“Why pay for Direct Primary Care when I already pay for health insurance?”

As a direct primary care doctor, I get this question all the time. The most common question patients, or skeptics, pose is why they would pay twice for health care. The first thing to point out is that health insurance does not equal health care. The two are not synonymous. Having health insurance does not guarantee you access to health care, and certainly does not give you access to quality health care. It simply provides an avenue to have costs for specific services “covered.”

​As for the pay twice question, everyone already pays twice for health insurance. The first time you pay is when you (or your employer or the government) pay a monthly premium. The second is when you pay any out of pocket costs for health care, whether that be copays, coinsurance, cost for prescriptions, etc. With the recent trend towards cost shifting, many patients are getting plans with higher and higher deductibles. This means that even if you have insurance, you are stuck paying the first several thousand dollars before that insurance even kicks in!  Direct primary care practices can actually help with both payments. For patients who already have high deductible plans, direct primary care practices allow for a fixed, known budget for high quality, direct access to primary care that covers 85-90% of most patients’ health care needs. This access leads to better relationships with your doctor and less visits to other, more costly, providers like urgent cares, specialists and emergency rooms. One ER visit, for something as simple as a sore throat, stitches, back pain, etc can cost upwards of $2,000! And many people go simply because their primary care doctor is too busy or unavailable after-hours. Saving you from one ER visit can more than cover an annual membership to a direct primary care practice.​For patients who have lower deductible, or “cadillac,” plans, direct primary care can help lower your monthly premiums. By switching to a higher deductible plan, many families save hundreds of dollars a month (or thousands of dollars a year) on those insurance premiums. If most of what you need is good quality primary care with great access (which is most people), why not pocket all that extra money you’re giving to insurance companies and give a small fraction of it to a direct primary care doctor!

    Unfortunately, many people who hear about direct primary care assume it is only for the rich. In fact, it is exactly the opposite. Direct primary care is a great option for the uninsured as well as low to middle income patients who are spending a large portion of their yearly income on all-encompassing health insurance which provides them with months of waiting to see their doctor. Then, the average adult spends a total of 84 minutes at the doctors office but only gets twenty of those minutes in front their doctor.  For less than the monthly cost of a cell phone, many patients are now choosing to partner with a direct primary care doctor (like us!). This gets them a doctor who they can build a strong relationship with, contact via multiple ways whenever they need them, and have direct access to at all times - all while saving money… what’s better than that?!?!?
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