Direct Primary Care Summary

1. This is a membership in primary care, not insurance.

We cannot give you insurance advice, but do encourage you to have some form of insurance for emergency situations. When choosing the best plan for you, you may want to add up your copays, coinsurances, deductibles, prescriptions, labs and imaging costs over the last year and discuss with an insurance agent or your employer. We want you to make a decision about what is best (and affordable) for you. If you are concerned about costs, please consider that the cost of our plan is less than most cell-phone plans.

2. DPC is less expensive for most patients:

Medicare patients: save an average of 7% out of pocket over the cost of seeing a participating Medicare provider and paying their Medicare coinsurance (20% of bill total). People with supplemental policies to cover the coinsurance most often pay a premium much higher than our monthly cost.

Uninsured patients: DPC prices are much less than practices that bill insurance

Patients with high-deductible (catastrophic) PPO plans such as BCBS: about 82% less out of pocket expense, assuming the high-deductible is not reached (no catastrophe) – this is the case for most patients with these plans most years. HSA plan benefits will be discussed.

Patients with traditional low-deductible PPO coverage (such as BCBS) with copays for primary care visits: DPC was shown to be 12% less out of pocket than using insurance and seeing an in-network provider for the same services.

Medicaid: Apply for our reduced rates.

3. Insurance was created to cover things that happen rarely and are very expensive, not routine things.

For example: if car insurance paid for oil changes then the premiums would have to go up about 10 times the cost of the oil change per year to cover it due the administrative overhead.

Another example is flu shots. If you chose a plan that covers flu shots, they increase the premium $144 per year more even though the flu shot (preservative free) only costs $20. Wouldn’t it be better to just pay the $20?

4. This is the only primary care model approved under the ACA (ObamaCare) that may not trigger penalty

5. DPC is patient-centered with plenty of time and resources for care coordination.

6. Provides a safety net alternative for uninsured or underinsured.

7. Reinforces the patient/physician relationship. There are no conflicts of interest.