Frequently Asked Questions
Direct Primary Care (DPC) is a model of care that returns to the way health care should be by putting patients first. Patients have a direct relationship with their physician and pay a monthly membership fee for primary care services with no insurance involvement. In addition, DPC doctors work to save patients money by finding them the least expensive options for their care. Also, by separating patient care from traditional insurance, DPC eliminates insurance red tape and allows doctors to focus solely on taking care of their patients. DPC will allow you to receive excellent, timely and convenient medical care while saving you money.
Acute and non-acute clinic visits are included as well as easy convenient access to your board- certified physician via phone, secure text messaging and telemedicine virtual visits. Minor procedures, some lab tests that can be done in the office and certain treatments administered in-office are also included. Labs and imaging through select vendors are heavily discounted. See our detailed listing below for more information on what is currently included with membership.
Fingerstick blood sugars
Urine pregnancy testing
Simple laceration repair
Punch biopsy (Lab analysis of any samples collected is not included)
Incision and drainage of minor abscesses (Lab analysis of any samples collected is not included)
Pap smears (Lab analysis of any samples collected is not included)
Cryotherapy (freezing of benign skin lesions)
Yes, absolutely. However, it is important to note that the monthly membership cost is not covered nor reimbursable by Medicare. On the other hand, things we do not do or provide such as labs, supplies, imaging and medications can still be ordered by us and covered as normal by Medicare.
Yes. Since Direct Primary Care only covers your routine outpatient primary care, we recommend you obtain insurance coverage for hospital based care and specialist care. Coverage plans that pair well with Direct Primary Care are high deductible plans, HSA, and Health share plans.
We offer deeply discounted wholesale pricing on labs and imaging services through select vendors. Labs fees will be collected in our office at the time of service and you will always know the cost before labs are drawn with our transparent pricing. Imaging fees may be collected in our office or at the imaging facility at the time of service, with payment plans available at some imaging locations. Patients with PPO insurance may have the option of using their insurance to pay for their labs and imaging. However, they may find that it is more cost effective to get their labs and imaging through our select vendors especially if they have a high deductible plan. Medicare patients may have the option to have their labs and imaging paid for by Medicare depending on their Medicare plan or they may choose to go through our select vendors.
Your care will be coordinated with specialists with as much detail as possible so that they are aware of your health history and the reason for the referral. We will also work to make sure you are seen in a timely manner. Specialist fees can be billed to your insurance or Medicare.
The membership fee allows us to provide primary care in an innovative way for a simple, fixed price. It allows members to better budget their health care expenses and helps our practice provide the services we offer at affordable prices. It also allows us to spend majority of our time taking care of you rather than dealing with red tape and paperwork.
The membership fee is better thought of as a more affordable and efficient way to access primary care. Most members will actually save money by combining Katy Premier Primary Care with a high-deductible health insurance or medical cost sharing plan when compared to traditional insurance models where co-pays and co-insurance expenses can really add up. For example, with a typical high deductible insurance plan, multiple trips to your primary care physician, urgent cares, imaging and lab can easily add up to be thousands of dollars which you would have to pay out of pocket. With DPC, you would only be responsible for your monthly membership fee and your labs and imaging would be heavily discounted leading to significant savings.
No, Direct Primary Care is not Concierge medicine. Concierge care doctors bill your insurance in addition to charging you hundreds of dollars per month in membership fees. Unlike Concierge care, the goal of DPC is to help most of our patients save money on their health care expenses. Unlike concierge care, we work to find patients the least expensive options for their care. We also do not require any long-term commitments. In addition, since we accept only a limited number of patients, do not accept insurance and therefore do not deal with insurance red tape, we are better able to focus only on taking care of patients. This is a good thing! With Concierge care, you pay a lot more money, you have to sign a long- term contract and your doctors still have to deal with insurance red tape which will affect their focus on you.
Yes, absolutely, and often these are the members who see the most benefit from our services. Our memberships (eligibility and fees) are not based upon any existing medical issues or conditions. However, on your first visit, we will inform you if there are any conditions you have that are outside our scope of practice and appropriate referrals will be made if needed. You may also contact us at [email protected] with any questions prior to enrolling.
That is great! Our primary focus is to keep members well. As such, we can dedicate more time to prevention and lifestyle issues to continue to keep you away from the expensive, cumbersome health care system. However, when you do need care, we are available to help get you back on track. An unexpected trip to ER or urgent care that would have emptied your pocketbook can easily be covered in a same day visit with us often saving the member enough to justify the cost of a year worth of membership fees!
No. All acute and non-acute visits are included in the membership fees. However, for tests that are not included in the membership fees, we are always transparent with the pricing. If we recommend outside services, we try very hard to find you an upfront, reasonable price if paying cash.
No. We require scheduling all visits beforehand. However, we are able to accommodate most patients the same day or next day. A quick phone call or text message to request to be seen is usually all that is required.
For the time being, insurance companies do NOT recognize our membership fees as a reimbursable expense.
In most cases, yes, your insurance plan will continue to operate as usual at other doctor’s offices, hospitals and pharmacies etc. However, it depends on the type of plan you have: PPO plans do not require a designated primary doctor for referrals, medications, tests, etc. so Katy Premier Primary Care physicians can order or refer just as any other doctor would do and you can use your insurance to pay for those services if you want to. However, HMO plans require an in-network designated primary doctor for access to other services. In this case, you will not be able to use your insurance without electing an in network primary doctor through the HMO. This is something to keep in mind. Many times, we are still able to offer HMO patients affordable cash pay options for tests and procedures. Traditional Medicare patients will be able to use their Medicare elsewhere for services we order or refer for but do not provide (such as labs, imaging & specialist visits) without any limits. Patients with Medicare Advantage plans may in some cases require an in-network primary care doctor for orders and referrals and so are advised to check with their plan.
We are able to treat acute pain without any reservations. For chronic pain, we have a cautious and conservative approach to using narcotic/opiate medications in general and will refer patients to a pain management physician as needed. That said, each patient’s needs are assessed and addressed on an individual basis.
Please feel free to reach out to us at [email protected] to ask questions or to arrange a meeting to see if we can meet your needs. We will be happy to help.