Health Coverage Should Flex in Real Time with Your Personal Health Needs – Medical Alley Association

Health Coverage Should Flex in Real Time with Your Personal Health Needs

How did you use health care in 2019? (I would ask about 2020, but Covid-19 has thrown everyone off.) Think about how many times you sought care, and what medical treatments you received. Got a rough idea? Was it the same as in 2018? The same number of visits, for the same health needs, with the same treatments, and the same costs? If you were unusually healthy, maybe so. But for most of us, the answer is no.

We’re humans. And, regardless of age, no two years of our health needs are ever exactly the same.

Why then, do health plans expect us to accurately predict our needs in advance, once a year during an annual enrollment event? That prediction requires us to do three very difficult jobs all at once—be an actuarial scientist, a clinician, and a fortuneteller. We have to get out a crystal ball to foresee what health care needs might arise over the coming year, know which treatments would address our conditions, and do difficult math to figure out which plan offers the best coverage. 

This is an impossible task. It doesn’t enable us to be smart consumers of health care—it makes us dart throwers.

So, instead of selecting a plan and activating coverage once a year, we should be able to flex our coverage, in real time, as our health needs change. Designing insurance this way instantly changes how we engage with our health and health care. Instead of a health plan that makes us pay for all of the possible health situations that might arise, we can have a personalized health plan that empowers us address health issues as they occur.

As consumers, we think and act like this: “I have a health problem. What kinds of treatment can help me manage it? Which is the best way to help me get healthy? And once I know my treatment options, where can I go to get care, and what will it cost?” It’s an intuitive process like any other familiar consumer behavior. 

Insurance coverage that flexes with our needs has the potential to transform health insurance into a decision-making platform—a personalized health plan—that enables us to get to our best health affordably, by choosing the highest-value care, while avoiding wasteful or low-value care along the way.

When health coverage doesn’t flex, we can end up in a position where we’re either over- or under-insured. Both are bad news for our pocketbooks and, potentially, our health. We could end up paying too much premium for coverage we don’t use, having to cover high deductibles and coinsurance before our health benefit kicks in, or paying out of pocket for care that’s not covered. It is unfortunately common for people to avoid care when they find themselves in the latter two of those situations. Alternatively, when coverage flexes in response to emerging health needs, we are always covered, and can elect coverage for plannable, non-emergency care as we need it.

Life is unpredictable, and it just makes sense that health insurance should reflect the way we live—flexing with our needs and offering us standard consumer tools to make our best buying decisions.

The health insurance industry owes consumers a better, more flexible, more affordable, personalized health plan experience. We owe it to everyone who’s ever been shocked by a surprise medical bill, to everyone who’s avoided care due to fear, uncertainty or doubt about costs, to everyone who’s rationed medicine, and to everyone who’s worked multiple jobs to cover a high deductible.

We also owe a better health insurance benefit offering to every employer who has had to make the tough choice to shift more of the health care cost burden to their employees, or to cut other benefits.

There’s a lot at stake. It’s time to build better together.

New Bind data illustrates the impact of better health insurance design. See our impact summary here.

Tony Miller, Bind CEO, believes the health insurance industry should deliver a marketplace-like experience—one where consumers can see and compare costs in advance of seeking care to make informed treatment choices. He founded Bind on the belief that people should pay less for providers and treatments that have a greater potential to get or keep them well.    

Bind redesigned health insurance to give employers the opportunity to offer a sustainable, attractive health benefit—without compromising coverage or quality. Members can see treatment options and compare costs before making a decision. The Bind personalized health plan delivers the freedom to choose—and the information to choose wisely. Learn more at yourbind.com.

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