Services Offered at Liberty Direct Primary Care

While there are a lot of similarities between DPC and concierge medicine, there are several key differences that make Direct Primary Care better for the patient. Annual DPC membership usually costs far less than concierge membership (i.e., usually $600-$1200 for DPC vs. $1600-$5000 or more for concierge). With a concierge practice, patients still must deal with co-payments and all the other rules that insurance companies enforce to take as much of your money as they can, while at the same time paying as little as possible for the health care you deserve.

Because DPC practices do not contract with insurance companies, the doctor cares about your needs, not insurance company rules. The term “concierge” has taken a negative connotation as being very expensive and elitist. We are convinced that DPC provides a better level of service, which is also more affordable. Some have started to call Direct Primary Care “Blue Collar Concierge Medicine.”

Whether you have insurance through your employer, individually, or through the Obamacare exchange, membership in a DPC practice probably still makes good sense. Even when most people had insurance deductibles of $2,000 or less per year, over 90% of patients never reached those deductibles so they ended up paying almost all of their health care costs out of their own pocket.

Now that deductibles are going up, often as high as $6,000 per year for an individual, almost no one will reach their deductible unless they have a major illness or accident. A family physician can take care of approximately 80-90% of most people’s medical problems. For an annual cost of $600/year, which may be only 10% of your deductible, we can handle up to 90% of your medical care. For every emergency room visit we prevent, we save our patients the equivalent of 2-5 years of subscription payments.

A DPC membership is not insurance. It should be considered more like a personal service contract with your doctor. Only having a membership with our practice will not protect you from the Obamacare individual mandate tax/fine/penalty. We strongly recommend that our patients partner their DPC membership with a high-deductible health insurance policy or a faith-based health ministry sharing membership. (We can provide you with more information on this option.).

Combining these arrangements with your DPC membership should shield you from penalties. We also recommend the use of health saving accounts (HSAs) to bridge the gap to pay for services we cannot provide in our office, up to the point the high deductible is reached.

That is a good question. While it makes perfect sense that HSA funds should be able to be used to pay your DPC doctor, there is nothing we can point to in the tax code saying that it is permissible. There are bills in front of the US Congress to fix this oversight. Until they are passed, we recommend consulting your accountant or tax preparer.

We are in the medical field to take care of people. Insurance regulations and Medicare laws were interfering with our ability to do this. Filling out paperwork and trying to keep up with all the bureaucratic rules were taking too much of our time away from our patients. We would rather work directly for our patients than any insurance company or bureaucrat.

By taking the insurance companies and the government out of the doctor-patient relationship, the doctor works for you. Rest assured that the choices we make for you about your care are not influenced by your insurance company or any other organization that could gain from you not getting what you need.

We will be able to respond to your needs, not the demands of the insurance companies. We work for the benefit of the patient, not the stockholders of an insurance conglomerate. Your care can never be rationed if you are paying for it yourself.

This type of medical practice will benefit many different types of patients. Patients who have no insurance or patients who have high deductibles will probably spend much less money for medical care in this office. Patients who have PPOs (Preferred Provider Organization) who do not need referrals for care may or may not spend slightly more for care with us. We are confident that the level of service will more than make up for the financial cost.

Patients with government insurance (Medicare/Tricare) will pay more. Again, we are sure that the service we offer will be worth it for most people. For patients who have HMOs with strict network restrictions, this may be a more difficult proposition if they require you to be seen by a doctor in the insurance company’s network to get referrals.

It is unlikely that any insurance company would reimburse you for our subscription fees.

The government has very strict rules about this. If a doctor has “opted out” of Medicare, he/she cannot submit bills to them for at least 2 years. Medicare patients must sign an acknowledgment of this with the understanding that they are forbidden from asking for reimbursement for our office visits.

This contract must be renewed every 2 years unless the doctor agrees to start taking Medicare again. These rules apply only to services performed in our office.

We can still refer you to specialists who take Medicare. We can also order medical services and supplies from vendors who accept Medicare (e.g., oxygen, visiting nurses, physical therapy, medical equipment, etc.) We can order CT scans, MRIs, and other procedures, which are done outside our office. These should be covered by your insurance just like it always had been.

The facility doing the test will bill your insurance company. Labs that we draw in our office that we send to an outside lab (i.e., cholesterol panels, liver and kidney functions, thyroid tests, blood counts, etc.) will also be covered by your insurance as before. Services that we provide in the office, such as EKGs, breathing tests, urine tests, and forger prick blood tests, will not be billed to your insurance and will be part of our bill to you. Prescriptions will be covered under your current insurance as before.

For patients who have PPO insurance, there is not usually a referral required. For people who have HMOs with very strict network requirements, we should be able to refer but may not be covered. We strongly recommend that you check with your insurance company to find out if this will present a problem or not.