Direct Primary Care Works with Medicare

A common question from our patients in their 60s and up is, “How could your practice at Direct Doctors actually make sense with my medicare?”  It is a smart question.  It’s important to understand how medicare works when you have a doctor, like Dr. Henseler, who does not bill medicare (aka a doctor who is “opted out” of medicare).
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At Direct Doctors, patients in the age group of 65 and above will pay a membership fee to have convenient access to their physician.  They will be able to reach their primary care doctor when and how it works for them.  They will avoid long wait times at the office or on the phone.  And, they will have a meaningful relationship with a doctor who knows them well and spends the needed time listening to their needs.  ​
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Many prospective patients and many critics of Direct Primary Care are surprised to know that over 15% of our patients are “on medicare.”  That means, those patients have chosen to pay for our monthly membership fee “out-of-pocket” to cover a majority of their needs without any copays (primary care visits, chronic care visits, acute illness visits, phone & email questions, joint injections, skin procedures, gynecologic preventative services, etc.) while paying for supplemental medicare plans.


Those patients are still able to use their medicare coverage (specifically those with PPO plans) for medications at the pharmacy, blood and urine samples at the lab, x-rays, MRIs and other imaging, specialist visits, and emergency room & hospital care.  But, when they are sick with a cold, need a medication adjustment, would like preventative and wellness advice, or just have a question for their doctor, they are able to reach the physicians at their Direct Primary Care practice (in RI, Direct Doctors) right away.
 

When they aren’t sure if the medication they just picked up at the pharmacy should be taken with a meal, they can call their doctor and get an immediate answer.  When they feel a cold coming on and want some advice, they can reach their doctor that day.  When they need a visit that works with their schedule, Direct Doctors can see them within days - not the usual months-long-waits that other practices have.
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Some patients have chosen to leave Direct Doctors when they turn 65 and start on medicare, but we have found many of those patients return to the practice quickly, realizing that the level of attention, care and time-savings they have become used to is near impossible to find anywhere else!  Check us out for more info at www.directdoctors.org or schedule a visit to learn more.