What is Direct Primary Care (DPC)?
Direct Primary Care (DPC) provides a solution to problems plaguing our current health care delivery system: rushed office visits, fragmented care , difficult access to a physician, and long wait times for an appointment. The “Direct” in Direct Primary Care refers to the relationship between a patient and his or her physician. Instead of relying on payments from insurance companies the doctor receives payment directly from her patients, through a monthly subscription fee. The simplicity of this relationship allows for easy access, personalized care and a true collaboration between patient and physician. Since the physician no longer needs to pay additional staff to collect payment from the insurers, report data, and chase down collections, the cost of providing exceptional medical care decreases dramatically. Most DPC doctors limit their patient panels to guarantee full, convenient access for their established patients.
FAQ about DPC through Ivy Family Medicine, PLC
What is included in the monthly fee?
- Unlimited visits without copays
- Management, when medically sound, via phone, email and telemedicine
- Access to your personal physician by phone call for urgent matters arising outside of regular business hours
- In office lab tests (strep, flu, urine tests)
What is not included in the monthly fee?
- Vaccines (see below)
- Imaging Studies
- ER/Urgent Care visits-though these are far less likely to be necessary when you have easy access to a physician who knows you well
How will I, or my child, get vaccinated?
- Due to the high cost of vaccines, we are not able to offer vaccination in the office.
- We expect all patients of Ivy Family Medicine, PLC to be vaccinated in accordance with current guidelines. If this is not a decision you are comfortable with, Ivy Family Medicine is not the right medical practice to meet your needs.
- Routine childhood vaccines can be obtained, at no cost to you, at your local health department. The childhood vaccination schedule recommends vaccines at ages 2,4,6,12,15 and 18 months. The visits are straightforward, brief and uncomplicated.
- Vaccinations for children older than 5, adolescents and adults can also be obtained at the health department or at Costco pharmacy (you don’t need to be a Costco member to use their pharmacy) and billed directly to your insurance.
Do I still need insurance if I sign up with you?
- Yes. Your subscription fee does not replace a health insurance plan. However, you may decide to purchase a less expensive higher deductible insurance plan to make sure you are covered for emergencies, hospitalizations, expensive imaging studies and labs. Often times the savings from switching to a higher deductible plan is more than the cost of your yearly subscription fee.
How will I pay for things that aren’t covered by the monthly fee like specialist visits, high cost procedures, imaging studies and hospitalizations?
- You will use your insurance. It should continue to cover anything it has contracted to pay for, though you will still have to meet the agreed upon deductible. This is true for both commercial insurers as well as Medicare.
If I haven’t met my insurance deductible, will I have to pay full price for labs and X-rays?
- If you choose to use your insurance to pay for labs, yes you will. If you decide that you would like to pay for them out of pocket through Ivy Family Medicine, you will have access to wholesale pricing on labs. This is typically less than 20% of what insurance would pay for the same labs, and is usually between $7 and $20 per test. IFM will not be charging any markup on these labs; the price we pay will be the price you pay. We are working hard to find similar benefits for X-rays, MRIs and even medications.
Can I still see my specialists?
- As long as the specialist or hospital is in your insurance network, your insurance should pay for this. The fact that I am out of network does not change this at all. This is true for commercial insurers and Medicare.
I have Medicare. Can you still be my provider?
- Yes. You have to sign a one-time waiver declaring that Medicare will not be asked to reimburse for services provided at Ivy Family Medicine. Medicare should still pay for any medically necessary tests, labs, or hospitalizations, just as they always have.