WHAT ABOUT PRE-EXISTING CONDITIONS?

Pre-existing conditions are covered. However, elective procedures e.g. knee or hip replacement are not eligible for first 3 years. For prospective members, coverage is limited to the amount contributed for the first year.

AM I OBLIGATED TO PAY FOR ANY LENGTH OF TIME?

No! There is no contractual obligation to remain a member. There is also no termination clause as with Company insurance. If you lose your job, you can still remain a member. Since we are a nonprofit organization, we can accept charitable contributions to help members that are down on their luck. We can also ask fellow members if they would like to contribute extra funds to help.

IS THERE AN INITIAL HEALTH SCREENING?

Yes. This will help to identify early disease as well as pre-existing conditions and medical compliance.

WHAT IF I FAIL TO MAKE A MONTHLY PAYMENT?

If payment is not made by the 10th of the month, membership will be inactive and will terminate by the 10th of the 2nd month. A $25 late payment fee will apply. If you are in financial straits e.g. lost your job, notify us immediately so that charitable funds may be used to help.

WHAT DO I TELL THE HOSPITAL OR DOCTOR AT TIME OF SERVICE?

You are a self pay patient but you are a member of the Houston Healthcare Initiative that will help you pay the bills. Also inform the doctor that if he provides good service at a fair cash price, you will share this information with other members of the group.

HOW DOES THE DOCTOR OR HOSPITAL GET PAID?

You pay the bill from your health savings account. Bills can be paid directly using your debit card.  Bills that are eligible to be paid by the trust fund are sent to The Houston Healthcare Initiative. Discounts are applied to the bill and the appropriate funds are transferred to your HSA after the provider has agreed in writing to accept these funds as full payment. We monitor your account to be sure the provider has in fact been paid by you so that the provider will trust us in the future. If you fail to make the payment, you will be terminated from the group.

IS THERE A DEDUCTIBLE OR CO-PAY?

Yes. Although these terms are used with insurance and are not applicable here, there are amounts not eligible for sharing. See Plans.

WHAT IF EXPENSES ARE DETERMINED NOT TO BE ELIGIBLE?

If you disagree, call our office and see if the dispute can be resolved informally. If not, send a written Request explaining the dispute. If a written answer, does not resolve the issue, we will ask a group member, you will ask another group member, and these two members will pick a third member. These three members should resolve the dispute. Alternatively, if it is a medical question three doctors can be chosen in the same way and everyone agrees to abide by their decision.

THERE IS NO LONGER A PENALTY FOR NOT BUYING INSURANCE. WHY SHOULD I JOIN HOUSTON HEALTHCARE INITIATIVE IF I AM YOUNG AND HEALTHY?

The free annual physical will help identify early disease such as hypertension. Treating disease early will prevent further complications. (An ounce of prevention is worth a pound of cure). Education about healthy lifestyle choices– physically, mentally and morally can be invaluable.

The free doctor hotline will save trips to the ER and save trips to the doctor for minor illnesses.

If one trip to the ER is prevented, the savings would probably be more than the contributions to the trust fund for 2 years. ($80/month X 24 months = $1920)

Discounts of routine lab tests, x-ray and imaging may come in handy if there is an injury or an acute illness.

WHAT IS A SUBSCRIBER SAVINGS ACCOUNT?

HHI is a nonprofit healthcare cooperative and is owned by the members. The subscriber savings account is an account created in the trust fund of HHI in the name of each member (subscriber) and represents his/her share of the ownership. These monies may be used in the future to lower the monthly payments or can be distributed to the members as directed by the Board of Trustees.

WHAT IS AN HSA?

The Health Savings Account (HSA) is an account maintained by the bank in the name of each member. The monies belong to the member and not HHI and can be used to pay medical bills through the use of a debit card.