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Why Does Optimal Male Not Accept Insurance or Medicare?

Why Does Optimal Male Not Accept Insurance or Medicare?

Dear Optimal Male,
Why does your clinic not accept health insurance or Medicare?  I have Medicare and my wife has insurance through her work.  We love your services, but would like to take advantage of our insurance coverages.  Thank you in advance for your response.


Dr. Freier:

This is an excellent question, and one that we are asked often.  We do not accept health insurance for a variety of reasons.  We believe the barriers set by many insurance providers can lead to the worsening of patient’s conditions, sub-standard quality of care, and poor outcomes for patients.  Health insurance companies sometimes put patients at risk with policies that require prior authorizations ahead of filling prescriptions, or allowing patients to have necessary procedures.
Sadly, I have seen some patients’ health condition grow worse due to these red-tape regulations, and patients often suffer prolonged pain as a result.

Prior authorizations (approvals from the insurance carrier) are especially troublesome for patients as their doctors attempt to get approval for medications or procedures.  Approvals are not always granted, and when they are, prior authorizations still delay necessary care by days or even weeks.  The reason for the prior authorizations is because insurance companies do not want to pay for more expensive, often superior treatments or medications, and instead restrict physicians by prescribing lower cost, sometimes inferior or less effective medications or treatments.  This keeps their costs low.  Additionally, insurance companies engage in a practice called “non-medical switching,” which forces patients to accept less costly, but potentially less effective medications.  Because of insurance policies such as these, physicians face greater legal malpractice risks since these decisions are being made by insurers and not the physician.

This leads to probably the most frustrating, and potentially dangerous aspect of accepting any insurance plan…..the ability of insurance companies to override the professional judgments of the physician.  So many insurance company regulations routinely interfere with the ability of physicians to provide personalized care and individualized treatments for each of their patients.

Finally, working with insurance providers put a substantial administrative burden on the physician.  This negatively impacts patients due to the volume of paper work required in order to be reimbursed by the insurance company.  After the doctor has finished seeing patients for the day, a significant amount of time is spent processing paperwork required by the health insurers in order for the physician to be paid, which is often a small percentage of the amount the services actually cost.  This is how the paperwork impacts you… in order to make ends meet, many physicians must squeeze more patient visits into their day.  It is not uncommon for physicians to see as many as 30 patients in a day.  Consequently, the time available to each patient visit shrinks, giving doctors barely enough time to assess a patient’s main concern, let alone build rapport and deliver quality care.  Patients soon feel they are being herded through the office like cattle and the physicians start to feel like hamsters in a wheel!  This system doesn’t work out well for anyone especially the patient and their physicians.  When was the last time you visited your doctor and sat with them, face to face, for an uninterrupted 30 minutes?  Unless you have visited Optimal Male, you have not experienced this level of service.

Insurance providers are one of the largest contributing factors preventing physicians from spending as much time on patient care as they would like.  As you can see, it doesn’t take much for all this paperwork and bureaucracy to interfere with the services provided by the physician.

Beyond the potential harm that insurance policies cause patients, premiums and deductibles continue to rise as coverage continues to fall.  The vast majority of insurance carriers do not pay for preventative care medications or procedures, or most sexual health treatments, or alternative therapies.  Insurance Companies are one of the predominate causes of the rising cost of healthcare.

Doctors take a vow to do no harm; insurance companies take no vow, nor any oath to provide you with the quality care you deserve.  The vast majority of the doctors I know do their best to live and practice their promise.

At Optimal Male Performance Center, our physician and medical team deal directly with patients on their diagnosis, discussions of standard care vs. gold standard treatments and procedures, as well as individual financial matters.  By not accepting insurance, we are able to establish a doctor-patient relationship.  Also, since we do not have to complete mountains of paperwork, we are able to spend more time with each patient.  In short, the benefit of not working with insurance companies means that physicians no longer work for them, but instead the physician works directly for YOU…. putting you back in control of your health and medical decisions!

Optimal Male Performance Center provides FREE medical exams and consultations for all new patients.  Thereafter, if you choose a treatment package, all office visits are included in the package price.  In addition, if you need us for any general medical services such as check-ups, prescription refills, second opinions and more…. our visits are just $99.  I would like to personally invite you to visit us today to see how we believe medicine should be practiced, with your best interests in mind!

Live Well!

Richard Freier, M.D.
Medical Director
Optimal Male Performance Center

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