a lower cost, while helping them take ownership of their health. This program is an affordable way to provide preventive services, access discount prescription drugs and 24/7 primary care. It can be an incredibly valuable benefit for employees at a very reasonable cost to employers and works great for individuals as well.

Unlike so many others in the health coverage space, the folks over at Health Access Solutions aren’t content with just beating their heads against the same wall. They’ve taken the time to look up and realized there is a better way. If you’re tired of getting a headache every year at renewal time, it’s worth checking them out to see if they can help stop the pain.