I’m getting phone calls from my health insurance company, first from a “registered nurse” with no information in the voicemail other than a call-back number (seems like it could be a scam, but I need to verify the number, so far people are saying the number is legit), and now I have a second phone call where the voicemail mentions they are calling from the insurance company’s “concierge program”.
Mostly I want to know if I can ignore these calls without consequence, or if I have to return them, and if so what should I expect?
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I thought a ‘concierge program’ was similar to OneMedical. You pay an annual fee, have a PCP, but the PCP doesn’t typically do much besides refer you to specialists, give advice, or prescribe meds.
A concierge service can be immensely helpful. My company got bought by a giant tech company in 2019, when it happened, a) I was 4 weeks into a 6 week open heart surgery recovery and b) they changed my insurance causing me to lose my existing hospital and all my current doctors.
The concierge set me up with a new hospital and new doctors. When I started having post surgical complications that would have killed me, and the new hospital told me I’d have to wait 3 months to see someone, the concierge got that time cut down to 2 weeks.
I mean, I still almost died, and wouldn’t have if I had been able to keep my existing insurance, but the concierge took care of things that I was in no shape to deal with.
Think of them like the medical version of a hotel concierge. “Hey, can you arrange for a cab to meet me here at 2:45 PM?”
“Certainly sir.”
The fact that concierge services like this are not only possible, but in many cases necessary to achieve optimal outcomes, is really the only reason anyone should need to jury nullify Luigi’s case.
So basically something that should be commonplace to navigate the hellscape that is US healthcare.
Pretty much!
“My primary care physician retired, can you find me a new one?” that kind of thing.
Maybe that would have been helpful when my doctors office closed suddenly (permanently) on a Friday last year and I’ve spent the entire time until now just trying to get a primary doctor again that wasn’t an hour away. Whenever I call its “Sure, here’s 50 numbers for an endodontist that does retreats!” none of those numbers do that
Reading this question and these comments, the US healthcare system must be so fucking exhausting.
“Are these scam calls or will I lose my coverage if I ignore them? I literally can’t tell.”
I hate it so, so much, on a deeply visceral level. I work in biotech, and have worked at a med tech previously that focused on care coordination, and additionally had to fucking force my insurance, hospital, hospital billing department, and HRA provider to get on the phone together and walk them through debugging each other’s bureaucracy to track down the one fucking RefID that some idiot stuck in the wrong box - that last one took fucking WEEKS. So yeah, I know a thing or five about the shitshow that is health insurance in the states, and I’ve been radicalized by my experiences.
Please send more blue shells - it seems that’s the only thing they respond meaningfully to.
As someone that’s spent over a decade working in US healthcare, I can easily say it’s exhausting for everyone involved. It’s busy work. Especially if you are not providing direct care. Everything else is extractive fluff that makes cost of care more expensive, burdensome, and just dumb. And now with VC companies wading into healthcare everything is becoming even more expensive, even more dumb, and greedy.
Yes, I’m always worried about being penalized for not navigating the bureaucracy well enough, or for letting things slip through the cracks.
It’s gotten to the point where you need to have an attorney on retainer just to get real answers from these companies. Instead of saying you’ll get an attorney to the underpaid customer service rep with no power who can’t care less and people threaten legal actions with no follow through constantly… an actual attorney sending a letter calling the company out for their failure to address your issues gets you put into a separate system where they know you actually have representation they want to avoid.
Those monthly retainer services are surprisingly cheap too if you just need something verified or a notice sent once in a while. Many companies even offer discounted legal retainer services as part of their benefits packages.
It really is.
I can’t answer why you’re getting calls, but I’d be suspicious.
It’s where your primary care physician goes independent and stops accepting insurance. You pay them a flat fee a couple of times a year, and get their service for free. That is, you’re obviously paying them whether you use them or not, but you don’t pay them every time you see them.
You still need insurance, to cover things like specialists, and many tests the doctor performs - blood work, etc - can still be billed to insurance. But you go to a flat fee for your doctor.
My wife and I did it because our primary care physician, who we’ve been with for years and like, went concierge; we decided to stay with her despite it costing more than to switch to a different doctor.
Many things changed, mostly for the better.
- It is more expensive
- We get appointments with her often the same day - no more scheduling three weeks out
- We have an instant messaging app, and message her any time, and get a response within minutes up to a half hour. I’ve messaged her on the weekend and gotten an immediate response. She’s not the only one who answers - her PAs field some stuff, like appointments, but getting the immediate response is fantastic
- We no longer worry about co-pay or getting bills from her. Unless there’s lab work, all we pay is the bi-yearly fee. The emotional value of feeling free to contact her any time about anything can not be undervalued
- She loves it because, apparently, working in a clinic is hell for physicians. Shitty records systems, slow information responses, bureaucracy, crammed scheduling. She’s happier.
- I have yet to have to wait to see her. If I have an appointment, any time of the day, I show up and she’s ready. No sitting in the waiting room for a half hour.
- We’re able to hold cheaper insurance, because we’re paying for the GP out of pocket.
There is really the only one downside: insurance does not cover concierge, and it is not cheap. It’s within reason for middle class, but it’d be utterly unaffordable for lower or lower-middle class. It’s totally entitled. OTOH, if we had a single payer universal healthcare system, or if every provider were concierge, healthcare would be cheaper all around and maybe it’d be affordable.
Anyway, we did it because we followed a doctor. I don’t know that I’d jump into it with a provider I didn’t know. In our doctor’s case, she only offered it to her existing patients and doesn’t take on new ones (or, not often), and keeps her work load more manageable; I’d expect this to be common.
If insurance is trying to get you to do this, there’s an angle and I’d be suspicious. Either because they have to pay less (because concierge fees aren’t paid by insurance); or some company has figured out a way to “give you insurance” where you pay them and they pay the concierge fee, in which case they’re just a middleman skimming money and you’re paying more.
We are extremely happy with our concierge service, but we love our doctor, we can afford it, and it’s been a massively better experience for us. But that’s us. YMMV.
For BlueCross/BlueShield it’s “pay more to get priority access and continuity of care”.
Seriously.
My mom has it, we decided it was worth the premium bump because she’s in Palm Springs and it’s a consolidated health system there, everything from Medicaid to Concierge BlueCross is in the same building. I’m not sure if it’s totally necessary but they do treat her really well.
Hm, why would they be reaching out like this, is that typical? Is it an attempt to get me to pay for the concierge program?
Its for people that require several specialists for their health coverage. For example cancer patients who have surgeons, screenings, treatments all thru seperate departments or facilities all together. The concierge helps coordinate your shit and helps keep everyone in communication and keeps you on schedule.
Doesnt have to be cancer tho. They can be helpful for example my case where I’m seeing psych for counseling, psych MD for prescribing, endocrinologist for type 1 diabetes, primary physician cuz its req. So I’ve used them to keep all that shit in line.
This seems more likely - I am just suspicious about their role - what exactly are they helping coordinate, and what role do they actually play in this “coordination”? Hm, it does sound like I should call back, though …
Concierge service is usually separate from traditional health insurance. Idk what it means in the context of an existing plan.
Do they specify “I am from x company” or do they say “I am calling about your health insurance”?
They claim to be from the health insurance company that I have, which is Anthem BCBS.
Probably trying to upsell you a premium service but I’ve never had anyone call me over that, only seen letters/ads.
Edit: just read the other comments here and realized it could also be because of your utilization. You might have been flagged as being high risk, so they are targeting you for the product.
If you are getting calls about this, it means you are costing them money. They want you to use their nurses and doctors through telehealth visits first to dissuade you from more expensive treatment like er visits.
This is what I suspect too, I would expect that they will only come calling when they want you to stop costing them money.
