As a patient, health insurance in Vermont is an absolute mess.  Half the people in the state are on a federal programs either Medicare or Medicaid, and the other half have commercial plans.  Of those in a commercial plan, 70% have a high deductible health plan defined as a yearly deductible of $1,650 individual and $3,300 for a family. This means that you have to pay your deductible before insurance pays anything despite your high premiums. And, the deductible resets every January!  Insurance companies have made massive profits on the backs of hard-working Americans.  They are generally more interested in satisfying their investors than satisfying their patients. Denials and roadblocks for providers have become the norm.  This has led to both patient dissatisfaction and provider dissatisfaction as reimbursements have not kept pace with inflation. Also, medical practices need staff just to deal with insurance claims and denials.

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Health insurance has now become akin to a catastrophic insurance plan.  If you have to pay thousands of dollars out-of-pocket before your insurance kicks in, then the money that you spend out-of-pocket is your money and you should choose where you spend it wisely.  You should not accept substandard communication, poor follow-up, or long wait times.

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Our practice has gone to a direct payment system.  We charge you a reasonable surgical fee which covers all postoperative visits.  You may submit our bill to your insurance company for reimbursement of their customary fees, or it could be applied to your deductible.  This takes the insurance middleman out of the patient-physician relationship and provides for more satisfying experience for both the patient and provider.

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