EDUCATION: The 101 on Direct Primary Care

Web: www.JonesHealthLaw.com Phone: (305)877-5054 Instagram: @JonesHealthLaw Facebook: @JonesHealthLaw YouTube: @JonesHealthLaw Direct primary care is a type of primary care that differs from traditional practices in terms of patient care and billing. In contrast to traditional models that rely on insurance billing, direct primary care operates on a membership model. In the membership model, patients pay a membership fee. This membership fee typically ranges based upon factors such as location, experience, and services offered. Employers may also offer direct primary care as an employee benefit. Because the membership fee is the source of income for direct primary care practices, they do not accept insurance and do not participate in Medicare, Medicaid, or other government programs. Due to the smaller number of patients that are commonly seen in direct primary care practices, one of the main advantages of this model is how patient-oriented it is. On average, physicians can spend more time with each patient, allowing for more quality care. Other examples of increased quality care may include reduced wait times, customized treatment plans, and same or next-day appointments depending on the practice. Under a direct primary care model, most routine medical examinations, treatments, and services are covered by membership dues. Unlike traditional insurance, the membership fees typically do not contribute to your deductible. Meaning, patients may still have out-of-pocket costs for visits outside the scope of primary care such as specialists’ visits, hospitalizations, and other emergency medical needs. Because of this, patients may need to have additional insurance to cover those unforeseen events, which can be costly.