Questions Answered About Your HMO

February 5, 2019

 

Q: What does HMO stand for?

A: It stands for Horrible Medical Office, but originally, it came from the phrase “Hey Moe” as in Moe of the Three Stooges who pioneered the most economical medical procedure known today, which is if you want to forget about your pain, poke yourself in the eye.

 

Q: Does all care require precertification?

A: No, only care that you need.

 

Q: After joining, how do I know how to find a good doctor?        

A: All of those on the list will do what is best for you, as long as it’s economical and we (your insurance) tell them it’s OK. If you want a good doctor, you should go to one not on the list.

 

Q: Can I get coverage for my pre-existing condition?

A: Yes, as long as you don’t expect us to pay for it.

 

Q: What happens if I want alternative treatment to medicine?

A: You’ll need alternative forms of payment.

 

Q: What if I have a heart attack, a stroke, surgery, or an old condition, all of which may require long-term rehabilitation?

A: Find a cheap doctor or a great stock because our policy is: “If you can stand, you can walk. If you can walk, you are well. And if you are well, we don’t pay.”

 

Q: My plan only covers generic drugs, which I heard are even less safe than usual. What if I want a brand name?

A: Convince that particular drug company to offer us a better kickback, or pay for your doctor to go to Hawaii. If that doesn’t work, poke yourself in the eye.

 

Q: I have a $150/month premium, my doctor’s visits are $360, and my co-pay is $10/visit. How do you profit or not lose money?

A: The doctor promises us not to provide any treatments that cost us any money, and we promise to send his nurses enough co-pays to cover their salary and the doctor’s rent. The drug companies cover the golf, tennis or whatever else it is that doctors do anyway.

 

Q: What do I do if I get sick when I am away?

A: You really should wait until you get home to get sick because we do not have any deals worked out with out-of-town doctors.

 

Q: I think I need to see a specialist, but my doctor will not allow me to go. Can a general practitioner really correct your spine and perform a heart transplant in his office?

A: Listen, you got an HMO, so you can have affordable coverage right? Well, you might as well have it all done in one place for one price where you know you are covered. All you are risking is the $10 co-payment, so there really is no harm in giving him a shot.


The average insurance premium in 2017 was about $400/mo per person. Which is 22% higher than the average premium of $321 for 2016 open enrollment. The average deductible per person is just over $4000. This means for a family of three you are going to spend out-of-pocket over $14,000 a year in premiums and then another $12,000+ a year in deductibles (some family discounts may apply).

 

Chiropractic care cost $1092/year per adult to be under wellness care at one adjustment a week here. That cost is less for a second adult and only about $500 for a child 12 and under. That same family of three in above example under wellness here would spend about $2500. That is 5.7 times LESS costly or a savings of $11,900 up front if you don’t even use insurance like my family and even more like $24,000 savings if you had to pay all those deductibles. Then you have to consider that Chiropractic patients take 85% less medication. Have 60% less hospital admissions, 62% fewer outpatient surgeries and spend more than 50% less in healthcare. The savings is off the charts. 

 

People ask me all the time questions that are based on who is covered under their insurance policy. The problem with this line of thinking is that the foundation of the question is the issue to begin with.

Give up your insurance policy. It doesn't ensure that you end up in good health. In fact it doesn't actually ensure anything other than you'll probably be sick when you use it, and more sick because of using it. Most people using “health insurance”(really its sick care insurance) are short sighted about how to create health in the first place and are listening to “health professionals” who are just reactive and have not studied and dedicated their lives to proactive real health care.

 

Get on a Health sharing plan, there are tons out there. The cost can be as little as $45/mo for an individual and there are family plans that cost roughly $400/mo (no limit on kids). No or low deductibles are available. They cover everything that should be covered and nothing that shouldn't. Then used that saved money for other healthy habits. Some of the people I know that use their health insurance the most are some of the sickest people I know.

 

If you need more help with this ask any of your Bandana doctors since we all have used this model for years. My health sharing plan cost my 4 person family $135/mo (it used to be $1150+/mo with insurance)or $1,620 in premiums last year which saved me more than $13,000 in one year! Some companies to look into Samaritan Ministries and Christian Healthcare Ministries.

 

https://www.zanebenefits.com/blog/affordable-care-act-policy-costs-up-in-2017

 

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