Direct Primary Care Explained

What is Direct Primary Care? Can I still use my insurance? 

Find answers to these commonly asked questions about Direct Primary Care, and more—watch the video below.

FREQUENTLY ASKED QUESTIONS

Your Questions, Answered

Do you have questions about Health360 Direct Primary Care?

We have put together a list of the commonly asked questions and answers. If you have any other questions, feel free to connect with us via email at: info@health360dpc.com.

Click on a tab to open the section and view the answer.

HEALTH360 Direct Primary Care uses an innovative model of care, bypassing insurance, cutting out the middle man, along with the paperwork, claims, and prior authorization requirements. This model of health care is rapidly growing and rekindles the provider-patient relationship as it used to be. Fewer patients, more time with you, quick appointments when needed, access to your provider via telehealth, text messages, email, or phone call. Cutting out all the middlemen and hassles that come with it increases the provider’s and the patient’s satisfaction, and significantly cuts costs.

You will experience shorter wait times, longer appointments, and easy access to your provider. No more in and out visits or waiting weeks or months for an appointment. Your provider is reachable via phone, social media, e­mail, and text messaging day or night. Members have access to labs, medications, and imaging prices that are 80-90% less than insurance costs.

All patients are encouraged to have at least major medical insurance coverage. The ACA legislation does exempt patients from the underinsured/non­insured tax if you have major medical/catastrophic coverage and a provider on retainer, which is what you will get with HEALTH360 DPC.

You can save money on your healthcare is by getting insurance with low premiums and high deductibles.  Health360 DPC aims to do away with insurance claims.  Paying $200-300 for lab work toward a deductible you may never meet or get the same tests through HEALTH360 DPC for $15-20 in cash?

You can submit a receipt for your membership fees or lab/medication costs.  Some insurance companies will apply these payments toward your deductible.

The law currently allows the use of HSA money to pay for medications, imaging tests, labs, etc.  However, it is legally unclear if HSA funds can be used to pay for DPC membership fees.  This is a question for your tax professional. Legislation has been proposed to clear up the question regarding if HSA money can be spent on a provider’s retainer or membership fee.

Our monthly membership fees are based on the patient’s age. In addition to low monthly membership fees, patients will be offered wholesale cash prices on lab tests as well, and we currently have contracts for access to discount radiological services such as X­-Rays, CT scans, MRIs and mammograms. We are always seeking ways to reduce costs for our patients and are continually negotiating bottom dollar cost for high-quality labs, imaging, and medication.

HEALTH360 DPC will only be accepting a limited panel of patients per provider. Traditional medical prices currently have a provider to patients panels of 2,000-4,000 or more resulting in long waits and never any available appointments. By keeping our patient panel low we ensure we have plenty of time with you and get you in quickly.  We offer you the kind of attention we would give our family. 

We are not the admitting doctor when our patients need hospitalization but can coordinate care and follow up with you through the process. Our provider will stay in close communication with the doctors caring for you, and will be ready to assume post-hospital follow-up care. 

HEALTH360 DPC is in collaboration with various specialists willing to provide cash pricing for services and procedures in our community. Those cash prices are often less than what your deductible would amount to.  Our provider spends the time to carefully coordinate your care with a specialist team as needed.

We know that illness and injuries don’t respect office hours.  If you need to order a medication refill or schedule an appointment, you can directly e-mail your provider anytime or leave a voice mail.  For non-urgent question, but one that probably shouldn’t wait until tomorrow, members can send their provider a text message and expect a prompt reply.  But rest assured that if you have an urgent issue after-hours, your provider is only a phone call away!

We are not accepting new patients requiring pharmaceutical treatment of Chronic Pain.  New Opioid Prescribing Guidelines have recently been released by the CDC to combat the prescription drug abuse epidemic, and those patients who use narcotics for chronic pain are encouraged to seek a pain treatment center.

We do not manage chronic pain and do not prescribe controlled or chronic pain medications. These medications are heavily regulated, need substantial monitoring, have a high rate of diversion and for most patients, long term, and are detrimental to their overall health and well-being. 

We do not prescribe controlled sedatives for the treatment of chronic anxiety.

Most routine procedures your provider performs have no additional charge to members.  There are a few exceptions, for more complicated procedures. Your provider can discuss all prices with you in detail.  We pride ourselves in being transparent in our prices. There will never be a surprise to you. 

We will gladly see you but, please check our prices to see what benefits are available to our members that non-members do not receive.  We offer cash prices on minor emergency surgical procedures (stitches, abscesses or skin tag removal) to non-members.  These procedures are very expensive without insurance, traditionally. We also are happy to provide Physicals, New Employment Physicals, and PPD placement very affordably for local employers, to non-members.

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