I'm on ACA. I get between $100 and $150 on a gift card to do my annual PCP visit even though my premium is $0/month.
Why? Obvious if you know about the perverse incentive tqi mentions
Why? Obvious if you know about the perverse incentive tqi mentions
1. On average, how healthy is your group of ACA plan holders? If the group has a bunch of chronic conditions, they get more subsidy money to offset the increased care costs. Going to the PCP allows them to have official medical evidence of those conditions.
2. The government gives these plans quality ratings to help people compare them to each other. These ratings are partially based on how often patients get their annual screenings and patient satisfaction. A gift card for a PCP visit accomplishes both aims.
There are also more practical concerns. Preventative care is cheaper than an acute incident for the company. You'd rather catch an arrhythmia at a PCP appointment than pay for the cost of a heart attack.
On your specific example, my understanding is that the odds are very low that a random PCP visit will detect an arrhythmia.
Of course, if you mentioned to doc that you're having fainty spells or heart palpitations, then maybe hen'll give you a holter monitor-- but then you've now increased your risk by waiting for the PCP visit instead of doing it when you first notice the symptoms.
I had an ACA "marketplace" plan back for my family back in 2017 when I was self-employed. My premiums were >$15K / year for a >$10K deductible and no tax credits (because of my income).
$25k today or $15k/yr for 20 years?
Gastric bypass surgery happens once. Many bypass patients require lifelong prescription nutritional supplements and all require lifelong lab monitoring.
Ulcer risks increase severalfold.
High risk of hernias, osteoporosis and complications thereof.
It's not just surgery and no immediate cost. But then again, any of those issues are options for denial, so...