Q: What do you mean by "health event"?
A: A health event is any unique health scenario that comes up for a Member and includes all the expenses and visits related to it. It could be something big, like a knee surgery (which might entail doctor's visits, the surgery itself including facility fees and anesthesia, physical therapy afterward, and prescription pain meds) or something minor, like one of your kids needing to see the pediatrician for a lingering cough or cold.
Q: Does my CrowdHealth Membership satisfy a state or federal individual insurance mandate?
A: No, your CrowdHealth Membership does not satisfy a federal or state individual Minimum Essential Coverage (MEC) mandate. If you live in a state (e.g. California, District of Columbia, Massachusetts, New Jersey, Rhode Island, Vermont) with a state-level individual MEC mandate, you are responsible for securing that coverage independently from your CrowdHealth Membership.
Q: How do I schedule a doctor appointment using CrowdHealth?
A: Before you schedule any care, please contact your Care Advocate so we can ensure an excellent Member experience for you! To schedule your doctor visits, you can use the CrowdHealth app to help you find the highest-rated doctors in your area, or you can see a doctor you already know and love. Once you choose a doctor, you’ll call or schedule online like you normally would and log the visit in the app. This keeps your Care Advocate in the loop and helps us make sure you’re getting the most out of your CrowdHealth Membership. Remember: CrowdHealth isn’t insurance, so you won’t have a card to present at your appointment, and your doctor won’t recognize CrowdHealth as an accepted insurance provider. Don’t worry; you can still see any doctor you want to, and we’re here to help you navigate these new situations of health care as a cash-pay patient.
Q: Can I contribute to an HSA using CrowdHealth?
A: Since CrowdHealth isn’t insurance, you cannot contribute to an HSA with our plan. This may be an option in the future, in the meantime, and you can still expect to save hundreds to thousands of dollars a year on your health costs. If you have existing money in an HSA account, you could use that to pay for your medical bills that fall within the $500 Member Commitment (each Member pays up to $500 per unique health event before expenses are submitted for Community funding). However, existing HSA dollars could not be used to pay your monthly subscriptions or contributions to CrowdHealth.
Q: What about big health events?
A: There is no maximum amount of health care costs you can share with the Community. The CrowdHealth platform is designed to maximize the probability that all Members’ eligible bills can be funded in full each month. You can learn more in the Member Guide.
Q: What are some examples of treatments and procedures that are not eligible for funding by the Community?
A: To protect the Community from excessive expenses, CrowdHealth certain conditions and treatments are limited or excluded from funding by the Community—things like alternative treatments, fertility, preexisting conditions over a certain cost, and anything medically unnecessary. Memberships currently don’t include mental health care or vision and dental, but we look forward to expanding what can be funded by the Community as we grow. You can learn more in the Member Guide.
Q: What about my prescriptions?
A: Prescriptions related to a specific health event that occurs while you are a Member are eligible for funding by the Community for 120 days after that event. For prescriptions lasting longer than 120 days, you are responsible, but regardless of the timeline, you have access to our pharmacy discount partner, which reduces your prescription costs by 50-60%.
Q: What if I have a pre-existing condition?
A: For pre-existing health conditions, you are responsible for all costs associated with the condition(s) in the first year. The Community will contribute up to $25K to bills related to pre-existing condition(s) in the second year, $50K in the third, and $100K in each year after. Prescriptions for your pre-existing conditions are not subject to the 120-day limit but are subject to the annual pre-existing condition maximums outlined above. You can learn more in the Member Guide.
Q: What do you mean by monthly subscription?
A: In addition to the amount contributed to the Community each month, every Member pays a $25 monthly subscription. This covers our operational costs so every penny of your monthly contribution goes directly to reduce the healthcare costs of the CrowdHealth Community.
Q: Why is my contribution to the Community lower this month?
A: The per-Member contributions you see are monthly maximums. If you and the Community spend less in a given month, your contribution can be lower than these numbers. When you make healthy and smart spending choices, you and the whole Member Community benefit.
Q: I still don't get how this is so much less expensive per month than my insurance plan. What will you do if a Member has a massively expensive medical bill that's more than the Community can afford?
A: The CrowdHealth platform is designed to maximize the probability that all Members’ eligible bills can be funded in full each month. For big, planned bills (like expensive surgeries), we’ll negotiate the cost to a 30-60% discount before the procedure event happens. For big emergency bills, we’ll negotiate them after the fact and set them up to be paid by the Community over 12, 24, or 36 months. So, a huge $500,000 bill after a cardiac arrest and hospital stay could come down to $240,000, divided by 24 months and 5000 Community Members, and amount to just $2 of funding from Member contributions per Member each month over the two-year payment period.
Q: Do you accept everyone?
Almost! The Community is not currently open to tobacco users (defined as daily use for a period of 3 or more months, past or present) or those who weigh over 260/300 pounds (female/male). We want the CrowdHealth Community to be a place for anyone looking to improve their health and contribute through the Member Community, so we hope to add an option for people with more varied health histories soon.