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
Inpatient Hospital, Inpatient Hospital Physician Visit, Partial Hospitalization
Program, Office Visit/Outpatient Therapy
We have a team of specialists who provide advanced care for complex health conditions. Our specialties include cardiology, neurology, and more.