A health care services discount program has been wrapped in a rainbow flag and is now being marketed to the LGBTQ+ community. The OutBüro Care+Plan is neither health insurance nor an indemnity plan. It is a discount program where members receive discounts on health care services. While it may hold some value for some people, the plan should be carefully scrutinized before an individual enrolls into it.
Discount Health Plan Not Necessarily Gay Friendly
When I first read about the OutBüro Care+Plan, with its rainbow and transgender flags prominently displayed in the brochure, I was excited about a health program that focused on the unique health care needs of the LGBTQ+ community. I erroneously thought that the doctors and other providers would all be LGBTQ+ understanding and welcoming. Unfortunately, the more I read the brochure and saw the companies involved, I could see this was just the old discount plan gift wrapped in a rainbow flag.
Discount From What Price?
Multiplan, the doctor provider network behind the OutBuro Care+Plan, is little more than a membership discount program for health care services. The pitch is that by being a Multiplan member and visiting providers in the Multiplan network, the plan member will receive discounts from the traditional over-the-counter price for the health care services. The literature claims the members can receive between 5% to 40% on medical services. While I have no reason to doubt the estimated discounts, the list prices of most health care services are horribly inflated.
When a health insurance plan member receives their Evidence of Billing from the insurance company after a health care service, they will typically see a negotiated amount as the actual cost of the service. This negotiated rate, sometimes referred to as the allowable amount, can be over 50% from the providers billed amount. If the health care service is subject to the plan’s deductible or coinsurance, the Evidence of Billing will detail how much the health plan pays and how much is the member’s responsibility.
What is unclear with Multiplan, and always has been, is what is being discounted. Is it the inflated list price or something closer to the rates the provider has negotiated with other health insurance companies? This gets to the heart of the issue of health care in the United States; there is no price transparency for consumers to use to make intelligent decisions with. I would feel much more comfortable if the provider posted their list prices for health care services and then the discounted or negotiated rates a Multiplan member is offered. But that is not how the system is set up.
Are The Providers LGBTQ+ Welcoming?
The other disappointment with the OutBüro Care+Plan is that the providers have not been vetted for a willingness to see and treat LGBTQ+ individuals. One of the big impediments to proper and continuous health care services for the LGBTQ+ community are finding providers who understand their needs and will not judge their lifestyle.
The Multiplan network offered in the OutBüro Care+Plan is the same affiliated providers available to anyone who enrolls in the discount health care plan. No special accommodations have been made, that I could see, to highlight LGBTQ+ providers.
What is truly needed is a list of providers who specifically state they welcome LGBTQ+ community members.
The Multiplan provider search tool is also not consumer friendly. Most health plan’s online provider search function, after designating the zip code, display a list of available providers. The user can filter this list by provider specialty such as pediatrics or oncology. With the Multiplan provider search, you put in the zip code, then you have to put in the provider’s name. How does the consumer know the providers name if they don’t even know what doctors are in the area? Perhaps I missed something while testing the Multiplan provider search tool, but it seemed woefully inadequate for searching for providers in my area.
The OutBüro Care+Plan does include discounts for dental, vision, hearing and prescription drug services and products. These ancillary products, and associated discounts, are provided by AtlasCare. The AtlasCare provider search tool is much better than the Multiplan website. Similar to Multiplan, there are no prices attached to the purported discounts of 10% to 85% that the plan member receives. At least with a Dental HMO plan, that anyone can enroll in at between $10 to $15 per month, there is a set copayment schedule of costs for dental services. The Dental HMO member can refer to the fee schedule to see exactly how much a filling or crown will cost.
The OutBüro Care+Plan costs approximately $60 per month for an individual. That is $720 per year. It is entirely possible, based on the health care, dental, vision, and pharmacy utilization of a given individual, that they will receive discounts for those services and products greater than what the annual membership costs. It all depends on how the plan member uses the benefits to manage their specific health care challenges and the ancillary costs for dental and vision services.
The literature very clearly states that the OutBuro Care+Plan is not insurance. It is also not an indemnity plan, such as AFLAC, that pays the member in the event of an accident or other health care service. It is a discount plan with specific conditions for receiving discounts and no guarantee of any discount such as in the event of emergency room treatment. There is a patient advocacy assistance element that members can contact to negotiate on their behalf if they are hospitalized and receive outrageous hospital bills. But there is no guarantee of any significant discount.
Each person or family must evaluate whether the OutBüro Care+Plan makes financial sense for them. In the absence of any health insurance, it is probably better than nothing. But the consumer needs to manage the benefits and understand how to find providers willing to accept the Multiplan or AtlasCare discount program in order to maximize the benefits.
If a person does not have health insurance because the premiums are too high or they have missed the open enrollment period, in California, there are not too many alternatives. California has banned short term medical plans. The other alternative are health care sharing ministry plans. Unfortunately, because the health care sharing plans are usually based on religious principles, they usually will deny coverage for many health care services for LGBTQ+ individuals.