What is FMA-Direct DPC?
What is Direct Primary Care (DPC)?
Direct primary care is a new relationship between the patient and their physician. In this model of healthcare, the patient contracts directly with their physician for their services in the outpatient clinic. The patient pays a monthly or annual fee. This fee serves as a retainer for the services provided in the clinic. There is no additional cost for most services, labs, and procedures. Those services which are not included are provided at a deeply discounted cost. (See included services) THIS IS NOT HEALTH INSURANCE.
How will I as an individual or my family benefit from joining a DPC?
You benefit by having access to your physician without the interference of third parties (like insurance companies or government bureaucrats). This means you and your physician work as a team to set goals for your healthcare without any outside interference. The majority of patients who join a DPC will see a significant cost savings over their current plans required by federal law. Finally, there is a price transparency on all services provided, and we have partnered with local pharmacies and a private radiology group to get discounted prices.
Will I benefit from FMA-Direct DPC if I don't require frequent medical attention?
Of course. We might argue that everyone benefits from healthcare service tailored directly to them. We offer truly customized health care. All our time together is devoted to the maintenance of your good health, to the enhancements of your daily experience that only physical well-being can bring. We are here for your immediate needs. Proactive healthcare is important, and we're here for that, too.
Every visit will be tailored to your concerns for that visit and we will thoroughly address those concerns. As months and years go by, we will build a comprehensive, intimate knowledge of your health, which is critical to understanding how to best provide the healthcare you need and desire.
Does FMA-Direct DPC accept insurance?
No. We do not bill insurance for services provided by the DPC. If you have health insurance, it certainly can be used if referred to a specialist, if hospitalized, and for labs and tests which are not provided by the DPC.
As a patient of Family Medicine Associates DPC, will I still need insurance?
Yes. The providers at FMA-Direct recommend our patients continuing to have a major medical plan with a high deductible and/or a health savings account to ensure financial help should hospitalization or a referral to a specialist be necessary. We are happy to refer you to an insurance representative who an help you customize a plan for your specific needs.
If I have Medicare, can I still join FMA-Direct DPC?
No. Unfortunately at this time, patients receiving Medicare benefits are not eligible. If there is enough interest in the future, there may be an opportunity to provide this service to Medicare beneficiaries as well.
Is my membership in FMA-Direct DPC tax deductible?
Unfortunately, no. Your retainer is not yet defined as a "medical expense" and as such it is not deductible. The American Academy of Private Physicians, however, is lobbying hard to win rightful deductibility for these expenses. In the meantime, confirm with your tax consultant to clarify tax consequences in your particular circumstances.
What happens if I need to go to the hospital or see a specialist?
By providing superb care with easy access, we seek to prevent or reduce the hospitalization and specialty referrals. In cases where this type of care is required, we will continue to work with your hospitalist during your hospital stay as well as work closely with any specialist. In some cases, depending upon the level of care and sorts of expertise required, we may rely on these specialists to help manage your treatment.
Can children become members of FMA-Direct DPC?
Yes. We are happy to accept children from birth to age 20 in our practice.
Can I contact my physician after hours? And how?
By all means, yes! You can contact a healthcare provider from the practice who is on-call for the practice after hours. The on-call provider covers all hours outside of normal business hours. As part of the enrollment package, a patient will be provided with the phone number to call for after-hours questions.
What if I require medical attention while I'm away from home?
Many illnesses can be diagnosed and treated with a simple conversation by phone, email, or text. In these circumstances, we can locate the nearest pharmacy and order medications most appropriate for your circumstances. Certainly, if the provider on-call feels the matter may be more urgent or emergent, it is possible that it may be recommend to seek care immediately where you are. We will make every effort to do what is medically appropriate.
How can this be so inexpensive?
Primary care physicians (PCP's) are known for their ability to provide comprehensive, high quality care at low cost. For decades, insurers and government agencies have relied on tremendous cost savings that PCP's provide in order to reduce the cost of care. Unfortunately, when insurers bundle the inexpensive primary care with high-cost medical treatments, surgical care, hospitalization and drugs, it raises the cost of routine care for everyone and creates a barrier to access.
At FMA-Direct, we believe that everyone should be able to afford primary care. We have uncoupled primary care form the cost-driving services, and added a network of affordable services for our membership-based primary care packages. By bundling all of the routine and necessary services into a low monthly fee, our members enjoy an affordable patient-centered medical home with true price transparency.
With FMA-Direct, 100% of your expense goes towards your healthcare, and we pass the savings onto you.
Is FMA-Direct DPC insurance?
No. We are physicians who have contracted directly with our patients to provide primary care services. Our plan is membership-based with a low monthly fee, much like a gym membership.
Are there any exclusions for pre-existing conditions?
No. There are no pre-existing condition exclusions and there are no increases in the membership fee based upon prior health history. In fact, those with chronic medical conditions are perfect for FMA-Direct DPC. The only exception is that FMA-Direct DPC physicians will not prescribe chronic pain medications or chronic controlled substances.
I am already paying a monthly fee for health insurance. Why do I need FMA-Direct DPC?
In most cases, patients save money by choosing a higher deductible health plan and paying directly for medical care through FMA-Direct DPC. Plus, at FMA we don’t believe insurance should be used for routine , expected medical care. For example, we do not use homeowners insurance to pay for lawn maintenance or make minor repairs. Additionally, you don’t use automotive insurance to fill the gas tank or replace tires. Why would you use health insurance for a cold, to treat diabetes, or treat high blood pressure? Health insurance should be there to cover unexpected or high ticket medical costs. We will make routine medical care cost less than you pay for your cell phone bill.
Is this concierge medicine?
If providing high quality care is “concierge” then perhaps we are. This is concierge medicine for the little guy. We provide high quality care and service at a price anyone can afford. Our physicians practice is independently owned and operated. This means that your doctor works for YOU, not a corporate employer. Expect same day or next day appointments for urgent conditions, extended visits if needed, and direct coordination of care. Also, messages will be returned and prescriptions filled in a timely manner. The office staff will know you, and care is provided in a comfortable and clean environment. We treat our patients like family.
Do I need to sign a contract?
Yes. Patients can pay monthly but are encouraged to sign up for an annual contract which helps keep the cost of service low. Additionally, patients get a discount for paying annually.
What if I need medication?
Most medications are available in generic form. Our physicians are knowledgeable on how to get you the best prices on medications by working with our partner pharmacies.
How can I enroll?
Simply click HERE!