Basic Care Coverage:
A Plan for Everyone’s Needs
Regardless of a person’s age, the need for regular preventive care, combined with unexpected medical occurrences, make having healthcare coverage a wise choice. Aliera’s basic healthcare plan—PrimaCare—is based on the direct primary care model. With a PrimaCare plan from Aliera, 80% – 90% of a person’s daily needs are met when it comes to their everyday healthcare. Most people will need primary care visits during the year, or may even require a visit to the urgent care facility, which is where a Primacare plan helps everyone. With the PrimaCare and PrimaCare Senior plans, Aliera Healthcare offers basic care coverage for every stage of life.
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What basic care coverage provides
Whether a person is just starting off in life or nearing retirement and Medicare age, a plan for basic healthcare needs is the most important healthcare coverage one can have. With basic healthcare coverage, members receive preventive care, primary care, urgent care, labs and diagnostics, telemedicine, chronic condition care, pediatric care, some OB/GYN, and prescription discounts for a set monthly fee. There are no extra co-pays or deductibles that need to be paid. All of these services are included in the monthly premium. The only exceptions are consult fees at the doctor’s office, averaging $20 per visit.
PrimaCare’s basic care coverage focuses on quality primary care
At the heart and soul of DPC is primary care—a key component to getting and staying healthy. Aliera’s basic care coverage includes a wide range of benefits offered as a part of primary care, including office procedures such as nebulizer treatments, ECG strips, and audiometry, as well as skin procedures and wellness visits. Most immunizations and vaccines are done in the office at the time of the visit for just the cost of the medication. Annual check-ups are included in this plan and are a vital part of maintaining a healthy lifestyle—yearly well visits help ensure that regular examines are being performed.
Based on the direct primary care (DPC) model, the goal is affordable coverage by reducing redundancy and cost
Traditional health insurance premiums can be rather costly. On top of premiums, members have co-pays at the office and for prescriptions. For many services, deductibles must be met before the insurance even kicks in and starts to pay a portion. With PrimaCare and PrimaCare Senior, members receive direct primary care for one monthly fee and have no deductible: “fees-for-services” are removed.
The monthly premiums for primary care coverage may range from $69 to $99 per month depending on the plan that is chosen, the age of the members, and the number of dependents. In order to keep premium costs down, DPC members are encouraged to remain healthy throughout the year by having fully-covered, no-cost preventive care which includes screenings, immunizations, and flu shots.
All labs and diagnostics are fully covered and have no additional cost if performed at the member’s primary care physician or urgent care facility. To make the doctor more accessible and convenient, basic healthcare coverage includes telemedicine doctors with no co-pays. Now, whether members are at work, at home, on vacation, or on the road, a U.S. board-certified doctor can be reach via phone or video chat 24/7. These doctors can easily diagnose many problems and write prescriptions over the phone. If necessary, they can recommend follow-ups at a qualified doctor’s or specialist’s office.
When telemedicine just won’t do the job, members can visit their primary care physician with only a $20 consult fee. Depending on the DPC plan, primary care visits may be limited to either three visits per year or unlimited. Every Basic care coverage plan includes a prescription discount program that can save up to 55% on medications. For families with children, plans that offer up to five pediatric visits per year are also available.
Aliera’s Basic care coverage is not traditional health insurance
PrimaCare and PrimaCare Senior are part of a growing movement called “direct primary care medical home,” and are not considered health insurance. A direct primary care plan is designed to aid the member in navigating healthcare in a cost-effective and meaningful way. It is not intended to cover hospitalization or other major medical needs, but rather to provide everyday basic care that most of us need and can afford.
PrimaCare and PrimaCare Senior, two different plans for two different groups
Although PrimaCare and PrimaCare Senior are essentially the same, they are designed for two different groups of people. PrimaCare is direct primary care for individuals or families ages 18 to 59 who do not normally require chronic care or have more severe health concerns. PrimaCare Senior is direct primary care created specifically for individuals or families ages 60-64, as it includes chronic care visits and encompasses more of a senior’s health concerns.
The pros and cons of basic care coverage
Basic care coverage has both advantages and disadvantages. With the lower cost in premiums and all-inclusive primary care office treatments, members can set aside the monthly savings to help offset the times when larger, unexpected medical expenses hit. Being able to save the cost of co-pay’s by using telemedicine is more money to be used for the large medical bills later.
Since Basic care coverage doesn’t include hospitalization, a second policy would have to be purchase, which means an additional premium. With Aliera’s catastrophic coverage, the additional policy would still be less expensive than the cost of traditional health insurance. The monthly premium savings can then be used to offset the higher deductible for the catastrophic policy.
Making decisions about healthcare coverage is extremely important, and making the right decision is even more important. Sacrifices to quality healthcare don’t have to be made simply because of the cost of premiums. With PrimaCare and PrimaCare Senior, people once again have the power to have quality healthcare at a cost they can afford.