August 11, 2015 by Tony Novak
A number of services are sprouting up across the country that revive the old-fashioned practice of physician house calls. Usually these are young doctors moonlighting through one of the Uber-like internet firms. These firms require credit card payment at the time of service. It is up to the consumer to submit this expense to an insurance company for reimbursement.
In fact, most of these house call doctor visit services are be covered by regular medial insurance. The problem is that the cost is covered under out-of-network provisions, subject to a typically large policy deductible and required co-payments. This translates to a payment of next to nothing from the insurance company. Considering the amount of work to submit a claim and the relatively low price of a house call, it just might not even be worthwhile for a tiny reimbursement from a traditional health insurance plan.
However, there are a number of supplemental health insurance plans that cover house calls at 100% or something close to that amount. While the cost of a house call is meant to be manageable without insurance, there is often a tax advantage and a cash flow incentive to having this cost reimbursed through supplemental insurance.
These are a few of the most popular supplemental insurance plans of this type listed from Freedom Benefits online insurance exchange partners:
AUIC Deductible Supplement Insurance
AUIC Qualified Health Plan Supplement Insurance
Core Health Insurance
Value 24 Hour Accident Insurance
Value Med Insurance
Consumers Direct Accident Medical Insurance
Smart Accident Insurance
Inbound Immigrant Insurance
Consumers Direct Critical Illness Insurance
Availability of these plans changes and not all of these insurance plans are available in all areas. Check your specific state page at Freedom Benefits for links to the most up-to-date information.
The number of services that provide house calls is also growing and changing. Here are highlights of how a few of these services interact with insurance:
Pager – serving New York City and San Francisco
The company’s website says “While we don’t accept insurance at this time, most insurance plans reimburse members partially or fully for preventive care services, including the flu shot.”
“How does reimbursement for Pager work?
When you register, you enter your relevant insurance and credit card information.
At the completion of your care, you pay the price you saw upfront, billed to your credit card.
Pager sends you an itemized receipt with everything you need to submit for reimbursement. If you prefer, Pager’s support team can automatically submit the reimbursement requests for you.
Your insurance company will reimburse you based on your individual plan.”
Apparently this company is still in the pre-launch stage so no information is available about insurance. New York state laws restrict the availability of supplemental health insurance so we expect fewer choices available. See the New York state insurance listing page.
The company’s website says “RetraceHealth care can nearly always be applied to your insurance deductible. After each visit, we will provide you with an itemized receipt that can be submitted to your insurer.”
The company’s website says “True North can treat just about anything that can be seen in an urgent care center and a few more things. Examples include respiratory infections, urine and skin infections, minor trauma, lacerations, asthma attacks, allergic reactions, and dehydration. We are contracted with Medicare, Medicaid, Tricare, Humana, Cigna, United, Aetna, and Anthem BCBS. Currently, we are actively negotiating contracts with all major insurers.”
This graphic from the Wall Street Journal summarizes some of the current doctor house call company offerings: