A New Way of Looking at Affordable Health Insurance Plans in Texas

Health insurance is complicated in Texas. Most people turn to their employer for health insurance coverage, frequently being pressured into choosing a plan shortly after being hired. Once they have that plan, they pay high monthly premiums and are limited to a small network of healthcare providers. High deductibles also prevent many consumers from taking full advantage of their health insurance plans. 

Medicare and Medicaid are government-sponsored health insurance options, but many of the same problems exist. Consumers are given tons of health plans to choose from and relatively short enrollment periods to do research, frequently paying too much for Texas health insurance or finding out they don’t have enough coverage when it’s too late to do anything about it. Patients are often encouraged to purchase a Medicare Part C Advantage Plan as well, again limiting them to a small network of health care providers. 

If you’re tired of costly plans, high deductibles, and limited provider networks, a company called CrowdHealth is looking to flip the health insurance paradigm on its head. Whereas traditional insurance companies put profits before people, CrowdHealth isn’t insurance. Plans are designed to help the public access essential care without breaking the bank. Please continue reading to learn more about how CrowdHealth is disrupting the health insurance industry.

CrowdHealth doesn’t have the monthly premiums, networks, or deductibles that define the broader health insurance industry, and we aren’t even an insurance company. Instead, our mission is to help each Member crowdfund whenever they need care in excess of $500, spreading the bill across multiple Members. We do so in four simple steps:

First, new Members sign up for CrowdHealth and agree to make a regular monthly contribution to our platform. The standard cost for most people (ages 6-54) is $175 per month, of which $30 goes to CrowdHealth to help cover administrative costs. The rest is placed in your crowdfund account where you can use it to help with your healthcare expenses or assist other Members with their costs to improve your “generosity score”. 

Since we want to make coverage as transparent as possible, we’ll share the other rates right now: Families of 4-8 eligible members can all enroll together for $695 per month. Again, none of these prices are premiums because the vast majority of the money collected is placed in your crowdfunding account. 

The next step is seeing a health care provider and asking for the cash price. If the total is $500 or less, the patient is responsible for the entire bill. However, totals in excess of $500 require patients to make a down payment of $500 and submit a funding request to CrowdHealth for the rest. We encourage Members to tell us they plan to receive costly care beforehand so we can negotiate a better price with their provider than a traditional insurance company would. 

You might be wondering why a care provider would have any incentive to negotiate with us. The answer is simple: Doctors like being paid in cash because they don’t have to shell out for the administrative costs of filing an insurance claim, fight over prior authorizations, or wait 90-120 days to be compensated for their services. All told, we save our Members an average of 60% on emergency room visits and 30-50% on other costs otherwise negotiated by insurance companies. 

The third step is submitting your bill, which is as easy as downloading our mobile app, snapping a picture, and clicking submit. The final step consists of CrowdHealth facilitating your funding request, ensuring that bills are paid quickly and smoothly. Funds are transferred directly from other Member accounts to yours for maximal convenience. It’s really that easy!

While CrowdHealth is interested in providing affordable coverage to as many people as possible, there are a few things we cannot cover at this time. Alternative therapies, cosmetic procedures, long-term prescriptions (defined as longer than 120 days), fertility treatments, vision, and dental coverage are not currently eligible for crowdfunding.

Similarly, we are not currently looking to enroll Members who use tobacco, are 65 years of age or older, or exceed certain weight limitations since such Members present too much risk to our Community. Our enrollment efforts are available to people with pre-existing medical conditions, but any care associated with those conditions will not be eligible for crowdfunding in the first year and will be subject to strict maximums thereafter. 

If you have an HSA account, you will not be able to use it to pay your monthly contributions to a CrowdHealth plan. However, you will be able to use it to pay your $500 per-event payments. Altogether, these restrictions pale in comparison to the limitations of the classic health insurance plan.