The CrowdHealth plan doesn’t include premiums, deductibles, physician networks, or anything else typically associated with the health insurance industry in New York. Our health plans emphasize reducing cost and working together to help Community Members instead. Here is how the coverage we provide works:

First, new Members are asked to make a monthly contribution to our service. Unlike costly premiums, this small payment covers our administrative costs ($30 per month) and then the rest is placed in a savings account for the individual. Money in your account is still yours and you can use it to pay a hospital bill in NYC or get yourself any medical care you need. Should you ever decide to leave CrowdHealth, your money is refunded to you minus a small fee. You can also use your funds to help other Members pay for care at your discretion to improve your generosity score. 

The next step is visiting the New York physician of your choice. Unlike plans that try to tell you which doctors to see, you can choose anybody with CrowdHealth. At the conclusion of your visit, ask for the cash cost. Doctors don’t always publish their cash rates, but they all have them. Furthermore, medical professionals love getting paid in cash because it means they don’t need to fight with a health insurance company over prior authorizations or wait four months to get paid. Cash payments also let doctors save on administration costs. 

If the total cost is $500 or less, you pay the bill. If your bill is more than $500, you make a $500 payment and submit a funding request to CrowdHealth for the rest. Submitting a claim is as easy as downloading our mobile app, taking a few photos, and clicking a confirmation button. What other insurance company makes the process so easy?

CrowdHealth facilitates every funding request we receive, so other Members will see your bill and be able to transfer funds directly to your individual account to help you pay it. Our expert negotiators will also try to reduce the cost and spread it out over a payment plan lasting up to 36 months, a process that makes health care much more affordable for our community. 

For instance, let’s say that you were treated for myocardial infarction in a New York hospital and received a bill for $500,000. Yikes! Our negotiators can bring the total cost down by 30-60 percent, so that $500,000 bill becomes more like $240,000. Then, we’ll negotiate a 24-month repayment plan so that 5,000 Members only have to pay $2 a month to cover the bill. That’s how our health plans work for New York consumers. 

CrowdHealth makes no guarantee that medical bills will be paid, so we technically don’t qualify as health insurance in New York or anywhere else. We know that sounds a little shady, but we think it gives us a competitive advantage over other health insurers in NY. 

The Affordable Care Act capped how much money insurance companies can make on monthly premiums at 15 percent and we’re sure they had the best of intentions. Unfortunately, capping profits at a percentage incentivizes health insurance companies to increase their premiums as often as possible to make more money. If you pay $1,000, they can make $150 off you per month. If they increase your premium to $1,100, they can make $165. 

Furthermore, health insurance companies frequently market their plans on the size of the network they’ve created. They could lose customers if they lose providers, giving them every incentive to capitulate whenever a provider asks for more money to keep them in the fold. Worse, they can then use the higher price points to justify raising premiums, making health care in New York even more expensive. 

CrowdHealth only increases revenues through enrollment and negotiating better deals for our Members, so we don’t have the same incentive to raise prices that health insurance companies do. We also question the value of any guarantee when the Kaiser Family Foundation found that nearly 20 percent of claims submitted on plans purchased through New York’s health insurance marketplace were denied.