Why Insurance Companies Will Not Pay

Our health care system is based on paying to treat for illness or injury care. Insurance companies (third party payers) collect premiums from employers and employees to cover the costs of medical care and to insure a profit for stockholders. This after-the-fact approach to health care essentially ignores the philosophy of prevention -- that it just makes sense to stay healthy and be productive rather than wait for disease and disability to set in.

So why don’t health insurance companies cover services intended to keep you healthy? Most policies will cover well-child visits, immunizations, mammograms, pap smears, and screening colonoscopies. And that is a start, but that is not nearly enough to help people actually attain optimal health. Insurance companies are not willing to invest in your health because they have calculated that providing extensive preventive services to a population that moves (on average) every 4 years is simply not profitable. They are unwilling to invest in you now, knowing that you will likely move or change jobs (and health insurance companies), because they would not receive any cost benefit from their efforts to keep you well. Your new health insurance company would enjoy the savings. The bottom line is it is just not "good business" to help the competition. 

So where does this leave you if you really are interested in staying healthy and feeling your best? The simple answer is: You are on your own, unfortunately. Until there are dramatic reforms in our health care system, you will have to look out for yourself. We are interested in helping you do just that. Following your visit with us at Optimal Health Institute, we will provide you with enough information (diagnostic codes and service codes) to file with your insurance company in hopes that part of your costs can be reimbursed.

Since we do not participate in the Medicare program, we cannot provide the same information to Medicare patients; and we have to ask our Medicare patients to sign a waiver stating that they, too, will not file a claim with Medicare. Of course, we had to exempt ourselves from Medicare because that system does not pay for you to stay healthy, either.

When we decided to establish Optimal Health Institute, we admit we were a little scared. Would people be willing to pay out of their own pockets to feel better – to achieve optimal health? We’re taking the chance that you are; and, in return, we have worked very hard to provide you with the best, most comprehensive services for the lowest price - because we know that you will most likely be paying for these services yourself.