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What is Direct Primary Care?

Employer-provided plans are too often restrictive. And what about entrepreneurs or those in the gig economy?

 

Even people with comprehensive employer-based plans often find their coverage confusing or not suited to their unique medical needs. Disappointment in in insurance networks can lead to despair: “What if my plan won’t cover my condition? Can I afford the deductible? Will my costs climb next year?”

Concerns like those are driving more people to Direct Primary Care. DPC is, you might say, 'open source'.  It's your doctor's way to better serve you, and not a company or franchise

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Dr. Eleanor Host, MD

DPC is the compelling alternative to traditional fee-for-service insurance billing.

Typically, when a person receives care from their doctor, the practice bills the insurance company, and the insurer bills the patient for uncovered services.

This can lead to unpleasant surprises. Insurance policies can be confusing to navigate and are filled with loopholes.

Direct Primary Care is far simpler. DPC-NWO member-patients are charged an annual, monthly, or quarterly fee. This covers nearly all primary care services such as office visits, clinical and consultative services, care management, and coordination. It even covers some laboratory work, and your visits to the office are generous: Up to 99 per year, and we don’t watch the clock when you’re here.

Direct Primary Care is similar to concierge medicine. Your provider is available to you whenever you need them. You’re never rushed. Your care is relaxed and so are you.

Do DPC Patients Still Need Health Insurance?

Direct Primary Care operates solely on patient fees. That income is used solely to serve our patients. Without an insurance obligation, DPC-NWO practices are more efficient and the doctors are not hamstrung by insurance “rules”.

However, we recommend that member patients and companies also purchase wraparound coverage to supplement the DPC plan, as there are some needs (such as trauma requiring emergency care) that will not be covered.

DPC works great as a complement to high deductible health plans or sharing plans like Sedera. We can also set up a plan using an HRA.

As a model of care centered on patient health, DPC is ideal for individuals and for businesses hoping to provide more convenience and transparency for their employees.

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Dr. Murthy Gokula, MD

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