Routine / Wellness doctor visits are covered if your total bills for a medical event are over $1,000 if you have the Gold plan... Routine/wellness visits are not covered for Silver or Bronze members unless there is a medical event exceeding $2,500 for Silver or $5,000 for Bronze members.
Telemedicine visit(s): Included for all members and all plans and there is NO copay for each visit. Doctors are available 24/7/365.
Click here for more information about Telemedicine visits
$1,000?! So how can I afford to go to the doctor?
Regular doctors visits (routine/wellness) with the GOLD plan are covered if your total bills for a medical event add up to be $1,000 or more.
Say you to to the doctor and he orders blood work, a test and a follow up. These bills can easily add up to be $1,000 or more. If they do then you can submit your bills to CHM for reimbursement. You do have a PR - Personal Responsibility of $1,000 per year and the minimum amount of all bills together for the one medical event have to be over $1,000 for the Gold plan. See examples here
If you go to the doctor and your total bills (before discount) are less than $1,000 after self-pay discount then you can not submit your claim to CHM for reimbursement. You do have access to free Tele-Medicine (online doctors visits). For more info continue to read below.
Silver / Bronze plan members:
Wellness/ Routine visits are not eligible for reimbursement unless they are related to a medical event/incident.
Free Tele-Medicine for all members
As of of October 1 2021 a 'telemedicine' visit (talk to a licensed US doctor via phone/video chat) is covered, 24/7 for all CHM members at no additional charge. Scroll down for more information.
So how can I afford to see a doctor or a specialist if my bills are less than $1,000 or if I have the Silver/Bronze plan?
With 'regular' insurance, on average people pay about $35 copay.
Also the average person pays $541 on health insurance premium, per person, per month (source: ValuePenguin.com).
With the Gold plan you pay $235 'premium' per person, per month
You save approx. $306 from the national average, per person, per month.
Put this $306 (or at least a portion of that amount) in a savings account every month and it will be easy to pay any doctor's bill when you need it.
If the doctors visit requires lab work, testing, a follow up, and the total bills for a medical event add up to be over $1,000, then you can submit all your bills to CHM. You will have a $1,000 yearly deductible and CHM will reimburse you the difference (with the Gold plan). If you already have met your PR/deductible then you will get reimbursed in full (however you can not submit a medical event until your total bills ad up to be $1,000 or more).
At the doctor's office:
At the time of check-in and making the appointment, explain that you are "self-pay"
Most doctors offices have significant reduced fees for self-pay patients as their billing department don't have to file (and deal with insurance) a claim and wait for their money. Doctors offices love self-pay patients and most of them have a self-pay discount policy in place.
Use the "health savings account" technique -as described above to pay for doctor visits.
Questions (click to learn more):