The DPC fee and your insurance premium: Why I don't think You're Paying Twice for Healthcare
"Hi Dr. Hedde, I saw your information online. Your reviews are glowing - unlike any other doctor I looked at. It says you can get me in today. I have a pressing medical issue that I want to be seen for today. Can you call me back when you have a chance?"
- prospective patient voicemail
2 minutes later -
"Hi It's Dr. Hedde, returning your call. I have a few spots left in my practice for new patients and I can see you today to deal with your issue. I just want to be sure you know how our practice works?"
"OK great, I really need a visit today, my old doctor can't see me for weeks, and the urgent care treats me like a number. This can't wait. So, how does your practice work?"
"It's a Direct Primary Care practice - so we don't bill insurance. For you it would be $75 per month, no additional fee. We can see you when it works for you, you can call or text me directly anytime you need me on my cell phone, and you will never wait in the waiting room."
"That sounds amazing but unfortunately I already pay for health insurance."
The affordable care act made that a requirement - let's improve health CARE by improving access to health INSURANCE. Right? Wrong! Just because you have health insurance (like the many patients I speak with on the phone do), does not mean you have access to health CARE when you need and want it.
Your doctor is not available today. You have to wait three hours in the waiting room and be seen for eight minutes. Eight minutes allows you to discuss only one of five things you came in for today. You are going to an urgent care to see someone who doesn't know that steroids cause you to react funny because they know nothing about your medical history. But, hey, at least you have insurance!
You have car insurance, life insurance, travel insurance, and disability insurance. Do you expect those to cover the little things that come up? Let's say you need wiper blades and a headlight - do you expect your car insurance to cover this? Of course not!
OK let's say you can up your premium on car insurance and then it will cover the lights and blades when you need them as long as you go somewhere that "takes your coverage" - would you prefer to pay $200 more per month so that when you need wipers, you can get them "covered" but you have to wait three weeks and go to a different mechanic than the one you've always liked because your old guy isn't in your network?
Or would you like to pay less of a premium and handle the small stuff. This is what we do - we handle those things that don't require a specialist or an ER. We charge a nominal fee (averaging $75/mo for adults, $25/mo for kids - i.e. less than you pay to get a latte twice a week) for attention and access to a board certified Family Physician who is at your beck and call. But, I get it, you already pay for insurance, so who needs care.
If you're thinking any of the above makes sense to you, talk to us about alternatives to "cadillac" insurance plans that can save you out of pocket premium and co-pay costs, and when paired with a membership in our practice, can cover your primary care needs (90% of what most patients need/use!). Plus, we'll work as a team to take a holistic view of you, to keep you healthier, save you money on meds, labs, and imaging tests, and prevent you from going to the ER or specialist unless you really need it. All for $75/month.
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Lauren Hedde, DO; James Hedde, DO and Mark Turshen, MD are Family Physicians and Co- Founders of Direct Doctors, Inc. a Direct Primary Care Practice.