About Us
Certus Health is a family-owned company. As a self-employed family, we also had the need to find reliable, affordable health coverage. As former medical practice business consultants for 7 years, we teamed up with various healthcare providers in Houston to come up with a simple, yet effective way to not only save on health coverage, but to also have safe coverage. It is a THREE-part "program" and is very easy to follow:
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Purchase high-deductible health insurance to protect you and your family against "unexpected" and costly health events. For example: accidents, surgeries, cancer treatment - anything that is catastropic. You will use health insurance ONLY for these types of events, and NOT for routine health events. This way, your premiums will be low. How low will depend on how much you can comfortably contribute towards the medical payments in case something catastrophic does happen - the more you are prepared to contribute, the less your premiums will be. These policies average out to $75 per person per month.
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Reduce your exposure with accident gap insurance. This is insurance that pays for the deductible in your high-deductible health insurance plan in case anybody in your family suffers an accident. For example, let's say you have a health insurance plan with a $5,000 deductible and you have accident gap insurance that pays out up to $5,000 in case of an accident. If you then have an expensive accident, the most that you will pay out of pocket will be $100. It is a trick of the trade that few people realize, but it does work and it can reduce your exposure cheaply. A policy for $5,000 per accident costs only $36 per family per month.
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Pay wholesale for primary and routine care. Since you have a high-deductible health plan, you now have to become a "shopper" of primary care. It was this challenge that led us to create the Certus Health Routine Care Wholesale Club. What better way to save than to see the prices of doctors in Houston up front and online, and to get a deal on top of that.
How to lower the cost of health insurance?
We started our company by asking: “Why is health insurance so expensive and what can we do to lower the cost of premiums and other out-of-pocket expenses?” We found that we needed to separate "expected" healthcare expenses from "unexpected" healthcare expenses. In short, we need to
Insure against the unexpected and pay as you go for the expected.
We have been spoiled into thinking that health insurance should pay for every single medical service out there, and that we should just pay a small co-pay. Traditional co-pay insurance plans are therefore, not just coverage against unexpected injuries, chronic illnesses, surgeries, and hospitalization; they are also expensive prepaid plans for your routine care expenditures.
Imagine for a second what would happen to your car insurance premiums if they were to also pay for all your tune-ups, oil changes, mechanical fixes, and new tires. Well, your premiums would shoot way up because the car insurance company will be forced to collect sufficient funds from everybody to account for all those people who get a lot of these services - the people who say “Hey, if I’m pre-paying for an ‘all-I-can-eat’ plan, what is my incentive to think about I’m spending on all these services – it’s not my money.”
This is what has happened to healthcare and why it is so expensive. Traditional co-pay insurance plans have to have high premiums to account for those who are sicker than the majority of the population or for those who just indiscriminately use routine care services for any symptom. So we ask you: Do you think it is fair for your premiums to be high because you have to cover the expenses of those folks who don’t take care of themselves, or who have an “all-I-can-eat” attitude towards routine care? We understand that many folks are sick through no fault of their lifestyles, but still, is it fair to pay high premiums when you’re healthy?
When we ask ourselves these questions, the solution becomes very simple: What if I just paid for coverage against unexpected injuries, chronic illnesses, and hospitalization, AND paid as I go for routine care?
This is exactly what health insurance should really be about – a tool to protect yourself and your family against the high costs associated with an unexpected injury, chronic illness, surgery, or hospitalization. By doing this, your premiums will be 50%-75% lower than if you paid for a traditional co-pay insurance plan. Certus Health has license health insurance agents and we’ll be happy to help you purchase the right health insurance policy for your family.
How to lower the cost of primary (routine) care?
However, it doesn’t just end there. What about routine care? Due to years of being spoiled by an employer prepaying for our routine care, we really don’t have a clue how much things cost. To understand the real cost of things, we first have to understand a little bit about the business of routine care doctors.
Self-pay patients pay a lot higher prices than co-pay patients because doctors have been forced to look at self-pay patients as an opportunity to make up for losses in insurance collections. We ask doctors: "If doctors are getting paid by the insurance companies 35%-40% of an imaginary retail price, and they are not getting paid for 45-60 days, wouldn’t it make sense to charge a self-pay patient a little bit less of what they collect from the insurance company, collect it 100% of the time, and have no payment delays, no billing costs, and no collection costs?" Self-pay patients can and should be the most valuable consumers for their businesses.
As former doctor practice consultants, Certus Health shows doctors the benefits of changing their payer mix to include more business from self-pay patients. Self-pay patients are not only more profitable, but also more enjoyable to work with than traditional co-pay patients because doctors deal directly and only with the patient – without an encumbering, third-party payer.
Certus Health and its participating providers have formed a Sam's Club of routine care - a marketplace where routine care doctors and self-pay patients can come together and bring back the patient-doctor relationship. This is the Certus Health Savings Club, where doctors offer price transparency, wholesale pricing, and great customer service; and self-pay patients pay in full at time of service. We invite you to join us in making healthcare more affordable and more pleasant for everyone.
* The Certus Health Routine Care Wholesale Club is not health insurance, but instead allows members access to health care services from third party providers at published, wholesale prices. Certus Health does not guarantee the compliance of third party providers with regard to availability, specialties, or cost. |
