Health Access Cooperative—Direct for Individuals

 The Health Access Cooperative—Direct for Individuals (Co-op Direct) is not health

insurance; it’s a consumer cooperative that provides affordable health care tailored to you,

as a member, and to your health care needs. This model allows members to avoid the

costly overhead associated with insurance companies, ensuring more of their investment

goes directly into care.

Owned and operated by our members, Health Access Cooperative prioritizes patient needs

and satisfaction. This structure means we're focused on delivering the best service and

health care experience possible. Your health is our priority, not profit. We have stayed true

to our core focus of providing real access to health care with financial security for you and

your family.

We believe health care should be centered around the doctor-patient relationship and that

is where health care decisions should be made.

We believe that patients should have the freedom to seek care from the medical

professional of their choosing and not be restricted by arbitrary network limitations.

We believe that health insurance has failed to provide affordable premiums for many in

our country and it shifts an unfair burden of out-of-pocket costs onto patients. We can

provide higher-value care with more financial security by taking a cooperative approach.

 Annual Preventive Breast Screening: Mammogram or Thermography (including Breast Ultrasound or MRI following a preventive mammogram or Thermography) Covered once annually from age 40-80

Year 1: $250 allowance

Year 2+: $500 allowance

Colorectal Cancer Screening: Age range: 45 - 80 (covered from age 40 if 1st degree relative has positive history of colon cancer) every 5 years.  Cologuard every 3 years.

Year 1: $500 allowance

Year 2+: $1,500 allowance

 Waiting Period for Existing Conditions

To keep premiums low for all members, there is a waiting period for medical conditions

that exist prior to an individual’s enrollment date as a new member.

There is a waiting period for any illness or injury for which in the prior 24 months a person

has been:

1) Examined; or

2) Taken medications to treat or manage; or

3) Had a diagnostic test performed and/or ordered by a health professional; or

4)Received medical treatment to treat or manage.

Exceptions:

Conditions regarded as cured more than 24 months ago and that did not require

treatment or medication in the preceding 24 months.

High blood pressure, high cholesterol, and diabetes managed by medication and/or

diet and exercise for which hospitalization has not been required in the previous 12

months.

Cancer that has been in full remission for a minimum of 6 years for which all

appropriate scans or tests have been performed and were negative.

Maternity is subject to the existing condition waiting period if the expected delivery

is within 5 months of enrolling, and deliveries within the first year of membership

will have a $7,500 Per-Incident Deductible. 

In Year 2 and beyond, the standard Per-Incident Deductible of $1,000, $2,500, or $4,000 will apply.

 Year 1: Amount available $0

Year 2: Amount available $25,000

Year 3: Amount available $50,000

Year 4+: Unlimited

 $4,000 / $8,000

Do not worry if you have a lot of smaller expenses that never add up to meeting a deductible.  Health Access Solutions Direct protects you on an annual max out of pocket as well.

Prescriptions for medications related to a Medical Incident are considered an eligible

member benefit (e.g., anti-biotics, chemotherapy, short-term pain medications, etc.) and

will be included after the Per-Incident Deductible for that incident has been met.

For maintenance medications filled at a pharmacy, members are Drexi Members and have access anytime to some of the lowest-priced prescription medication locally or by mail order, including international mail order.

Specialty Maintenance Medications

Specialty Maintenance Medications are medications that are prescribed long-term and cost more than $1,000 a month.

If a member has a newly prescribed specialty maintenance medication after the coverage

start date, members will be responsible for the first $2,500, then the cooperative will reimburse the costs above that for the remainder of that year only.

 Inpatient Hospital, Inpatient Hospital Physician Visit, Partial Hospitalization

Program, Office Visit / Outpatient Therapy

• 100% after Per-Incident Deductible/Member  
• Limited to $6,000 per incident

 Inpatient Hospital, Inpatient Hospital Physician Visit, Partial Hospitalization

Program, Office Visit/Outpatient Therapy

• 100% after Per-Incident Deductible/Member  
• Limited to $6,000 per incident

Phone support while enrolling - 845-641-9123