How does the Direct Primary Care Plan work?
The Direct Primary Care Plan allows us to provide the vast majority of care for most patients at an affordable, fixed price. For about as much as a monthly gym membership or cell phone bill, our Direct Primary Care Plan allows you to budget for healthcare without worrying about extra costs, co-pays or deductibles for routine care. Think about this – routine maintenance on your car is not covered by insurance…why should routine maintenance on your body be any different? Just like your car, if your body is maintained properly it will last much longer than if it isn’t. That’s why our primary care, which focuses on health promotion and disease prevention is so important!
Why monthly fees in the Direct Primary Care Plan?
In a typical primary care office, an insurance company reimburses your provider only when the provider sees you in the office. This means that your provider could be encouraged to see as many patients as possible in any given day, resulting in less time for each patient. How often have you waited a long time just to see the provider for only 10 minutes? You may have questions you never asked because the provider seemed rushed. Our Direct Primary Care Plan changes everything! You pay a low monthly fee, which allows your provider to have longer appointment times, be available by phone, text, or email, and even the ability to diagnose and treat issues without the immediate need for an office visit. If you want to be more in contact with your provider and have a partner in your heath, the Direct Primary Care Plan is ideal for you.
Are there any other costs with the Direct Primary Care Plan?
The Direct Primary Care Plan covers annual visits, basic annual labs, in house testing, all follow up visits, sick visits, and a yearly EKG. Any non-routine labs or imaging such as x-rays, ultrasound, CT scans, or MRIs are offered by our community partners at a much-reduced rate. Any service that is not covered will be discussed up front prior to ordering. After all, we are your health partners and part of that is helping you save money.
How does the Fee for Service Plan work?
Patients will pay for care each and every time they come to the office just like a traditional practice. Your initial visit will be an annual/new patient visit and will encompass a discussion of your health history, current health goals, and medication regime. You will have a complete physical as part of joining the practice. After that, you will pay for each visit every time you come to the office. Expect to be at the office for 45 minutes to 1 hour at your initial visit. You will be billed at our reduced rates for all visits, labs, EKGs, and any other necessary procedures at each visit.
How will I save money?
For patients without insurance or with high deductibles, you will be saving money simply because we charge less than most other practices. Since we cut out insurance billing, we can offer you prices lower than traditional practices, while maintaining a high standard of care. Patients who utilize our Direct Primary Care Plan combined with a high deductible health insurance plan can save money when compared to traditional insurance plans with low or no deductibles and copays. Patients who do not have insurance will pay lower costs at our practice than opposed to practices that take insurance.
Are there any contracts or commitments?
For the Fee for Service Plan, there are no commitments or contracts. You pay each and every time you come to the office for care. Under the Direct Primary Care Plan, there is also no annual contract. Memberships are ongoing month to month and must be paid in order to receive uninterrupted care. Please note – care can be canceled at any time. However, if monthly fees are not paid, or you cancel and want to reinstate at a later date, a reinstatement fee of $200 will be charged to each patient.
Are there any hidden fees?
No – We provide most care to our Direct Primary Care Plan patients without any fees at all. If we do charge for non-covered services, we always discuss prices upfront. For Fee for Service Plan patients, all costs are known upfront. If we recommend outside services, we will work with you to get you the best price available. The bottom line is we work for you and with you to get you the lowest healthcare costs possible.
Is your Direct Primary Care Plan the same as “concierge” healthcare?
Our Direct Primary Care Plan is similar to what is thought of as “concierge” healthcare in that no insurance is being billed. However, our Direct Primary Care Plan is different because it is affordable. “Concierge” healthcare has a connotation of being expensive and exclusive. In contrast, our Direct Primary Care Plan is very affordable and inclusive. We provide a “concierge” level of service and care while making it affordable for people of all incomes, regardless of insurance status.
Are there any restrictions to joining the practice?
There are no restrictions to joining our practice. Regardless of your income level, insurance coverage, level of health or utilization of our services, the fees we charge under the Fee for Service Plan are the same for all patients. Under the Direct Primary Care Plan, monthly fees are charged based on age. See our pricing for more details. Please note: If you have an HMO or Medicaid plan, we will be restricted as to the extent of our ability to refer you to a specialist if one is needed.
What if I am healthy?
Congrats!! Keeping you healthy long-term is our primary goal. Not receiving preventative care and neglecting to make your health a priority will NOT keep you healthy in the long run. Not “going to the doctor” is the same as ignoring your health. Everyone, no matter how ill or healthy, can learn new ways to improve health through nutrition, exercise and healthy lifestyle choices. This is where we fit in. Our goal is to work with you to maximize your health and when you do need care for illnesses, we will be here to help you avoid expensive trips to urgent care or the ER.
Do you take walk-ins?
In general, we do not take walk-ins and appointments are necessary. If you are ill, contact the office and we will do our best to work you in that day. We are able to accommodate you either the same day or the next.
Do you accept insurance?
No, we don’t. We can offer you lower costs for healthcare specifically because we don’t accept insurance. We do not directly bill any insurance companies for our services. Depending on your insurance, you may be able to submit your bill to your insurance company for reimbursement. Contact your insurance carrier to answer this question.
Do you accept Medicaid or HMOs?
No, we don’t contract with any insurance, including HMOs, or Medicaid and cannot bill them for our services. Medicaid/HMO recipients are welcome to see our providers out of pocket. However, you will likely also be assigned an in-network Primary Care Provider or PCP who would be required to access other health plan benefits and services such as specialists.
Do you accept Medicare?
No, we don’t contract with Medicare. We can provide care to Medicare recipients but our fees cannot be billed to Medicare by us or by the patient. Additionally, the Medicare recipient must sign a Private Contract prior to receiving care acknowledging this fact. Medicare patients may continue to use their Medicare benefits elsewhere with participating providers as normal.
Do I need insurance?
Our practice is not a substitute for insurance. We will provide great quality primary care and can cover a large part of your healthcare needs. However, we believe everyone should have insurance for unexpected and expensive events. A high deductible or catastrophic insurance plan may be an option to pair with our Direct Primary Care Plan to keep healthcare costs as low as possible. Since we are not insurance advisors, consulting with an expert in this area is recommended.
What if I need a specialist, special labs, or tests?
Our providers can refer just like any insurance-based provider. For many outside services, we have partners that have significantly reduced cash prices especially for labs or radiology. We can provide urgent care and minor emergency services during regular hours (including stitches, strep throat, etc.). This will help you avoid an expensive trip to the ER. However, we do recommend having health insurance in the case of an unexpected, expensive event such as surgery, ER visit or hospitalization.
What if I have other questions?
What if I have other questions?
Call our office. We are happy to answer your questions!