What about if I need a specialist?

We will coordinate your referral to a specialist in your insurance network. They will bill your insurance.

 What if I go to the hospital?

Our program does not cover hospital care. This is why we suggest you look into at least a high deductible health plan (HDHP) for catastrophic coverage for health insurance. Should you require admission to the hospital, our provider will be glad to coordinate that for you.

Do you accept people on Medicare?

Yes.

Are there any exclusions for pre-conditions?

No.

There are no pre-existing condition exclusions and there are no increases in the membership fee based upon prior health history. In fact, those with chronic medical conditions are perfect patients for Preferred Direct Family Care.

I’m young and healthy, how will this help me?

We provide you with the care you need to optimize your health and to reach your wellness goals.

At some point, you will be sick or injured and need acute care. When that happens, you will have immediate access to your medical provider who knows your personal health history completely and will take your circumstances into account when developing a treatment plan.

We will do our best to keep you out of the emergency room. If we can save you one simple ER visit, the yearly fee (possibly up to 2-3 years) will pay for itself.

Is Direct Primary Care a Concierge Practice?

The terms Concierge medicine and Direct Primary Care are often used interchangeably. Both types of practices charge a monthly fee, but a Concierge practice will also bill health insurance companies for office visits and in-office tests and procedures while a DPC practice does not. Generally, the monthly fee that a Concierge practice charges is much higher than the monthly DPC fee.

Are my monthly fees eligible for HSA or FSA reimbursement?

This issue is currently being addressed at a Federal level by the Primary Care Enhancement Act to help clarify the interpretation of current laws regarding DPC membership fees. IRS regulations, however, make it pretty clear that DPC services are covered medical expenses reimbursable through HSAs and FSAs. In the meantime, you should consult with your health plan administrator or accountant for guidance on these issues.

As a patient, do I still need insurance?

Yes.

Direct Primary Care is NOT insurance. We encourage all of our members to find either an insurance plan or a health sharing plan to help cover the costs of catastrophic illness or injury. Hospital bills that come from an accident or from a serious disease are simply too big to cover on your own and the medical assistance that you will need to deal with these types of situations are more than Preferred Direct Family Care is built to provide.

Members of Preferred Direct Family Care routinely use their insurance or government program (Medicaid) for medical procedures and specialist visits that happen outside of the Preferred Direct Family Care clinic, as well as prescription medications and supplies.

Many of our patients carry some traditional form of insurance with a high deductible. With these high deductible plans, patient's premium savings are often much more than the cost of membership and their insurance is there to cover the cost of large incidents.

Another option that is increasingly popular among individual Preferred Direct Family Care members are health-sharing plans. These types of plans are recognized under the Affordable Care Act and allow participants to avoid any penalties for non-insurance. They are more lightly regulated so it is essential that any plan be carefully considered. Generally, these health-sharing plans offer more financial support (have fairly low amounts before cost are shared) which they achieve by having significantly lower overhead and in many cases somewhat less comprehensive coverage.

If you have any other questions please feel free to call the office: 352-677-2025.