How does Direct Primary Care (DPC) work with insurance? It’s a great question, especially since it’s Open Enrollment Season.
Direct Primary Care, through Ultra Primary Care, is a model of healthcare that keeps your care, needs, and plans between you and Dr. Christy Arthur. For a low monthly fee, patients eight and older receive mental and physical health care in a timely, respectful, and compassionate manner, so they can achieve ultra health and we can heal healthcare. Claims are not sent to insurance providers, you don't pay any co-pays or coinsurance, or receive any surprise medical bills. Direct Primary Care is healthcare done the way medical providers wished they could do healthcare. Meet Dr. Christy and learn more here.
So, if you don't accept health insurance, how does this help me save money on my insurance? The quick answer is that a Direct Primary Care membership allows you to pick a plan with a lower monthly premium (and higher PCP co-pays). That’s because a DPC membership includes ALL doctor visits at NO additional charge—so there are no co-pays or co-insurance fees EVER.
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The longer answer is that a Direct Primary Care membership PLUS a high deductible plan can offer huge advantages, because of one, BIG difference: Unlimited access to a doctor who knows you and your history, so you can get the care you need from a trusted source, when you need it. Did you know? Most Primary Care Providers are trained to perform gynecological exams, as well as any reason you may feel the need to visit urgent care? In addition to supporting your mental health needs, weight loss and nutrition, even your sleep goals? However, most Primary Care Providers are required to carry a case load of over 3000 patients per year and are unable to spend the time needed with each patient to provide these services. A Direct Care provider only carries 400-600 clients per year.
Back to the insurance question! Let’s take a look at the math—the following is an example for a family of four, with an annual income of $100,000 (For ease of comparison, only Anthem HealthKeepers plans are included. There are many more products available on the marketplace):
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So, you can save $367.45 a month through enrolling with the Bronze plan instead of the Gold, and $342.40 a month compared to the Silver plan. A membership cost, for a family of 4, is only $300/month with Ultra Primary Care, so members save up to $67.45/month on insurance premiums, AND enjoy unlimited access to their doctor.
It is important to note that specialty visits also have a higher co-pay with the Bronze plan, and that there are higher out-of-pocket costs because the deductible is higher. That’s one reason DPC doctors often offer lower cost specialty referral options through a network of direct specialty care providers. And, your DPC doctor can help you find the most affordable studies, like MRIs, CT scans, Ultrasounds and X-rays through cost-saving partnerships with local radiology vendors, and programs like Radiology Assist that show you the lowest price with the highest quality.
DPC doctors also can help you save money on expensive prescriptions through relationships with local cost-only pharmacies and pharmaceutical savings plans.
As you make your open enrollment and wellness plans for 2024- Consider Ultra Primary Care for your individual and family’s medical needs in 2024, and experience the peace of mind that comes from saving money, AND knowing you have a doctor in your corner whenever medical needs arise! Schedule a meet and greet phone call here: Chat with Dr. Christy.
