It is vitally important that commercial truck drivers have some type of medical care plan due to the high rate of illnesses and injuries that they sustain. Most commercial truck drivers health is not the best and could be improved through better food choices. Typically, many truckers diets consist of far too many unhealthy food choices. High blood pressure, diabetes and obesity are a few of the conditions which require regular medical treatment. Accidents, injuries, heart attacks and strokes are some of the serious conditions which would require drivers to seek emergency room care. Health Insurance for truck drivers would cover these conditions and many more. Health insurance plans differentiate based on whether they provide regular health insurance or major medical health insurance.
Regular health insurance covers basic routine procedures. This includes regular exams and routine illnesses. This also includes colds, flu shots, vaccinations, ear infections, minor injuries, etc. It does not include coverage for serious health problems.
Major medical health insurance is for serious health concerns. This covers serious illnesses such as cancer, heart disease, strokes, accidents, etc. No one can ever predict when a medical emergency will occur as one could occur anywhere, and anytime to anyone. Serious medical problems such as these are very expensive and could financially devastate those who don’t have insurance coverage.
Major medical plans are often sold in combination with a comprehensive health plan that covers preventive care. One can be used to cover basic health care expenses such as routine doctor visits such as infections, colds, flu, minor injuries, etc. The other can be used to cover expensive emergency room visits and the treatment of serious diseases and long-term illnesses.
Many commercial truck drivers, especially independent operators don’t have any health insurance plan. Fortunately, a new plan offered by the Owner Operator Independent Drivers Association (OOIDA) can help by offering a basic health care plan. OOIDA is a company which fights for the rights of all professional truckers. OOIDA has introduced a plan called “My Community Care.” This is not an insurance plan but rather a membership program which provides medical care for injuries or illnesses as well as preventive health and wellness services. This plan does not cover life-threatening conditions or serious injuries. This health plan is available to truck drivers and their families.
This is a membership based program so interested drivers must join OOIDA and can do so for a very nominal fee. New members have 60 days from the effective date of their membership to enroll in the “My Community Care” Program. The open enrollment for the “My Community Care” program for current members has been extended until May 31, 2012. The cost for this program is $89.00 per month. That is your only cost for most services. All visits to the center for you and your family are provided at no additional cost. Infants are eligible once they reach six months of age. Adult children are covered through the age of 26. There are no exclusions for pre-existing conditions. There are no deductibles or co-pays at the direct health care centers. This is certainly a very affordable option for many drivers.
Services provided include illness, injuries, preventive care, general care and urgent care. The wide range of services offered include vaccinations, colds, flu, sprains, back pain, urinary tract infections, minor burns, sinus infections, bronchitis and annual work, school, sports and DOT physicals. Additional services offered are x-ray and imaging services. Limited lab work is provided at no cost.
OOIDA has contracted with over 1,300 direct health care centers throughout the United States to provide this service. One of the participating centers is Concentra Medical Center. Many truck drivers are already familiar with Concentra because it is a place where many of them obtain medical services and get their DOT physical. Services at these direct health care centers are available at no additional cost. A nationwide network of over 17,000 providers has been contracted for additional services such chiropractic and physical therapy. These services are available to members at a 25% to 30% discount. Discounts are available on eyewear including contact lenses, prescription drugs, dental care and diabetic care supplies. Discounts are also available for MRI and CT scans. Additional services include a 24 hour nurse-doctors hotline. Not all services are available at all locations.
The Affordable Care Act (ACA) mandates that health insurance companies pay for preventive health visits. However, that term is somewhat deceptive, as consumers may feel they can visit the doctor for just a general checkup, talk about anything, and the visit will be paid 100% with no copay. In fact, some, and perhaps most, health insurance companies only cover the A and B recommendations of the U.S. Preventive Services Task Force. These recommendations cover such topics as providing counseling on smoking cessation, alcohol abuse, obesity, and tests for blood pressure, cholesterol, and diabetes (for at risk patients), and some cancer screening physical exams. BUT if a patient mentions casually that he or she is feeling generally fatigued, the doctor could write down a diagnosis related to that fatigue and effectively transform the “wellness visit” into a “sick visit.” The same is true if the patient mentions occasional sleeplessness, upset stomach, stress, headaches, or any other medical condition. In order to get the “free preventive health” visit paid for 100%, the visit needs to be confined to a very narrow group of topics that most people will find vert constrained.
Similarly, the ACA calls for insurance companies to pay for preventive colonoscopy screenings for colon cancer. However, once again there is a catch. If the doctor finds any kind of problem during the colonoscopy and writes down a diagnosis code other than “routine preventive health screening,” the insurance company may not, and probably will not, pay for the colonoscopy directly. Instead, the costs would be applied to the annual deductible, which means most patients would get stuck paying for the cost of the screening.
This latter possibility frustrates the intention of the ACA. The law was written to encourage everyone – those at risk as well as those facing no known risk – to get checked. But if people go into the procedure expecting insurance to pay the cost, and then a week later receive a surprise letter indicating they are responsible for the $2,000 – $2,500 cost, it will give people a strong financial disincentive to getting tested.
As an attorney, I wonder how the law could get twisted around to this extent. The purpose of a colonoscopy is determined at the moment an appointment is made, not ex post facto during or after the colonoscopy. If the patient has no symptoms and is simply getting a colonoscopy to screen for colon cancer because the patient has reached age 45 or 50 or 55, then that purpose or intent cannot be negated by subsequent findings of any condition. What if the doctor finds a minor noncancerous infection and notes that on the claim form? Will that diagnosis void the 100% payment for preventive service? If so, it gives patients a strong incentive to tell their GI doctors that they are only to note on the claim form “yes or no” in response to colon cancer and nothing else. Normally, we would want to encourage doctors to share all information with patients, and the patients would want that as well. But securing payment for preventive services requires the doctor code up the entire procedure as routine preventive screening.