FAQs

What is direct primary care (DPC)?

 

DPC provide care with zero copays, convenient online scheduling options, near-wholesale prices on medications and blood tests, and close contact with their physician. It’s like having a doctor in the family.

Direct primary care practices cut out middlemen like insurance companies, freeing themselves to provide great care at fair prices. Unlike traditional third party practices that serve the needs of insurance companies, direct primary care is for everybody; most DPC memberships cost less than your monthly cell phone or cable bill, for great care whenever you need it

For more information see DPC Nation  https://dpcnation.org 

 

What are the benefits of a direct primary care membership?

Put simply: your DPC doctor is there when you need them.

You get unlimited office visits at no additional charge—and they’ll be as long as you need. Typically you’ll be able to book a same-day or next-day appointment, sometimes directly through the practice’s website, or call us if your situation is more pressing. You’ll have close access to your doctor, so you’ll be able to call or text them any medical questions as needed. Some simple diagnostics (e.g. strep tests) and blood tests may be performed in office for a small additional charge (or no charge at all). If you have a major issue, your doctor will coordinate any specialist referrals or hospital care.

Below is a comprehensive list of services provided by most direct primary care practices. Most of these services are provided as an included perk of membership; others are often provided for a small additional fee.  

  • Treating common everyday problems like colds, flu, strep throat, rashes, burns, joint injuries, and other wounds.
  • Keeping you up-to-date on all recommended preventative screening, like colonoscopies, and EKGs.
  • Managing chronic conditions like asthma, diabetes, high blood pressure, high cholesterol, or thyroid disorder. Your doctor will work with you to formulate a long-term personalized management plan.
  • Performing minor procedures. If you need a minor procedure like a mole removal, joint injection or stitches, your primary care provider may be able help with that. 
  • Managing your specialist care. If you have a medical issue that can’t be handled by your primary care physician, you’ll be referred to a doctor that can continue your treatment. And your doctor won’t just shoo you out the door; they’ll work closely with the specialist to make sure there is seamless continuity of care. 
  • Providing an annual full-body physical and checkup. Often, your doctor will do a comprehensive review of systems at your very first in-person appointment.

 

How much does direct primary care cost?

See our membership fees on home page. The typical monthly fee is about as much as your cell phone bill. That’s a small price to pay for a level of care you literally can’t get anywhere else. You are paying to have closer access to your physician and more time with them. Those things—any many more—come free with a DPC membership.

Not to mention: the membership  price can often pay for itself. Our DPC practice provides prices that are near cost with  local laboratories and radiology centers. That means you can get blood tests, pathology screens, X-rays, MRIs, and more for low cash prices. Most DPC practices dispense medications in-house at near-wholesale prices, so you can both save money and avoid extra trips to the pharmacy. Plus, as a DPC member, you may be able to save a lot of money on insurance by switching to a high-deductible plan. 

In short: being a member of a DPC practice is like having a doctor in the family. Your doctor will always be in your corner, working to keep you as healthy as possible.

Can direct primary care save you money?

For sure! Let’s go over some common scenarios where a DPC membership can save you money.

  • #1 You’re taking several medications. If you’re taking multiple medications and paying with insurance for all of them, your co-pays are probably adding up. Our practice will aim to dispense common medications directly from their offices, so you won’t need to do an extra trip to the pharmacy. Plus, your DPC doctor will purchase these medications at wholesale prices and they pass those savings through to you.  The value of this service depends on which medications you’re taking. Often your insurance provider will only cover a drug from a particular drug manufacturer, or they’ll require you to use a brand-name version even though a cheaper generic is on the market. If that’s the case you can easily be paying hundreds of dollars a month on medications—money you could save as a DPC member.
  • #2 If you’re injured. If you get in an accident, break a bone, need stitches, or require emergency medical care of any sort, you’ll probably go to an urgent care or the emergency room. This is an easy way to drain your pocketbook. Urgent care center will likely cost you a high co-pay—up to $100 in some cases, if you are in network. Emergency rooms are often worse: you will easiily have a co-pay of $1000 or more just to get seen, PLUS the cost of any additional scans or treatments, not to mention the excessive wait times of 4-6 hours.  One bad day can cost you thousands of dollars—enough to cover years of a DPC membership. As a DPC patient, you know exactly who to call when you need help.
  • #3 You’re overpaying for insurance. If you’re on an insurance plan named after a precious metal, you shouldn’t be.  Even the cheapest health plan your employer offers covers WAY more than it should, so don’t get conned out of more money by picking a low-deductible “Platinum” plan.  As a DPC patient, the bulk of your healthcare will be taken care of by your DPC doctor. All standard care, wound treatment, blood work, preventative screens, and physicals will either be included in your membership or provided at a fair price by your doctor. If your DPC doctor isn’t equipped to deal with a medical issue, it’s probably serious. And if it’s serious, then you’ll very likely hit your out-of-pocket maximum (OOP). (This OOP is what it sounds like: the maximum amount you can possibly spend on healthcare before your insurance plan starts footing 100$ of the bill.)Here is an example:Aetna’s cheapest plan costs roughly $600 per year and has an OOP of $6650. Their most expensive plan costs $4200/year with an OOP of $4000. That means you’d be paying a guaranteed $3600 extra dollars ($4200 – $600) to avoidthe small chance of paying an extra $2650 (6650 – 4000) on your healthcare. That doesn’t make sense! Unless you’re expecting to suffer a major health crisis every 9 months, you’ll be better off on a cheaper plan. Otherwise, just join a DPC practice and take the cheapest insurance you can find!
  • #4 Your health is important. Here’s the thing: direct primary care is the best game in town when it comes to healthcare.To keep a personal doctor on staff costs around thousands of dollars per month. The rest of us had to  wait until we were sick before talking to a doctor, then  schedule a visit weeks in advance just to  spend 10 minutes with a doctor you likely never met. With DPC, everyone can have a personal doctor on speed dial for a shockingly low amount. Having a medical expert at hand to answer questions, keep track of your preventative screenings, advise on your diet and lifestyle, and actually care about your happiness was simply not possible before and now it is.

Why is direct primary care a monthly membership?

  Subscriptions are the best way for a business (of any kind) to offer high-quality service and support over a long period of time. Insurance is formulated to be used only for an emergency. Primary care should be about maintaining good health and treating issues which are not emergencies.

The alternative would be itemized, “usage-based” pricing—the exact pricing scheme used by the traditional healthcare system. And that didn’t work out so well for anyone. 

Is direct primary care the same as concierge medicine?

You may have heard of a similar model called “concierge medicine”. While there are similarities with DPC, the two are different in some fundamental ways. For starters, concierge practices often bill your insurance in addition to a monthly fee (though some don’t—which makes them DPC practices!). This means they’re still a part of the insurance industry’s ridiculously complex reimbursement system, so they have to hire administrators to handle all the paperwork. This gets reflected in your monthly fee; the average concierge practice bills $200-300 per month. By comparison, DPC memberships cost approximately as much as your cell phone bill. Concierge was a step in the right direction, but it didn’t go far enough. To bring sanity back to primary care, you need to cut insurance out of the picture entirely.

Do I still need insurance as a direct primary care patient?

Yes, you’ll still need insurance, though you may be able to reduce the amount you pay.

As your DPC membership is not an insurance plan; you’ll still need insurance if you have a major health problem. (But when those problems arise, your DPC doctor will be next to you to guide you through the system and coordinate your care.) That said, you may be able to save money on your insurance! Since all routine care is covered by your membership, you can switch to a “high-deductible” health plan that costs less per month.

Recently, some alternatives to traditional insurance companies have been gaining in popularity. You may actually be able to save money by joining a healthcare cost-sharing community.

Should I join a direct primary care practice if I'm healthy?

    Of course, your DPC doctor will always be there for you if you’re get sick or hurt, however they also continue to keep you healthy and free of preventable diseases to extend that good health.

It’s hard to break out of the mindset of the insurance-based healthcare system. In “the system”, everything is centered around treating illness. It’s very hard for a doctor to get paid by an insurance company for detecting early warning signs of diabetes or encouraging a lifestyle change to decrease risk of heart disease. Doctors just aren’t rewarded for encouraging all-around good health.

 

How is Medicare covered?

If you are a beneficiary of Medicare, you may join the clinic.  As our physicians need to opt out of medicare, we will refrain from seeing Medicare patients until July 1st 2022. You may still sign up and will hold a spot for you. Once subscribed to our services, you will need to sign a statement indicating we will not charge medicare. You will still be able to participate in Medicare programs for other services, such as consultants, labs, imaging and hospitals stays. 

Will I be covered by Health care sharing programs such as Medishare or Samaritan?

We encourage you to discuss with  your health care sharing company as every organizations have different rules for their coverage or reimbursement. For example, Medishare states that they will apply up to $1800 of their cost to their Annual Household Portion(AHP) but only if you participate in the $12,000 AHP program. 

If I have insurance, why would I want to be part of a DPC practice?

Health care is expensive and even a with a great insurance plan, access to your doctor is limited. Cost can add up rapidly with the combination of lab test, urgent or emergency care. These fees can be easily more than an entire year worth of DCP membership. Also, waits in urgent or emergency care can be long and painful. So join a DCP practice and lets give you a chance to avoid the emergency department altogether.

What if I need medical attention while I’m away from home?

Yes, we can help! –  Because we know you well, we can streamline your care when you’re sick away from home. In the age of telemedicine, some illnesses can be diagnosed and treated with a simple conversation by phone or webcam. We’ll locate the nearest pharmacy and order the medications most appropriate for your present circumstances. 

How do you manage mental health?

We are happy to help manage complex health issues, including mental health conditions. Some management may be better suited by a psychiatrist and/or therapist. We have strict guidelines on use of benzodiazepines and stimulants, thus rarely prescribe ( Xanax, Ativan, Klonopin, Adderall, Vyvanse, Concerta, etc) We prefer to manage these conditions with other strategies and non-addictive medications when possible.

I own a business. Can I buy memberships for my employees?

Direct Primary Care helps employers to dramatically improve healthcare quality for employees and their families, while significantly reducing overall health plan costs.   The cost of employees’ memberships, if paid by an employer, are tax-deductible (please consult your accountant).  We are excited to offer this opportunity for  businesses as an added benefit to your employees to supplement high deductible insurance plans.

FAQs courtesy DCP Nation.