Cross posted on the Health board:

I know someone thinking about accepting an offer from a smaller company that has Curative as their health insurance. Does anyone have any experience with this? The benefits show you pay $0 for any service if you participate in their "baseline visit". It seems that most of the providers are in-network through "First Health". All I can find about this company is that it is out of Austin, started a health insurance business in 2022, and was a startup selling Covid testing in 2020.

Any thoughts would be greatly appreciated.

Our company just switched to a Curative this year. It was by far the best choice here locally, given that St. Joseph's network falls within First Health and while Scott & White did not renew with First Health, Curative negotiated an agreement directly with them to keep all S&W in network.

You have a 120 day grace period to schedule your assessment, which is basically a 30-minute discussion with a doctor about your general health, exercise, concerns, etc. Nothing discussed in the assessment will affect your coverage or your rates. They are trying to help guide people through preventative maintenance before things blow up to large, costly emergencies (or at least that is the business plan). If you decide not to do the assessment, it defaults to a standard HDHP, although I can't fathom why anyone would balk at it.

Only risk in my opinion is if the employees really hammer the policy and run up a ton of claims, your renewal will obviously increase the following year, since current premiums are based on estimated claim amounts due to demographics, etc.

We've had one of our employees get retinal surgery that BCBS balked at, Curative not only approved it immediately, they sent additional equipment to his home for better recovery. I've had an MRI and might have to have shoulder surgery. All of it will be covered at $0.

So far, I have been extremely impressed.

We have it at our firm. Some headaches initially because none of the providers had any experience with the company, but so far so good.

Thanks for the responses. Just curious - do yall work for smaller companies also? The one my friend is looking at is about 80ppl total.

We have around 35 people at our company.

25 or so

Bonfire97 said:

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Cross posted on the Health board:

I know someone thinking about accepting an offer from a smaller company that has Curative as their health insurance. Does anyone have any experience with this? The benefits show you pay $0 for any service if you participate in their "baseline visit". It seems that most of the providers are in-network through "First Health". All I can find about this company is that it is out of Austin, started a health insurance business in 2022, and was a startup selling Covid testing in 2020.

Any thoughts would be greatly appreciated.

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For me, it would all depend on whether my providers are in network, and what us the out of network cost.

Is First Health a large established insurance company or a broker? I'm not familiar with them.

The way I understand it is that First Health is a PPO network that has negotiated rates with doctors and hospitals that Curative pays to have access to. It seems like all the doctors I checked accept First Health as well as all the big Houston hospitals (Memorial Hermann, Methodist, etc.).

Bump. Any updated thoughts? This is what we're moving to next year and the pharmacy stuff has me nervous. There are only about 4 in network within 45 minutes of us. With two young kids constantly sick, same day med availability is a concern. As is my daughter's SLP that provides services at her school but does not appear to be in network and my PT I've been with 4 months and now seeing results after ditching the first PT where I did not.

I'm also curious, did they accept the position with that company? How did Curative do?

Our broker just brought up the idea, and if it all works perfectly, it's obviously a good idea (dependent on what the quoted premium might be when that comes back), but I've seen a lot of hit and miss on Rx coverage and things when searching around online.

Our company has been with BCBS for a decade+ and had plenty of headaches with denials of employees' procedures and prescriptions, but have found ways to navigate it to limit damage most of the time.

We're in DFW, so I would expect that people can find decent coverage, but our guys are all blue collar and don't need additional complications to get proper medical care.

Personally, I wish we had them the past two years, as my wife and I have had 2 kids in that span and hit our $12k out of pocket both years. Having an extra $24k would certainly be worth some minor inconvenience for me.

6 months in we are pleased with them. Our only complaint is local pharmacy availability but that is mostly because of where we live. However the one time we needed a medication urgently and had to use a non-network pharmacy due to it being after hours it was very easy to get that approved over the phone (use the term pharmacy override) and we paid $0. The mail pharmacy is easy as expected. Actually recently after a pulmonologist follow-up on a Friday they texted and called to find out if we needed to have a prescription transferred to a local pharmacy because it was a critical acute med and wouldn't be delivered until Monday at the earliest. We didn't need it right away because we already had some but I definitely appreciated them being on top of that. Ive also had no problems getting providers approved for zero card use and have had thousands charged to the card by now yet have paid not a cent out of my pocket. Providers are absolutely not fully in the loop about them and when they tell you they're out of network and you haven't hit your deductible yet it's easiest to just tell them you're charging to an HSA card but the end result is exactly what curative advertises. I did ahead of time after learning we were moving to them begin nominating providers for the zero card if they didn't seem to be in network, and began asking questions about prior authorization for provider types that could be problematic. Doing all of this ahead of time basically meant we didn't miss a beat and we have 5 specialists for our household (SLP, ENT, PT, allergist, pulmonologist). I will say the beginning of year meeting with a provider to be eligible for no out of pocket cost was a complete joke. There is zero chance the provided "counseling" is effective with anyone and they had not read the questions I submitted while completing the online portion but whatever, it was 10 minutes and pushed me through.

AlphaBean said:

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I will say the beginning of year meeting with a provider to be eligible for no out of pocket cost was a complete joke. There is zero chance the provided "counseling" is effective with anyone and they had not read the questions I submitted while completing the online portion but whatever, it was 10 minutes and pushed me through.

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yeah, I'm sure this was sold to investors as a revolutionary Value Based Care tool which will identify problems before they arise. Easier said than done of course.

Just curious, is the company fully subsiding your insurance? Or are you paying a portion of the coverage?

KYKing said:

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Just curious, is the company fully subsiding your insurance? Or are you paying a portion of the coverage?

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Our company fully pays the premiums.