What is the difference between Direct Primary Care (DPC) and Concierge Care (CC)?
It is similar in concept, but Direct Primary Care is more affordable than concierge medicine.The terminology is used interchangeable. Concierge practices require a retainer fee to cover special services (see below) and in addition charge insurance plans for primary care services.
- Extended office visits, 30 mins or longer
- Direct access to physician via phone, text and video conference
- Same day and next day appointments
- Unlimited office visits, no co-pays
Concierge medicine typically charges higher retainer fees (average $150 - $200 per month) compared to Direct Primary Care monthly membership fees (average $50 - $100 per month).
DPC covers primary care services along with the above special services at no additional cost. An agreement is made between patients and doctors for all primary care services for a flat, low monthly payment. It is an affordable way of providing high-quality, personalized private medical care outside the current insurance-based or government-based (Medicare and Medicaid) system. This allows easier more convenient access and more time with their physician. It reduces the overhead and expenses and allows doctors to spend their time on patient care passing the savings on to patients. Our goal is to keep overall costs low providing high quality care to patients of all incomes and levels of insurance coverage. This leads to fewer tests, medications, ER/urgent care/hospital visits, and overall lower total cost of care.
Other benefits include discounted in-office prescriptions, wholesale labs, pathology and imaging (see benefits).
What do the DPC monthly fees cover?
- unlimited office visits with no copays
- direct access to your doctor via phone, text, email or video conference
- same day or next day visits
- extended and relaxed office visits
- discounts on pathology, imaging, medications and labs
- online specialist expertise
- visit our patient page in the upper "tab" bar for a list of included services
- all of this without the need of insurance
What is NOT included?
Pathology, labs, imaging and medications.
However, you can expect them all at a discounted rate.
What are the prices?
Please find a complete list of our prices on our Patients page.
How to enroll and pay?
Enroll on our Patient tab and pay your doctor with a credit card.
Do I sign a contract with my membership? What if I decide to cancel?
Although there will be some paperwork and agreements to sign when you first join, you will NOT be required to sign a contract that commits you to a certain time frame. Accounts must be paid in a timely manner to maintain membership services. We expect to have an open, honest, respectful relationship with our patients. We ask to give us a 30-day notice if you wish to cancel. We understand that things happen. If you choose to rejoin, you may be charged a re-initiation fee.
What if I don't want to become a member, can I still be seen?
Yes, while the practice is growing we will see patients for a one-time fee if you are not ready to commit to a monthly membership. However, this may change in the future once the practice becomes busy. Please call before coming in to schedule an appointment.
What age group is seen?
Ages 3 and up Pediatric, Adolescent, Adult and Geriatrics.
What if I have a lot of medical issues?
Our doctors wants to help you manage your conditions and keep you feeling your best, membership prices are based on age, and are not based on number of existing medical conditions.
What kind of medical conditions are cared for and what if i need to see a specialist?
Your myMDhome's doctor is a primary care physician trained to handle most health care needs, we will coordinate the specialist referral for you.
Does myMDhome doctor accept Medicare?
Unfortunately, we currently cannot accept Medicare patient’s due to Medicare regulations for Primary care however we can put you on our waiting list.
What about Medicaid?
We do not contract with Medicaid and cannot bill the carriers for services. With that said, we are more than happy to care for Medicaid patients if they enroll in the membership. Please note, the cost of membership is not covered by Medicaid plans nor can we bill Medicaid for services provided.
What if I'm hospitalized?
You will use your high deductible insurance plan. Our goal is to provide excellent health care with accessibility and convenience in which we seek reduction in hospitalizations and specialty referrals.
In those instances, we will work closely with the hospitalist in providing post discharge care and work closely with specialist in working as a team.
Are my medical records shared with insurance carriers or government agencies?
No. Patient privacy is a natural benefit of this medical model. We will never provide any third party with a copy of your records, unless you specifically ask us to do so or if myMDhome is subject to subpoena or search warrant.
What if I need medical attention while I'm away from home?
In the age of telemedicine, many conditions can be diagnosed and treated via a simple conversation by phone or video conference. If appropriate, we will locate the nearest pharmacy (in the US) and order medication most suited for your circumstance. Alternatively, we can mail medications to you (in the US). If you need to go to the hospital or seek other medical attention while away from home, we can advise you on that as well.
Do I really get to speak to my doctor if I call?
Yes, during office hours you may speak to a secretary or nurse however if you leave a message for your doctor will personally respond. Once you become a member you will get the providers private direct after-hours number for urgent matters.
Can I contact my doctor after hours and how?
Of course! However, we can’t guarantee 100 percent availability. That said, a reasonable expectation for availability would be appreciated.
Once you become a member you obtain a personal number directly to her. In which she is available by text or phone after hours for urgent situations. However, if it is not an urgent matter and can wait until the following business day this would be appreciated.
If it is an emergency we do advise to call 911.
What if I have an emergency?
For problems that are not life-threatening emergencies, you can contact your doctor for their "on call" doctor via the direct member number given at time of registration. In most cases, she can diagnose and treat you without a visit to the ER or urgent care.
If you have a life-threatening emergency, call 911 immediately.
What if I need labs or imaging?
Arrangements will be made for you to get your labs done in-office or at a facility of your choice. Cost of labs will be given prior to collection. Charges for labs will be added and applied to your preferred method of payment for membership.
myMDhome has negotiated on your behalf with imaging centers for the best self-pay prices and will confirm prior to scheduling. Charges for imaging will be required upfront with imaging center.
Transparency is our mission so we will always let you know what you're being charged for prior to. However, if you would like to use your insurance for labs or imaging you can do so, just ask and we can guide you. Please be aware that prices will not be transparent if going through insurance. You will obtain a bill from the insurance and may be asked a co-pay.
If I pay for a membership do I still need insurance?
Yes you will need health insurance, we do not bill insurance nor do we require insurance for membership. We are glad to enroll patients who do not have insurance and help them negotiate cash prices for non-covered services, but we still advise patients to obtain at least a catastrophic plan to cover un-anticipated costly medical services such as surgery or hospitalization. Most patients combine the membership of Direct Primary Care with a high-deductible insurance plan or health sharing plan. We are happy to refer you to an insurance representative who can help customize an insurance plan that works best with our medical model and that will meet your specific needs.
Your myMDhome doctor will cover office visits, in-office procedures, and testing. We do not cover the costs of medication, labs, imaging, specialist visits, surgery or ER/hospitalization.
Are your services covered by my insurance?
No. The purpose of direct care is direct patient-physician care, no middleman, no insurance company to impose arbitrary measures to increase their profits and decrease your quality of care. The direct nature of this model frees us from the typical contractual agreements that prevent physicians in traditional practice from offering wholesale prices on laboratory tests, medications, and imaging. However, we can directly bill your insurance for labs, imaging and medications if desired.
What if I want to continue my current insurance? Can I use it?
Not for our services, but we will work with your insurance to submit any labs, imaging and medications that we prescribe to your insurance. If your plan requires you to use a particular facility, just let us know.
How can I save on insurance costs by being a patient of a myMDhome doctor?
Many times, patients purchase expensive insurance plans that require little or no co-pay and that does not cover all lab costs or prescription costs. However, with Aspire Health your monthly fee covers office visits and there are no copays. Plus, our patients have access to wholesale medications and labs sometimes at a 90% discount! Patients may find it worthwhile to change from an expensive health insurance plan to a basic health insurance plan to save money.
Why should I pay a monthly fee if I have insurance?
At a traditional primary care office, you will pay a co-pay to see your physician and on top of that, you will have an office visit charge of about $150. That charge is not including blood work, additional testing or procedures done at the visit. Our blood work is discounted.
Procedures and additional in-office testing is covered under the monthly fee (additional charge for pathology or medication). They are no co-pays or office visit charges. We are fully transparent regarding charges. Most insurances are high deductible plans in which majority of patients never reach that in a year so unfortunately there is a lot of out of pocket charges.
Are myMDhome's monthly fees eligible for HSA or FSA reimbursement?
Many patients find that their DPC fees are reimbursable through their HSA or FSA. Consult your tax advisor for guidance on your particular circumstances.
Would I benefit from DPC if I'm healthy and hardly go to the doctor?
Many people believe they should only treat illness when it happens instead of identifying and preventing disease before it starts. Our goal is not only to see you when you are ill, but to concentrate efforts on preventative care with long-term health and wellness goals. Dr. Tami's focus as a family physician is to help patients find health and wellness on a day to day basis. If you would like to discuss wellness, nutrition, dieting, or exercise plans that are right for you, this is an added component of the membership model.
We all benefit from services tailored to our needs, and your health care should be no different. We will provide you with the care you need to optimize your health and to reach your wellness goals.
Let’s be honest, at some point you will be sick or injured and need acute care. When that happens, you will have immediate access to your doctor who knows your personal health history completely and will take your circumstances into account when developing a treatment plan.
A DPC membership also allows you access to your physician for acute complaints and prevents costly trips to the ER or Urgent Care. Your myMDhome doctor will do their best to keep you out of the urgent care or ER. If you save one ER visit, your yearly fee will pay for itself.
How do employers benefit?
Employers benefit by their employees having unlimited access to their provider. We provide same day or next day appointments, extended and flexible appointment times and follow up appointments that can be provided via video conference or phone call. This decreases the absenteeism from work duties. Other incentives such as; medications at wholesale costs, in-office labs at discounted rates, no copays and no additional cost for procedures or in-office testing. In the end, the employer benefits by lowered premiums due to limit use of the insurance.
Do you give vaccines?
Unfortunately, with a smaller volume of patients, we are currently unable to stock vaccines in our clinic. We are working on potential solutions with our local pharmacies so stay tuned for more updates. If your child needs standard childhood vaccines, we may refer to the Health Department to provide vaccines in the meantime.
What exactly are e-visits?
Visits via phone, text, email or video conference can be more convenient for certain conditions and chronic care. As a general rule, any issue that requires a physical exam we will need to see you in the office. While virtual visits are a great addition to primary care, they still do not replace the diagnostic ability of a physical exam done in the office.
What if the doctor is out of town and I need to speak to them?
In the rare event that Dr. Tami is out of town, she will continue to provide and coordinate your care. When possible, she will arrange for another physician to see you if needed.
Who does the membership plan work best for?
It works especially well for those who want to participate in improving their health and staying well, including:
- Patients desiring easy and direct communication with their doctor.
- Patients who want a doctor who provides personal care and truly cares for their patient.
- Patients who want a doctor to address the root cause of illness, not just treat the symptoms.
- Patients who enjoy unhurried and extended office visits.
- People with busy lifestyles. Often issues can be addressed without the need for an office visit (text, phone, email or video).
- Those with high insurance premiums/high-deductible health plans or healthcare sharing plans.
- Self-insured business owners seeking to provide their employees with affordable health care while improving their well-being, simultaneously reducing health care spending.
This seems too good to be true, is there a catch?
No. This is the real thing. Quality healthcare the way you want it. This is just how healthcare looks when the middle-man is cut out. Keeping payment directly between the patient and the doctor. This keeps the price low and the care high!
What if I have more questions?
If we haven’t fully answered all of your questions, please contact us so we can further assist you. For more information on the many benefits of direct primary care and details, please call (954) 998-4468 to schedule a free introductory meeting. We would love to learn about your health concerns and goals and share why a myMDhome doctor might be a good fit for you.