A ‘Costco’
for healthCare Entree membership
promises discounts but
is not medical insurance
Amid rising health insurance premiums in Hawaii and a high number of working uninsured, the health discount card has entered the marketplace.
For a monthly fee of less than $100, depending on the plan, the cards promise reduced rates at participating pharmacies, dentists, hospitals and doctors' offices.
Texas-based Care Entree has been selling its product in Hawaii for the last couple of years. A local representative of the company could not say how many Hawaii customers had signed up, and a corporate representative could not be reached for comment.
Care Entree recently offered members of Small Business Hawaii a rate of $64.95 per month for a family of four or more.
Supporters of the discount card system and those who sell it say it is an affordable option for people unable to either access or afford a health insurance plan. By paying cash at the time of service to providers, members receive discounts. According to its Web site, Care Entree members can receive discounts ranging from 15 per- cent to 50 percent or more. But members have to pay cash -- no credit cards -- at the time of service in order to get the discount.
The Systemcenter Inc. President Joyce Edwards said she purchased only the dental portion of the Care Entree product for herself and her employees.
Edwards said she was aware the program was not an insurance plan when she made the decision to purchase. However, the size of the upfront costs required for dental care did catch her and some of her employees by surprise.
"It's cash upfront, no charge cards and no payments, so you need to be aware and evaluate whether you can afford that when you go in for care. It's OK if you don't have any alternative, but it's no replacement for dental insurance," she said.
The question of whether Care Entree makes it clear enough to consumers that its plans are not health insurance is among the issues that has made it the subject of complaints and investigations in several states, including Hawaii. While no claims have been prosecuted against the company, the Better Business Bureau has referred its advertising practices to the Federal Trade Commission for investigation, and two states have passed laws requiring the discount cards issued by Care Entree and others in the same business to clearly state that they do constitute insurance coverage.
Honolulu physician Dr. Robert Sussman describes Care Entree as "a middleman kind of deal."
"You pay a fee like you would to Costco, and you get a cheaper rate on what you purchase. It's just a discount card, but in this case it's health care," he said.
Sussman estimates 20 percent to 30 percent of his patients lack insurance.
He offers his own discount for patients willing to pay cash.
He has seen Care Entree patients before. When they realize they can get a discount directly from the him, they question why they are paying a monthly fee to Care Entree, he said.
"People then wonder why should they pay Care Entree to be the middleman. I guess overall what bothers me is that you are charging people an ever increasing amount of money for what you can walk into our office and get for $40."
Still, it may be a plus for some patients. Not every patient is comfortable with asking a doctor for a discount if they have no insurance.
"If you are sick with a chronic medical problem, it can offer some advantages, although you could probably negotiate a payment plan directly with a hospital," he said. The plan may also help with discounts on prescription drugs, he said.
Paula Arcena, executive director of the Hawaii Medical Association, notes that overall, programs like Care Entree are probably more appropriate for people who are healthy or self-employed, or if they plan to have a procedure that would normally not be covered by health insurance
But she said patients should not feel shy about asking their doctor for a discount. "I think with a lot of patients, the mentality is such that they think they have to have insurance to see a doctor. It doesn't occur to them they could approach a physician and say, 'Look, I don't have a lot of money, could we work something out?'"
