FAQ - Direct Primary Care Explained
Does Direct Primary Care bill insurance?
It doesn’t. Instead it allows us to work directly for you, rather than work for insurance companies. The for-profit insurance industry has put lots of layers between people and their doctors, which leaves less time for visits and has industrialized our industry. As far as doctors go, this has made us feel rushed, overwhelmed and pulled in too many directions when we would rather be working with you to improve your health. By not working directly with insurance, we are able to:
• Keep costs much lower
• Spend more time with you
• Be available to you in many more ways like - messaging, email, phone, telemedicine, group visits and home visits. These are all included with Direct Primary Care. There will be many times where we can deal with an issue by messaging or phone that we can’t afford to do with insurance coverage plans.
What about Medicare?
We do not bill Medicare in our Direct Primary Care practice. Medicare simply doesn’t acknowledge or pay for many of the unique and helpful services we offer in our Direct Primary Care practice so we opt out of billing them. If you are currently enrolled with Medicare and want to switch to Direct Primary Care to save money or for the unique services it offers you will be asked to sign a form at or before your first visit that shows you understand we will not bill Medicare for any of our Direct Primary Care practice visits or services and that you agree to not bill Medicare for any of our services. Your Medicare may still be billed for any and all services outside our Direct Primary Care practice, including but not limited to labs, radiology, specialist visits, and hospital care. Being a part of our Direct Primary Care practice doesn't impact your ability to use Medicare for everything else!
Do I need health insurance to become your patient?
We recommend everyone have some form of health insurance, but health insurance is not required simply to be a member of our Direct Primary Care practice. Health insurance helps pay for things that happen outside of our clinic. Most individuals or families will want to have a high deductible plan that covers catastrophic events. Our affordable membership is designed to cover your basic primary care needs for a predictable, transparent monthly price.
I already have health insurance. Why would I pay for this?
Excellent question. Health insurance doesn't guarantee you access to a doctor, to quality care or to the type of care you want. What we offer is a reliable, continuous partnership with patients with a staff and providers who really know you. In Direct Primary Care we offer the ability to communicate directly and in a timely manner. We will reserve same/next day visits for all Direct Primary Care members. Ultimately this model can save a lot of money for the individual and the system. It offers better access and better care. The model may not be for everyone, but many are finding it ideal for their medical care.
Can my HSA/FSA dollars be used towards the
monthly membership fee?
Current laws state that HSA dollars cannot be used for your Direct Primary Care membership fee, but can be used for all other medical care you receive, including labs, radiology, hospital care, specialty visits, etc. FSAs may be used depending on the employer's FSA criteria, so check directly with your employer or plan administrator especially if you’re a part of our Direct Primary Care for local businesses. There is current legislation to change this with the Primary Care Enhancement Act: Congress Bill SB128
But I only go to the doctor once a year! I pay for you every month whether I see you or not?
You're paying for access whether you use our clinic once yearly or weekly for chronic needs. By design this model is meant to be used collaboratively to improve your health. Your monthly cost is a great investment in your health and helps to sustain us as a practice to continue to deliver care to the thousands in our community. For your monthly fee you receive unlimited clinic visits (typically whenever you need them), home visits (when appropriate), communication through your portal, texts, email, telemedicine and phone calls. In addition many will save large sums on their monthly medication costs due to our low cost refill option.
Will my monthly fee ever change?
Our monthly fee is based on age. An increase will occur after age 64. All memberships may be subject to increases but members will be notified in advance of potential yearly changes.
Is this "concierge" or "boutique" medicine
No. Concierge Medicine charges very high fees for ACCESS but still bills insurance or Medicare. Our model does not bill either for any of our services. You can expect the benefits and level of care provided on a personalized basis.
Do you provide vaccines in your clinic?
Yes, vaccines are offered in our clinic for both pediatric and adult members.
Am I required to join the Direct Primary Care membership to get healthcare at Eventide?
Yes, Direct Primary Care is our only option.
What's not covered in Direct Primary Care membership at Eventide?
Any service that happens outside our clinic is not included - imaging, specialists visits, hospitalizations, physical therapy, etc.
What happens if I get admitted to the hospital?
Your hospital stay will be billed to your insurance or Medicare just as it would normally. You’ll still get follow up care here in our clinic via Direct Primary Care visits. All of the current data show that patients in Direct Primary Care practices have fewer hospitalizations.
What happens if I travel or live somewhere else part of the year?
You can still access your Direct Primary Care membership even if you travel or live anywhere else in the world for part of the year. Our visits will take place via telemedicine, phone or text/email messaging.
What if I want to cancel my membership?
You may cancel your membership at any time as per your contract. After 3 months you may apply to rejoin our Direct Primary Care practice. Eventide cannot guarantee re-enrollment.
Let us help you design better healthcare today with Direct Primary Care.
Email: use contact form below
232 A Street, #C3
Friday Harbor, Washington 98250