Discount plans offer pre-arranged discounts at participating providers and offices. These programs are not insurance. The Federal Trade Commission explains the difference between discount plans and health insurance this way:
- If you buy a health insurance plan, it generally covers a broad range of services, and pays you or your health care provider for a portion of your medical bills.
- With a medical discount plan, you generally pay a monthly fee to get discounts on specific services or products from a list of participating providers. Medical discount plans don’t pay your health care costs.
The Affordable Care Act changed the market for medical plans by requiring people to buy health insurance, although medical discount plans are still available. Dental and vision discount plans are widely available for purchase. Prescription discount plans are also available for those who qualify.
The companies that manage these plans have a variety of relationships with the providers in their networks. Here are some examples:
- Insurance Carriers: Assurant, Careington, Aetna’s Vital Savings program. Insurance companies offer discount plans using their PPO networks as a way to generate more cash business for their providers and make popular non-covered services available to their members. LASIK and teeth whitening are examples of services that are often purchased using discount plans. Typically discount plans define eligible services by vertical industry, such as alternative medicine, dental, or vision.
- Discount Program Organizations: AmeriPlan, Access to Healthcare Network, Patriot Health, dentalplans.com. Discount networks are purpose-built and sold in the open market. Providers like these plans because there is less paperwork, fewer rules, and payment is received when services are rendered. Members like them because they can choose any provider in the network, there are no deductibles or maximums, and there are no waiting periods. While these plans can’t be coordinated with Medicare or Medicaid, they can be used in conjunction with many commercial plans. These plans are usually organized by vertical.
Prescription Assistance Programs are included in the discount plan category, although they are a little different. They often have application processes that require approval from health care providers and are affected by income level and the cost of the medication needed. PPARx.org is a clearinghouse sponsored by the biopharmaceutical research companies that help connect qualifying patients with the program that’s best for them.
Do the providers in your network value discount plans as a way to diversify their income streams and attract new patients? How do your members feel about discount plans as a supplement to their insurance plans?