Frequently Asked Questions
What is Direct Primary Care?
Direct Primary Care (aka “DPC”) is a growing movement in Family Medicine.
Instead of the fee-for-service model, where you may be charged copays and expensive office visit charges, direct primary care uses a membership model to cut down on wait times, reduce the cost and burden of health care, and allow you to spend time with your doctor, both in person and online. It’s a simpler approach to care.
Basically, the middle men in the system is cut out.
How can Mission Medical DPC save me money?
The DPC model can make your regular medical costs cheaper and more predictable – leading to more financial freedom and independence no matter if you are self-employed, without insurance or on the plan of a third party payer. Typical insurance requires an expensive monthly premium followed by copays that are often comparable to our DPC monthly fee. These same copays often do not count toward the deductible and then typically continue to be required once deductible amounts are met. Additionally, a “max out of pocket” must usually be reached before insurance payment covers 100%.
Therefore, you may find that a less expensive traditional plan (low premium/high deductible to be used in case of emergencies) is more desirable for you and your family when you have reliable, regular medical care through our DPC.
In simple terms, how does this work?
The member pays a monthly fee like to any other membership based entity. This covers the majority of their primary care costs; basically, they have office visits with $0 copays, have access to meds at just over wholesale prices and access to deeply discounted imaging, etc.
By having their primary care needs met with their membership, they can save bigger money by having a higher insurance deductible or using a HealthShare program.
Is this the same thing as health insurance?
Your membership covers your primary care needs, but it is not the same thing as health insurance. We recommend (but don’t require) our members obtain health insurance to cover more expensive health care needs, which is typically done with things like a high-deductible catastrophic plan. Medical cost sharing programs are often a good match as well.
Do you take insurance?
We do not. We do not bill insurance, or contract with any private or public insurance plans. This allows us to keep our pricing transparent and our quality high—both which are destroyed by the bureaucracy.
If you have insurance, you are certainly free and welcome to use it as appropriate all other places as accepted by them.
What if I don’t have insurance?
No worries. You don’t need insurance to be a member with us. We recommend everyone have insurance for emergencies and other needs, but we don’t require it, and we don’t bill insurance companies for our services. In addition, to make sure our members are getting the highest value, we contract directly with vendors to get all of our members labs and imaging at cost. We can also get discounts on medications.
Why the monthly membership fee?
The affordable monthly membership fee allows us to provide you with the best care possible, covers a wide variety of routine health services, and allows us to negotiate lower prices for other services you may need, such as imaging and labs. (see our Pricing page)
We also find that when the office isn’t filled with seven-minute visits, you can be seen when you need to be seen, with minimal wait time, as well as have more comprehensive visits.
No copays? No office visit fees?
Right. There is no additional “office visit” charge for our appointments, and there never will be. We think things are simpler this way. (It’s kind of like a certain online video streaming service, where you only keep a membership, and are not charged for each time you watch a movie). Whether you’re sick or healthy, having a membership means no “cover charge” at the door. We feel that sometimes extra charges like these may discourage people from seeing their doctor (or encourage them to wait to until they’re a lot sicker to do so), and we really want to eliminate barriers to good care wherever we can.
What about charges for things in the clinic like EKGs, wart freezing, etc.?
The current medical culture has exorbitant, hidden pricing markups for many of these in-office services running up the cost of routine care. Rest assured that we don’t do that. For starters, we believe part of informed health care is patients generally knowing how much things are going to cost, upfront. We believe the patient should be informed of all charges beforehand. Transparency. No surprises.
Your membership pays for our services and care; they do not cost extra.
Do you accept patients with preexisting medical problems?
But of course! Having a medical condition before you see us won’t change your eligibility or our membership price. We believe in providing care for the whole community, and that includes patients who come to us with chronic conditions.
Is there some sort of long-term commitment when I sign up?
No. We want to earn your membership and nurture our relationship at all times. We want our relationship with each member to be open, respectful, honest—-in a bidirectional manner. With this mindset and goal, we require no long term obligations. You can unsubscribe at any time if we are just not the right fit for each other.
What if I need medical attention while I’m away from home?
We will take care of you while you are away; you can reach out to us whenever you need, wherever you are. Many illnesses can be diagnosed and treated with a simple conversation. We’ll also locate the nearest pharmacy and order the medications most appropriate for your circumstances.
How does my membership save me money on medications, labs and X-rays?
We are able to dispense most medications from our clinic at the time of your visit, or when you need refills. You will be able to buy them just over wholesale price—saving you large mark ups. For people on multiple medications, their prescription savings often pay for their membership.
Labs and X-rays are done at outside facilities whom we have negotiated discounts with. They do your lab and X-ray and bill us; we then bill you that same discounted price. Basically, we buy your lab & imaging and you just pay us back.
The cost of insurance is killing us and not sustainable. What are my options?
Unfortunately we hear this almost every day, and this is part of the reason we’re here. Health insurance is not the same as health care, and health care does not have to be expensive.
Primary care does not need to be insured. This is worth repeating. Primary care does not need to be insured. It can be affordable and the growing DPC movement is proving this.
However, even if you’re using DPC to cover your preventative care and routine medical needs, you still need to be protected from catastrophic expenses that can happen in the rare case of a medical emergency, hospitalization, surgery, etc. You need protection from the predatory system.
Some options are:
- High deductible, catastrophic plan. Keeping the deductible high lowers the premiums and the savings pay for your DPC membership.
- Christian Health Share Ministries which include Liberty HealthShare, MediShare, Samaritan Ministries, CMF Curo, and several others. A quick internet search will help you research these ministries.
- There are still catastrophic plans available as group insurance products, as well as self-funded or partially-self-funded “ERISA” plans. Although these plans can save you lots of money, they’re only available to groups, (i.e. employers.) Talk to your employer about finding a plan like this, as some of these companies give significant discounts to employers whose patients use DPC practices, and such employers are saving up to 60% on their insurance expenses.
What if I like my insurance but want to be a member?
A couple of common options:
- The first is to pay your membership yourself and use your insurance for other health expenses outside of our clinic.
- The second is to talk with your HR Department. Many employers have more than one plan available; a higher deductible plan from your employer often frees up money to be used for your Membership.
Can I just sign up my children?
The entire family does not have to enroll, but we do require at least one adult membership for children to be members.
Can just one or two people in a family join instead of the whole family?