“Insurance companies influence healthcare a lot more than they should in terms of what they cover and don’t cover.”

In this episode of UNCUT, Dr. Tom and health insurance broker Jeff Price team up to demystify the world of healthcare insurance in a revealing podcast. They discuss how insurance companies wield significant influence over what treatments and providers are covered, impacting the care patients receive. They discussed the importance of understanding factors like deductibles, copays, networks, and out-of-pocket maximums, warning against the potential pitfalls of opting for cheaper premiums, which might result in higher long-term costs.

The underinsurance of preventative care, especially in areas like physical therapy, is highlighted, with some plans imposing visit limits that could cut short essential treatments. Jeff Price advises listeners to opt for plans with broader networks, pointing out that Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs) generally lead to lower overall costs compared to high deductible plans.

The conversation stresses the need for patients to become savvy healthcare consumers, capable of navigating insurance intricacies and advocating for recommended care despite potential limitations. While acknowledging the call for a more transparent insurance system prioritizing treatment effectiveness over costs, the podcast also recognizes the slow pace of change due to strong lobbying efforts by insurance companies.