Hacker Healthcare - USA

I’d say that one of the most common problems that prevent successful bug bounty hunters from quitting their day job is that, in the USA, your healthcare is nearly always tied to your job. As such, when you quit your job to become self-employed, you will have to figure out how to get healthcare for yourself and your family. If you are in a single-income household, this gets increasingly difficult as you cannot rely on the healthcare provided by your spouse’s job, and must come up with an alternative solution. While the US Government has attempted to make healthcare easier over the past years with the launching of healthcare.gov, I think most people would still agree that the state of healthcare in the US for solopreneurs is quite challenging. As such, I thought it would be helpful to release this blog post explaining how I solved the healthcare problem for my family and me - after many hours of research.

Pre-requisites

I currently do not have any kids, and my wife and I are in our 20s, generally healthy, fit, and have no pre-existing health conditions. I am not saying that the route we have taken is for everyone. Everyone must do their own research, and this is in no way, shape, or form medical or legal advice.

The rest of the blog post will be broken down into 2 sections: Catastrophic Care and Everyday Life Care. These are the two primary areas that I am interested in having coverage for healthcare. If you have pre-existing conditions, this does not necessarily exclude you from taking a similar route, it will just up the complexity of the process. This path does, however, seem like it will continue to work for us, even if our family grows in size.

Part 1: Catastrophic Care

In this section, I will talk about my solution for coverage for large medical issues such as cancer, a bad car accident, etc. My solution to this is an alternative to insurance - this solution is not a high deductible health insurance plan; it is something called a healthshare plan. A healthshare plan is a (normally non-profit) organization that provides an alternative to normal US insurance by accepting a monthly premium from their members and using these premiums (as well as reserves, if necessary) to pay for the medical expenses of members that have a qualifying expense. There are many benefits to this structure, but one of the biggest benefits is that the bill for the medical service will not be as high as it would be if it was billed to a health insurance company as most medical providers have different rates for patients that don’t have qualifying health insurance. Due to the fact that a healthshare plan is not a health insurance plan, the healthshare company will be paying these reduced rates rather than the higher, insurance company rates.

The healthshare provider that I use is Zion Health. While I have not had to submit a claim through Zion Health yet, my interactions with their customer service and the reviews that I’ve read online have been generally positive. Unlike some other health share providers (and despite its name) Zion Health is not a religiously-affiliated organization (no one will be denied based on religious affiliation or lack thereof) and it does not require the client to pay the medical bill, then be reimbursed by Zion Health - Zion Health will pay your medical provider directly. Zion Health prides itself on fast customer service (I can personally vouch for this) and being quick to pay claims. Those are two very important things to me in a healthshare provider. There are also plenty of other additional features to the Zion Health program such as DPC discounts, Telehealth services, etc., which make them a great choice.

How it works

Ok, let’s say you get in a car accident and break your legs. Unfortunately, this will require pricey surgeries and months of physical therapy. The plans available through Zion Health each have varying IUA (Initial Unshareable Amount - I.E a deductible) amounts that you must pay before your additional expenses will be covered by the plan. Once you pay that amount, the rest of the expenses for this event will be covered by Zion Health. There are 3 different plans for the IUA - $1,000, $2,500, $5,000. Obviously the higher the IUA, the less you will pay per month.

So let’s say your bill for your leg surgery is $50,000. Assuming you’ve selected the $5,000 IUA plan, you will be paying the first $5,000 out of pocket. Then, the rest of the $45,000 will be paid by Zion Health. But you also need follow-up surgery, then physical therapy - well these are still part of the same event (need is the term they use in the documentation, I believe. This is under the same need). Thus the bill for the follow-up surgery ($30,000) then physical therapy ($10,000) will be covered in full by Zion Health. It’s that simple.

Conclusion

If you’re interested in using Zion Health or another healthshare provider as your primary source of Catastrophic care/coverage, I’d highly recommend that you speak with an agent at the company and thoroughly read the documentation on the website.

For my wife Mariah and I, we decided to go with the highest IUA plan of $5,000, putting our monthly payment for both of us together at: $185.

You can see the quotes for your age range and family size here: https://zionhealth.org/direct-membership/

Also, this is a great page describing how the financials work at Zion Health: https://zionhealth.org/zion-health-financial-stats/

If you do decide to enroll at Zion Health, please use my membership number (122316603) in your enrollment application as described here: https://zionhealth.org/zion-health-referral-program/ to get me a $50 Amazon giftcard!

Pros

  • Coverage for all needs above IUA

  • TeleHealth coverage

  • DPC Discount

  • Fast customer service

  • Fast claim coverage

  • Not participating in crap USA healthcare system

Cons

  • Not traditional healthcare, so slightly more complex

  • Zion Health is a young company - not a very long track record

  • You will have to explain all of this to your medical provider at the time of payment

  • Pre-existing conditions aren’t always easy to deal with

Part 2: Everyday Life Care

As mentioned above, Healthshare programs are only for catastrophic issues. As such, we also need a solution for our routine doctor’s visit, etc. The solution that I landed on for this is called DPC - Direct Primary Care. This is a newer form of healthcare in which the patient pays a monthly fee to the doctor, and that doctor takes care of the patient’s primary care needs. The DPC movement is currently growing and most major cities have at least one doctor’s office which offers the DPC model.

Once you’ve established a contract with your local DPC doctor, you can often expect:

  • Very limited wait-times

  • Same-day or next-day appointments

  • Direct line to your regular doctor via SMS, cell phone, or chat system

  • A doctor that is not rushing around and has time to have a conversation with you about your health or health problem

To be perfectly honest, it kind of feels like how I’d imagine having a friend or family member in the medical industry feels. I’m a big fan.

The pricing for a DPC subscription widely varies by provider. Mariah and I paid $59 per month per person as we got in with an up-and-coming doctor’s office near us. That puts our monthly expenditure for DPC at $118 for the two of us. The only extra fees are from additional services like bloodwork (which they send to a lab) or prescriptions, but these have been quite cheap thus far, and we’re paying at cost.

So far we have utilized the DPC more heavily than expected. After not having visited a doctor for more than 2 years, I’ve been twice over the past couple of months - once for a bad case of poison ivy and once for a normal checkup. My wife has gone 3 times, and she’s said that they cover a wide range of female-oriented services that she needs as well. She loves feeling not rushed by a doctor for once. It is nice to have such quick access to a doctor to get advice about one’s health concerns.

Total Expenditures

Total healthcare expenses each month for my wife and me:

Zion Health Healthshare: $185
Local DPC Subscription: $118
Zion Health DPC Discount: -$35
------------------------------
Total: $268

Total savings: ~$750 a month.

For us, this method of getting care is actually better than the traditional method. When I was on standard health care before, I still had massive bills when I broke my finger and had any other medical needs, and I also had to pay much higher amounts per month. Not my favorite thing in the world, needless to say.

Anyways, feel free to shoot me questions about the details of this system! I wish you the best of luck finding a solution that works well for you.

Justin Gardner (@Rhynorater)