Direct Primary Care FAQs
1. What is Direct Primary Care?
Direct primary care is a health care model in which family medicine physicians provide complete primary care services for a set monthly, quarterly or annual fee. It is a new alternative to the traditional health care plans.
Multicare Physicians Direct Primary Care (DPC) was designed for more affordable and more accommodating preventative healthcare. DPC fundamentally limits the number of patients an office can receive, which results in providing more time between patient and physician for more proper diagnostics. The average doctor spends 10 minutes with their patients. DPC allows for 30 minutes to an hour per patient.
2. Do I have to have insurance?
No, but we recommend you have some form of insurance to cover unplanned emergencies in your health. Due to the low monthly fee, membership-style payment plan, DPC eliminates the expense of a full-coverage insurance plan. High Deductible Plans also known as Catastrophic/ “Wrap around” plan is still recommended and required by the Affordable Care Act (ACA). However, DPC replaces the need for a high deductible, full-coverage plan with a plan insurance was made for- covering catastrophes.
Full-coverage insurance plans are normally twice the cost of a stripped down catastrophic insurance plan. Consider this: your car insurance is reserved for severe damages, not for maintenance like oil changes and tire rotations. Your health insurance should be the same. Reserve your plan’s deductibles for severities and pay for your health’s maintenance out of pocket. Thereby reducing your overall cost of healthcare by thousands of dollars each year. Most People enjoy an average savings of 30-60% on healthcare costs. Savings include eliminated co-pays and deductibles for primary care services and reduced cost of medication, imaging and labs.
DPC helps patients like you invest your money directly into monthly and yearly checkups. It improves your access to general health checkups, helping you invest in your healthcare more regularly – avoiding the “sick care” that results from a lack of frequent visits and checkups with a primary care physician.
In fact, a study by JABFM found that more than 50% of one DPC provider’s patients had fewer emergency/hospital visits after transferring to their DPC system.
While most patients can be cared for at the primary care level, if your medical needs expand to outside specialists in the case of emergencies, you will need to use your catastrophic insurance plan. We can arrange for specialty care physicians with custom, discounted rates depending on the circumstances of the emergency.
3. Do we accept insurance?
We don’t accept insurance and to be clear we are not insurance, but don’t let that scare you because most of our patients actually save money as Multicare Physicians DPC members. For healthcare expenses outside our office, we can help you find the combination of healthcare, and health insurance that saves you money when combined with our direct care model.
4. How do I pay for services?
You can pay monthly, semi-annually or annually with automatic enrollment with credit card or direct deposit just like you would with a gym membership. Below is a link to our fee schedule.
5. Can I get membership through my employer?
Yes. We are a great option for small business owners and self-funded companies who are looking to provide great benefits for themselves and retain great employees. Even if your employer doesn’t cover the membership, it is still a valuable investment in your health. The employer can design their perfect “wraparound” plan.
Most importantly, a self-funded plan benefits financially right away from the savings on copays, procedure fees, wholesale medicines, labs, imaging, pathology & decreased ER/Urgent care usage.
Improved access to Multicare Physicians DPC, employers can lower ER/Urgent care visits, hospital costs and specialty costs. Employers are healthier, more productive, and more satisfied with their healthcare experience.
We are glad to speak with your employer’s Chief Executive or Chief Financial Officer to explore these options.
6. Can I use my Health Savings Account to pay for Direct Primary Care?
The law currently allows the use of HSA money to pay for medications, imaging tests, labs, etc. No, HSA funds cannot be used to pay for DPC membership fees. Legislation has been proposed to clear up the question regarding if HSA money can be spent on a DPC physician’s retainer or membership fee.
7. Can I get all of my medications through MultiCare DPC?
As a member, you will have access to discounted medications and you pay only our cost, which is always below current prices. We only dispense medications we can save you money on. We do not dispense any DEA-controlled medications such as narcotic pain medicine, sedatives, anxiolytics or stimulants.
8. How can I contact the provider after hours?
We know that illness and injuries don’t always happen during office hours. If you just need to get in touch with us to order a medication refill or schedule an appointment, you can call the office, e-mail the provider or leave a voice mail. If you have a non-urgent question, but one that probably shouldn’t wait until tomorrow, you can contact your physician via the meVisit telemedicine app during specified hours. Lastly, if you have an urgent or emergent issue after hours, CALL 911 AND/OR GO DIRECTLY TO THE EMERGENCY ROOM.
9. Where do I sign?
10. Is this concierge medicine?
No. However, there is overlap between direct primary care and concierge medicine. The most important difference is in the cost and billing structure. In general, concierge practices charge and annual retainer along with billing insurance. The typical annual retainers are over $1800 per year. Direct primary care practices generally charge monthly fees which tend to be less than $100 and generally do not also bill insurance for other services. Both concierge medicine and direct primary care strive to improve the experience you have at the doctors office by making care more personal and taking more time to listen.
11. I own a small business. How can you help me?
Absolutely! We are happy to partner with you to bring our quality services to your employees and save them time away from work waiting at the doctors office. Please call us if you would like to learn more.
12. So you offer tele-health services?
Yes! Our partner mevisit uses a platform that will allow us to securely video chat and more. We will always strive to bring you appropriate care in the appropriate way. If we can use our tele-health services to help save you a trip to the office, we most definitely will.
13. What if I need a specialist?
If specialty care is needed, we have a large community of specialists that we work closely with. We will communicate carefully and consistently with specialists to be sure you receive an appropriate consult.
14. What is not included in my membership?
Our Primary care services can often address the vast majority of an individual’s health care needs. However, some services are not included in the direct primary care program. Patients are encouraged to combine Multicare Physicians membership with a high-deductible insurance policy to cover specialist physician and hospital services.
Our membership does not cover the cost of such services as:
• Laboratory Services
• Medical Imaging
• Surgery
• Specialist Care
• Emergency Department Visits/Hospitalization
15. What if I’m having a medical emergency?
As is customary with any true medical emergency, CALL 911.
16. What if I need care on the weekend?
If you have an urgent after-hours concern that you believe cannot wait for routine business hours, we will be available by phone or meVisit to assist you. We are not available for routine needs or matters that can wait until normal business hours on the weekends. Our doctors are dedicated to your care and to a healthy, cultivated physician-patient relationship.
17. So, no matter when I need you- you’re available?
No…not exactly. We are primary care physicians. This means we can address most problems, most of the time. We are cultivating something sustainable, enjoyable and trans-formative. And it requires a partnership with our patients.. In this age of instant responses and digital access, we are striving for sustainability. We ask our patients to utilize our services, in person or electronically, when they need us. We also ask that if matters can wait until waking hours that they do.
18. What is Considered an Emergency?
Urgent care is not a substitute for emergency care. In general, an emergency condition is one that can permanently impair or endanger the life of an individual. Some examples of conditions that require emergency medical care include:
• Severe chest pain or difficulty breathing
• Compound fracture (bone protrudes through skin)
• Convulsions, seizures or loss of consciousness
• Heavy, uncontrollable bleeding
• Deep knife wounds or gunshot wounds
• Moderate to severe burns
• Poisoning
• Serious head, neck or back injury
• Pregnancy-related problems
• Severe abdominal pain
• (Signs of) Heart attack (i.e.. chest pain lasting longer than two minutes)
• (Signs of)Stroke (e.g. loss of vision, sudden numbness, weakness, slurred speech, or confusion)
• Suicidal or homicidal feelings
19. What is Considered an Urgent Medical Condition?
Urgent medical conditions are ones that are not considered emergencies but still require care within 24 hours. Some examples of such conditions include:
• Accidents and falls
• Sprains and strains
• Moderate back problems
• Breathing difficulties (i.e. mild to moderate asthma)
• Bleeding/cuts — not bleeding a lot but requiring stitches
• Diagnostic services, including X-rays and laboratory tests
• Eye irritation and redness
• Fever or flu
• Vomiting, diarrhea or dehydration
• Severe sore throat or cough
• Minor broken bones and fractures (i.e. fingers, toes)
• Skin rashes and infections
• Urinary tract infections
Dial 911 immediately for any Medical Problem that Appears to be Life-Threatening
20. What if I need a specialist?
If specialty care is needed, we have a large community of specialists that we work closely with. We will communicate carefully and consistently with specialists to be sure you receive an appropriate consult.
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