No insurance, no problem

The Insurance Crisis

Health insurance is a precious commodity for most Americans, providing partial or complete coverage for the cost of doctor visits, diagnostic tests, treatments and/or hospitalization. According to the Henry J. Kaiser Family Foundation, about 60 percent of Americans have health insurance coverage through an employer-sponsored plan. However, last year, roughly two million Americans lost their employer-sponsored health insurance. Even those who still have access to health insurance often struggle with high premiums, co-pays and deductibles.

Older Americans typically get their health insurance through retirement benefits, Medicare or Medicaid. Children who don’t have insurance through a parent can often be covered under state or federal health plans. But those in between may not qualify for government assistance and don’t have any safety net. For those with pre-existing medical conditions, private health insurance may be too expensive.

Last year, roughly 46 million Americans under 65 had no health insurance. 80 percent of the uninsured are from working class families. Because they have to pay for medical expenses out-of-pocket, many of the uninsured don’t get preventive care and delay seeking treatment for health problems. Thus, when they do seek care, they tend to be sicker and require more expensive treatment. For some, cost of medical care can send families over the financial edge. Researchers report, in 2007, more than 62 percent of all bankruptcies filed in the U.S. were related to unpaid medical expenses.

One Solution

Health experts and Congress continue to debate the best way to provide reasonable and affordable health insurance for all Americans. In the meantime, one company offering a low-cost solution to health care access is, “No Insurance Club.”

The Arizona-based No Insurance Club provides participants with a limited number of doctor visits each year. For an annual fee of $480, single clients can get up to 12 visits to a participating physician. Couples can get up to 12 visits (total - not each) for $580. A family, which includes all children living in the home, can get up to 16 total visits for $680. No one is denied coverage, even those who have pre-existing conditions.

John Hensler, M.D. (featured in story), Family Physician in Phoenix, AZ, says the No Insurance Club may be a good option for people who have lost their insurance or are no longer able to afford the coverage they have. If the person’s physician is a participating provider, patients don’t need to change physicians. Thus, clients are assured continuity of care. As a physician, Hensler says he likes the plan because there is no extra paperwork, no worry about what charges will be reimbursed and no co-pays to collect from patients.

The No Insurance Club may be a good option for patients who are otherwise healthy and only visit their doctor occasionally. But there are several drawbacks to the plan. Availability is limited. Currently, physicians in only 10 states have signed on. In most places, just one or two doctors in the entire state are a participating provider. The plan doesn’t cover visits to specialists, emergency room visits or hospitalization, which account for a very large share of medical expenses for the uninsured. Covered services vary widely among physicians. Some offices cover a wide range of services (like vision screening, annual check-ups, immunization and priority scheduling), while others cover only the visit and patients must pay out of pocket for extra services. Once a plan is selected and finalized, patients can’t change provider or the terms of the plan (like adding another member) without purchasing a new plan. Finally, if a patient uses all of his/her visits before the end of the contract year, a new plan must be purchased to stay covered.