My experience/review with Surest (Bind) Health Insurance

For those unaware Surest (previously Bind) is a fairly new PPO subset of UHC that has the pitch of no deductibles, variable co-pays by doctor, & similar pricing to HDHPs. On paper it looks suspiciously too good to be true. While I found several posts asking for feedback, there was little actual feedback out there. I chose the plan mostly on faith, but thought I’d share my experiences now that I’ve been on the plan for several months. I don’t follow this sub, but find Google is pretty good about finding relevant information in reddit. Maybe this will help someone in open enrollment in the future!

Pros

– Crazy low co-pays are possible, I’ve seen multiple specialists for $15 a visit, some of which insurance paid up to $400 (making it equivalent to 5% coinsurance)

– It is nice knowing in the app exactly how much your visit will cost. This advertised feature mostly works with caveats (see cons)

– (may be employer dependent, as I am on a self-funded plan) but basic diagnosis blood tests & x-rays have always been free. I’ve had about 20 tests and not a single co-pay or denial. Surest’s marketing makes it sound like these are tied to an MD visit/co-pay but as far as I can tell they don’t tie the two together. Many diagnosis tests are just always free.

– (may employer dependent) free online dr on demand care is nice, though has the same common limitation of any online care.

– This will eventually change as they get bigger, but once you get past the teleprompts they have a small company customer support feel. I don’t think I’ve ever actually waited to connect to a rep, and I am pretty sure I have always spoken to the same person.

Cons

– For the information in the app to be accurate, both the provider and location have to be spot on identical. This is especially problematic for outpatient hospital work. E.g. I scheduled MRIs at 3 different hospitals and each time the estimate ended up going from $100 to $500 because the hospital does the MRI across the street. I am pretty sure Surest sets copays based on a bell curve- which basically means the false information in their app causes other MRIs in my area to be more expensive. To get a $100 MRI I had to travel 80 RT miles.

– This one is kind of obvious if you did any research, but to get the low co-pays you have to be very specific on your doctor. There doesn’t appear to be any correlation between experience/quality and co-pay. E.g. a MD at one practice could be $15, but if you see their PA it’s $60. Some larger doctor offices offer walk in services, but this doesn’t work well with Surest as you have no idea who you will see. In these cases urgent care may be cheaper.

– If you are chasing low-copays you will spend more time than you think finding a new doctor. Many larger practices can have long phone hold times, and doctors have particular schedules/preferences. E.g. a doctor in the app may be booked out months, work now in a different location, or only does a few specific types of appointments in their specialty. So if you call 5 XYZ specialists within 15 miles with a $15 co-pay maybe only 2 of them are real options. But those two as far as I can tell are perfectly fine choices.

– The co-pays you see when looking up a doctor don’t include named procedures/tests that occur at the same doctor’s office. E.g. an EMG that insurance pays ~$500 for has a co-pay of $190. Much higher than 20% coinsurance. It seems flat rate procedures that have the same cost regardless of doctor have the highest copays.

– Providers can get confused. I find it easiest to never mention the word Surest, just say United Health care. I once paid a higher co-pay because the provider was foreign to the concept that different doctors could have different co-pays. Eventually the money came back.

– My employer doesn’t do this, but apparently some Surest plans have extra premiums to cover specific operations. These are essentially extra large co-pays that are paid three days prior to the care that don’t count towards your out of pocket maximum.

Overall while there are some caveats , I am pretty happy with the plan and would choose it over the HDHP that my employer offers. Yeah I lost the most tax efficient investment account you can get, but the lower co-pays have encouraged me to stop sitting on going to the doctor. This mentally feels better, and also caught something relatively minor that likely would have turned into something worse down the line.