Doctor Visit(s)

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• Routine / Wellness doctor visits are covered if your total bills for a medical event are over $1,250 if you have the Gold plan... Routine/wellness visits are not covered for Silver or Bronze members unless there is a medical event exceeding $3,000 for Silver or $6,000 for Bronze members.

• Telemedicine visit(s): Included for all members and all plans and there is NO copay for each visit. Doctors are available 24/7/365.

  • Click here for more information​ about Telemedicine visits

• NEW as of 1/1/2025: $0 Copay Primairy Care Physician.

With CHM you can now choose a viritual Primairy Care Physician who will act like your real PCP like keeping track of your health and health records, prescribe all necessary medications and refills, and more. This is not like your regular Telemedicine visit, which is more meant for non emergency care. More info coming soon as this news was just released by CHM.​

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$1,250?! So how can I afford to go to the doctor? < Click for more info!

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Gold Members:

Regular doctors visits (routine/wellness) with the GOLD plan are covered if your total bills for a medical event add up to be $1,250 or more. 

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Say you to to the doctor and he orders blood work, a test and a follow up. These bills can easily add up to be $1,250 or more. If they do then you can submit your bills to CHM for reimbursement. You do have a PR - Personal Responsibility of $1,250 per year and the minimum amount of all bills together for the one medical event have to be over $1,250 for the Gold plan. See examples here

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If you go to the doctor and your total bills (before discount) are less than $1,250 after self-pay discount then you can not submit your claim to CHM for reimbursement. You do have access to free Tele-Medicine (online doctors visits). For more info continue to read below.

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Silver / Bronze plan members:

Wellness/ Routine visits are not eligible for reimbursement unless they are related to a medical event/incident.

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Free Tele-Medicine for all members

Telemedicine visits (talk to a licensed US doctor via phone/video chat) are covered, 24/7 for all CHM members at no additional charge. Scroll down for more information.

 

 

 

 

 

 

 

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So how can I afford to see a doctor or a specialist if my bills are less than $1,250 or if I have the Silver/Bronze plan?

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With 'regular' insurance, on average people pay about $35 copay.

Also the average person pays $541 on health insurance premium, per person, per month (source: ValuePenguin.com). 

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With the Gold plan you pay $235 'premium' per person, per month

• You save approx. $306 from the national average, per person, per month.

• Put this $306 (or at least a portion of that amount) in a savings account every month and it will be easy to pay any doctor's bill when you need it.

• How often do you go to your doctor? Twice, three times a year?

• Primary Care Physician is now covered (as of 1/1/25) at $0 co-pay. Even though this is virtual (via phone), you can choose your PCP from their network and it will provide the same services as a real PCP.

• If the doctors visit requires lab work, testing, a follow up (etc. etc.), and the total bills for this medical event add up to be $1,000 or more, then you can submit all your bills to CHM. You will have a $1,000 yearly deductible and CHM will reimburse you the difference (with the Gold plan). If you already have met your PR/deductible then you will get reimbursed in full (however you can not submit a medical event until your total bills ad up to be $1,000 or more). 

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At the doctor's office:

• At the time of check-in and making the appointment, explain that you are "self-pay"

• Most doctors offices have significant reduced fees for self-pay patients as their billing department don't have to file (and deal with insurance) a claim and wait for their money. Doctors offices love self-pay patients and most of them have a self-pay discount policy in place.

• Use the "health savings account" technique -as described above to pay for doctor visits.

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Questions (click to learn more):

What is a medical event? 

What is telemedicine?

What do you mean, "Self Pay"?

Frequently Asked Questions

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