Direct Primary Care – Frequently Asked Questions

This list of Frequently Asked Questions was compiled by the Think Freely Media (TFM) staff and originally published as part of “How Health Care Should Be,” a project highlighting the positive impact market forces can have on our health care system.  The complete FAQ can be downloaded here.

What is Direct Primary Care (DPC) and how does it differ from the insurance that I normally use to get health care?

Imagine having a personal doctor on retainer to call on at any time, but at blue collar prices.  70 – 80% of all health problems can be dealt with between a doctor and patient.  For an average of $50 to $125 per month, no insurance, no surprises – just your family and your primary care doctor.

Direct Primary Care is an innovative new take on an old practice model that eliminates third parties from the financial relationship between a patient and a physician. It turns basic health care into an affordable and manageable direct relationship between the patient and the physician.

What is typically included in the monthly membership at a Direct Primary Care office?

A single monthly fee allows us to become available to our patients in person, leverage technology to be present virtually, or be present in their home. When the member comes to our office, that single monthly fee allows us to not charge for several in-clinic procedures, including ECG, joint injections, suturing, casting, splinting, skin biopsy, and much more. Some practices might charge a small fee to cover costs, but revenue is not solely generated by these procedures.

Our visits are as long as the member needs. This could mean 30, 60, or even 90 minutes. Family meetings might take longer to review a complex situation or an illness. Finally, the member is offered discounted imaging, wholesale medications, and laboratory testing.

Do I still need health insurance if I can get a DPC provider?

Direct Primary Care is not a substitute for health insurance. DPC is a great way to receive high-quality primary health care for most medical needs, but an insurance plan of some type is needed for unexpected and expensive events.

Does a Direct Primary Care (DPC) membership fulfill the health insurance mandate?

Unfortunately, No. However, when used with a High-Deductible Insurance Plan or Health sharing plan, this combination can fulfill the mandate and be more cost effective.

How do the non-profit health cost sharing companies work and how are they different from the for-profit insurance companies?

Health Care Cost Sharing non-profit organizations represent an option for health consumers to collectively share medical expenses among like-minded individuals/families. Many of these Health Care Sharing Ministries are exempt from the ACA and thus, are exempt from the individual coverage penalty.

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