Exploring DPC As An Alternative to Insurance For The Self-Employed

Options for Healthcare For The Self-Employed

In the next few weeks, I will be reviewing various healthcare options that are evolving as alternatives for coverage to traditional insurance. For the self-employed micro-business owner, these options can save you quite a bit of money and are worth considering.

This subject is significant to me because I am a micro-business owner who is retiring before age 60, and whose wife is 10 years younger than myself, I must account for our healthcare costs in my post-retirement days starting in June 2024. I have budgeted for $25,000 annually for healthcare costs under the notion that I will go with traditional insurance. However, I think it is worthwhile to explore cheaper alternatives. The following is what I have found.

Exploring Direct Primary Care As An Alternative to Traditional Medical Insurance

With the rising costs and complexities of traditional medical insurance, many individuals are seeking alternative healthcare models that offer affordable and personalized care. Direct Primary Care (DPC) has gained popularity as a viable alternative for individuals who want comprehensive primary care services without the constraints of insurance. In this blog post, we will explore the concept of Direct Primary Care and its benefits as an alternative to traditional medical insurance.

1. Understanding Direct Primary Care: Direct Primary Care is a healthcare model in which patients pay a monthly or annual membership fee directly to a primary care physician or clinic. In return, patients receive comprehensive primary care services, including preventive care, routine check-ups, chronic disease management, and minor procedures. DPC aims to remove the middleman (insurance) from the doctor-patient relationship, allowing for more personalized and affordable care.

2. Benefits of Direct Primary Care:

   • Cost-effectiveness: DPC eliminates the need for traditional insurance premiums, deductibles, and co-pays, often resulting in cost savings for patients. Monthly membership fees are typically lower than insurance premiums, making DPC an attractive option for those who don't require frequent specialist visits or extensive medical procedures.

   • Enhanced doctor-patient relationship: With fewer patients to manage, DPC physicians can spend more time with each patient, building stronger relationships and providing more personalized care. Longer appointment times allow for thorough evaluations, comprehensive discussions, and better continuity of care.

   • Accessibility and convenience: DPC clinics often offer same-day or next-day appointments, minimal wait times, and extended office hours. Patients can reach out to their DPC physicians via phone, email, or virtual consultations, promoting convenient access to care, especially for urgent concerns.

   • Comprehensive care: DPC physicians focus on preventive care and wellness, emphasizing early intervention and disease management. Many DPC practices offer additional services such as minor procedures, vaccinations, and in-house laboratory testing, further reducing the need for external referrals. e. Transparent pricing: DPC clinics provide transparent pricing for services, medications, and procedures. This eliminates surprise bills and allows patients to budget and plan their healthcare expenses more effectively.

3. Limitations and Considerations:

   • Specialist care and hospitalization: Direct Primary Care primarily focuses on primary care services and may not cover specialist consultations, hospitalizations, or major surgeries. Patients may need to consider separate insurance coverage or health-sharing plans to address these needs.

   • Not a substitute for catastrophic coverage: While DPC can provide comprehensive primary care services, it does not typically cover catastrophic events, major surgeries, or emergencies. Supplemental insurance or health-sharing plans may be necessary to ensure coverage for these situations.

   • DPC availability: The availability of DPC clinics varies by location. Research local DPC practices to determine if there are providers near you and evaluate their expertise, services, and fees before deciding.

Conclusion

Direct Primary Care offers an innovative and patient-centered approach to healthcare, providing accessible, cost-effective, and comprehensive primary care services. It serves as an alternative to traditional medical insurance, focusing on strengthening the doctor-patient relationship and prioritizing preventive care. Consider the benefits, limitations, and your specific healthcare needs before deciding if Direct Primary Care is the right option for you. As the healthcare landscape continues to evolve, exploring alternative models like DPC can empower individuals to take control of their healthcare journey while receiving quality care from dedicated primary care physicians.

Bottom-Line

Insurance, DPC, or Health Sharing Plan (which I will explore next week) for your healthcare coverage option is a personal decision and also involves your budget and finances. Fortunately, with your high income, you can afford the most expensive and reliable option—insurance.

Regardless, of your choice, you will want to organize your healthcare costs as a business expense through your micro-corporation—this includes the premium or membership costs and any out of pocket healthcare costs (deductibles, etc.)

Out-of-pocket healthcare costs alone are a major concern for many of you. How to best minimize your out-of-pocket expenses involves understanding tax and business laws. The business deduction rules for sole proprietors, S-Corps and C-Corps are all different. In the end, C-Corps provide the greatest ability to cover your complete healthcare expenses. It’s why my last 5 SimpliMD clients have elected to choose a C-Corp as their tax entity for their professional micro-corporation.

At SimpliMD, when I collaborate with our legal network to establish your micro-corporation, sorting through your healthcare needs is a great example of why you need someone who will assist you in personalizing the entire business setup. At SimpliMD, we prioritize listening to you, understanding your needs, and then assisting you in creating the optimal business structure to ensure your success and growth.

Let me encourage you to go here to get started with your personalized micro-corporation set up through SimpliMD.

If you have a micro-corporation already, let me assist you by providing personal micro-business coaching, where we can discuss important topics such as healthcare coverage. Sign up for my highly popular coaching 4-pack here.

But before you sign up to be coached, I recommend you become a SimpliMD member here, and it will unlock $2500 in savings for you with all my SimpliMD products—including the coaching 4-pack.

Tod