Mountain Medical Arts —Direct Primary Care (DPC)

Mountain Medical Arts Membership Pricing Schedule: 

• $65 per month or $780 per year. $180 maximum per single household family.
• $35 per month disabled adults or financial hardship (financial hardship spots are currently full).
• $450 Seasonal Memberships are 6 consecutive months.  This arrangement requires you to have another doctor where you live the remaining months of the year who will be handling your care during that time.  Must be renewed at the one-year date to maintain membership privileges. 
• Children (up to 18 or in college up to 26) are $35 per month.
• We have a deeply discounted contract for cash prices on labs.  Even for those with insurance, simply paying the reduced cash rate is often less expensive than using insurance, especially if the deductible has not been met for the year.
• You may cancel your membership at any time. However, if you wish to return to the practice, assuming there is room to take you back, you will have to pay the intervening months membership fees.  Our membership model relies on our patients’ continuing payments when they are well in order to care for other patients who are currently sick and need more of the doctors’ attention.

VISITS

• $25 anytime you come in to see us (comprehensive yearly  visits, an acute illness or simple  follow up, or disease management at the same time as  yearly  visit)
• To see you at home $125 (subject to schedule availability and distance from office)
• Jonathan Polgar PA-C  Cranio-sacral, Reiki, IM hands on treatments $85
• Integrative Medicine management, Coordination of Care for direct admit to hospital or specialist $50 25min, $100 50 min 
• DOT/CDL physicals, includes written instructions and online paperwork for you and other necessary professionals $100 for members, $150 nonmembers
• Internet, patient portal or phone visit $25 simple, $50 complicated with coordination of care, integrative management and printed education information uploaded to your portal
• Any member can request integrative recommendations for any medical question,  $50 included review of your questions, discussion with Dr Polgar or Jonathan PA-C chart review and written recommendations.

Nonmember services:

• Aesthetic Treatments
  Prices vary depending on treatment. Become a member and enjoy discounted pricing!
• CDL physicals $150

Benefits:

• Unhurried appointments – freed from excessive paperwork, we are less likely to run behind and have more time to spend with you (emergencies do still happen) 
• Transparent and realistic billing pricing for visits, labs, pathology and medicines. You will never get a surprise bill from us.

Online resources for more information about Direct Primary Care

www.aafp.org

www.dpcare.org

Direct Primary Care

www.directprimarycarejournal.com

Summary of Direct Primary Care:

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.  You can ask us about Liberty, Zion Health, Sedera for cost sharing plans, these are alternatives to insurance for many people. 

   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, for visits, labs, even cash pay imaging etc
  • 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:  Now managed care so they may not let us order anything for you and you would need another primary physician for emergencies, we coordinate care and communication for many patients in this situation.
  • Most patients are coming in many times a year, which we want to encourage as needed, but consider this:  when someone comes in monthly at $25 for the visit + $60 for the month = $85/hour-long visit, even in our low overhead model, the hourly cost to be open (staff, mortgage, computers, phones, internet, supplies, etc.) exceeds that amount.  Most Direct Care practices charge a higher monthly fee than we do.  Many also charge more as people age, the assumption being that as people age, they require more medical care; but that isn’t true here – some of our oldest patients are also our most healthy!

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 $30.   Wouldn’t it be better to just pay the $30?
4. Laboratory prices usually less paying cash than when billed, also true for most medications these days – we can find you coupons that bring the cost less than  your copay
5. Laboratory prices in  cash versus billing, which may end up being much higher
6. 33% of independent practices are expected to be DPC.
7. DPC is patient-centered with plenty of time and resources for care coordination. 
8. Provides a safety net alternative for uninsured or underinsured.
9. Reinforces the patient/physician relationship. Since we are not paid by insurance, there are no conflicts of interest. We advocate for you.