Direct Primary Care Frequently Asked Questions
Please review the frequently asked questions below. If you don’t find the answer to your question, feel free to contact our new patient coordinator via email, or set up a FREE discovery consultation.
What is Direct Primary Care (DPC)?
DPC is a membership model for healthcare where patients pay their primary care doctor directly, rather than through their insurance company. A DPC practice offers the full range of services that you would expect from your primary care doctor’s office for a reasonable monthly fee.
Patients receive enhanced services beyond what traditional fee-for-service medicine offers. These may include real-time technology access to their personal physician, extended visits, and highly personalized, coordinated, and comprehensive care administration, with no additional visit charges or insurance company involvement or influence. Essentially, it cuts out the middleman.
What are the benefits of membership? Put simply: expanded access to a doctor that cares about you. 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. It’s an amazing feeling.
How is DPC different from traditional healthcare?
A focus of DPC is that the doctor’s income is no longer based on how often a patient is seen in the office and how many patients they see per day, as it is with the traditional “fee-for-service” model. Instead, the doctor is just paid to keep patients healthy. With fewer patient visits per day, the physician has more appointment times available and more time to spend with each patient, including office visits, phone calls, text messages and email communication.
Should I join a direct primary care practice if I'm healthy?
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.
What is included in my membership?
You’ll be able to see the doctor for a low monthly fee with no copay. You will have expanded direct access to your doctor by phone, text, or email, and most in-office procedures are included. You’ll also enjoy longer visits with your doctor and coordinated care, plus discount pricing on lab tests, prescriptions, and diagnostics.
Are there additional costs other than my monthly membership fee?
Many in office procedures are included in your membership fee! Members will receive up to 20% off from cash services including; pellet therapy, injection therapies, VO2 max fitness testing, custom orthotics, and bracing.
Most DPC practices have an established relationship 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.
For a list of our membership fees, please click on the link here.
Why is DPC a monthly membership?
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. There are a hundred little perks of being a DPC patient. Frankly, the benefits of being a DPC patient are too varied and rich to be broken down into a “menu of services”. Paying your DPC doctor for everything they do would be like paying Netflix for every episode of TV you watch. Sounds awful.
Will I have to pay a fee for my office visits?
Your membership covers up to 15 office visits per year. There is no copay. The only time you will have to pay a fee is if you exceed 15 office visits per year.
Are you a walk-in clinic? Do I need an appointment?
While we can always offer same or next-day visits to our members, we do require scheduling all visits beforehand. A quick phone call or text to verify that we are free is usually all that is required. In most cases, we can address your medical concerns via phone or video chat from the comfort and privacy of your home or office.
How long are doctor visits?
As long as you need! Taking into consideration the number and complexity of medical issues, most of our clinic visits are scheduled for 30-60 minutes. Continuing medical treatments may take multiple visits, but that is another great benefit of the DPC, no copay!
What type of visits can I do by phone or webcam?
“Virtual visits” should be thought of as a supplement to good primary care – not a replacement for in-person care. Generally, if the issue does NOT require a physical exam, a virtual visit is fine. Many chronic issues (e.g. diabetes, hypertension, etc.) can be largely managed by email and virtual visits. However, any issue requiring a physical exam (e.g. coughs, sinus infections, ear infection, new pain, etc.) we will recommend a traditional clinic visit.
What if I need outside care? Specialists, diagnostic testing, ER, hospital?
We can order or refer just as any insurance-based doctor can do. For some outside services, we can help find reasonable “cash” prices if you are paying out-of-pocket – especially radiology and lab. We also have agreements with the most commonly referred specialists for deeply discounted cash prices. We can provide many urgent care and minor emergency services during regular hours that can help people avoid a 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.
Do I still need Insurance as a direct primary care patient?
Your DPC membership is not an insurance plan; you’ll still need insurance if you have a major health problem such as a hospitalization, surgeries, or other life-threatening situations. When those problems arise, your DPC doctor will be next to you to guide you through the system and coordinate your care. But for routine cases like physicals, labs, or most other minor emergency situations, the Direct Care subscription fee covers nearly everything and can be handled in-house most of the time.
If you have a Health Savings Account or Flexible Spending plan, your membership fee MAY be covered under these savings plans. Check with your plan administrator and/or accountant to determine your benefit eligibility.
Recently, some alternatives to traditional insurance companies have been gaining in popularity. You may actually be able to save money on healthcare and direct primary care membership by joining a healthcare cost-sharing community, like Sedera. To learn more about how these communities, contact our office or search “health share” on the web.