In 2022, Blue Cross and Blue Shield of Minnesota began to offer an Alternative Health Plan, or AHP, designed by Coupe Health.

Like the sporty style of car that inspired its name, Coupe is a streamlined version of health insurance, distinguished by its “no surprise” flexible co-pay structure that shows the true amount owed by the member before they receive care.

Wally Gomaa, co-founder of Coupe and self-identified “healthcare evangelist,” offered his insights on what led him to get involved at the start of the biggest industry innovation in decades – and how he sees the role of AHPs in the overall market.

“An alternative health plan is not a point solution or a navigation company,” Gomaa explained. “My definition of an AHP is something that truly replaces a traditional Preferred Provider Organization (PPO) or High Deductible Health Plan (HDHP) with something employees have to elect and enroll in.”

The origins of Coupe as a business go back to 2017, when AHPs were just starting to emerge in the health insurance industry. “Before AHPs, the last major update to plan design was over 20 years ago with the introduction of the High Deductible Health Plan,” said Gomaa. “A new, innovative enrollment option was long overdue.”

Gomaa’s initial realization that health insurance needed to deliver better experiences took place 12 years ago, following a serious personal injury. While out on a bike ride, Gomaa was struck by a car.

“I was picked up by an air ambulance, which was out of network. I was then flown to an area hospital, and the surgeon said, ‘Listen, I can’t fix you, but they won’t allow me to transfer you to the surgeon who can because he operates at a competing facility.’ After the surgeries came the box of paperwork, the bills, the EOBs, demand letters and subrogation notices,” Gomaa said.

Thus, Coupe Health was designed to replace the complexity that can exist in the current healthcare system with easy provider selection and price certainty.

“I believe the greatest good of health insurance is to use that platform to connect patients with the best providers and the best programs that can extend the quantity and quality of people’s lives,” Gomaa said.

“The Coupe Health process is actually very simple, natural and intuitive because it works the same way when we buy other things in life,” he continued. “When you buy something in the ‘real world,’ you know the price before you buy it, and you can go online and read the reviews. With Coupe, our members have access to that same information for every covered medical and pharmacy service,” Gomaa said.

Rather than searching for a doctor simply by determining if the provider is in-network, members have the tools to find the highest quality doctor and see the cost for the services needed up front.

How does the Coupe Health process work for members?

1. Search for a service
2. Choose a provider based on cost and quality rankings. Coupe Health uses physician and hospital performance data to rank providers on three levels: red, yellow, and green with green representing the best value care.
3. Visit the provider and owe nothing at the time of service
4. Get one monthly statement for the price you selected up front
5. Pay just like any other bill

“I think our biggest learning over the last 10 years that we have been at this mission, is we underestimated how powerful we are at being consumers of anything,” said Gomaa. “But only when we have the information and we are empowered to make an informed decision.”

Learn more

If you have Blue Cross and Blue Shield of Minnesota coverage through your work, ask your employer about whether you have the option to choose Coupe during your next open enrollment.

Learn more about Coupe Health here.