What is Direct Primary Care?
To qualify as a direct primary care practice, the practice must charge a periodic fee, not bill any third parties on a fee for service basis and any per visit charge must be less than the monthly equivalent of the periodic fee.
What kind of office is this?
Coastal Direct Health & Wellness is a primary care family practice. We are a clinic that offers all of the same preventative care and treatment of chronic diseases that you would find in a “regular” primary care office. Because of the reimbursement model however, we are able to cap the number of patients in the practice which means more time for each of our members. We strive to be available whenever you need us.
Do you accept insurance?
We do not file insurance but a lot of people in our practice do have insurance, including Medicaid. We absolutely recommend catastrophic coverage as a membership with this clinic won’t cover hospitalizations, etc. Instead of us filing your insurance, however, we simply charge a low monthly fee to cover all visits and most office procedures and point of care testing. You may use your insurance for labs, imaging, specialist consults etc.
Do you have to be a member to be seen at this clinic?
The simple answer is yes. However, we do offer a one time “trial” visit for $75. Should you decide to enroll in the practice within the two weeks following that appointment, we will waive the enrollment fee (also $75).
Do you see children?
Absolutely! Both of our providers are family medicine trained and love seeing kids!
What is my visit copay?
Nothing! That is the beauty of this model. Your monthly fee covers ALL visits, even same day/urgent-care type of visits, gynecologic exams, procedures etc.
I’m healthy. Why would I pay $50-$85 a month when I usually never need a doctor?
Good question. First of all, the whole point of a primary care provider is to KEEP you healthy and screen for preventable and treatable diseases. We do a lot of nutrition and weight loss counseling, depression and anxiety treatment, annual exams, skin biopsies and so much more. There is a massive health benefit of having someone specialized in preventative medicine working with you throughout the year. This is the only body you’ve got. If you are extremely health conscious, self-motivated, have really good insurance and are happy with the availability of your current provider, then this may not be the place for you.
Unfortunately however, there are a lot of us who are unable to afford insurance that doesn’t require a significant copay for visits, imaging and labs. Because we are readily available to our patients, we can probably keep you out of the emergency department or an urgent care which means the membership fees are likely paying the copay for those other visits and labs even if you DO have insurance. I mean, think about it, you likely pay this much to caffeinate yourself for the month. Don’t take any changes and make your health a priority!
When will you be able to accept patients with Medicare?
Hopefully within the next 6-12 months! In order for us to see Medicare patients, we need to opt out of the Medicare system so that it is legal for us to charge patients with Medicare a monthly fee. The monthly fee for those 65 and older is $85/month.