How Does Direct Primary Care Work?

Direct primary care or DPC refers to a business model that is associated with primary care physicians’ ability to present services directly to their patients without having an insurance company interfere in the middle. The fee submitted by the patient for the member of direct primary care is either paid monthly or annually.

Under this membership fee, the patient is allowed to have access to numerous primary care inculcating examinations, consultations, certain lab services, and care coordination. Patients receive all of these without any extra or additional payment at the time of the service. Here this article will explain in detail about direct primary care membership.

1.      Advantages of Direct Primary Care

The advantages in the dimension of direct primary care are multiple which are as follows:

  • Patients do not have to deal with heavy insurance paperwork or bureaucracy. So patients feel less hassle.
  • Direct primary care tends to spend less money and time on administrative tasks, instead, they spend more money and time on patients.
  • Patients can make annual or monthly fee payments and then they do not have to worry about any deductibles or separate costs for each procedure.
  • Patients get easy access to healthcare providers. As they can easily communicate through phone, email, video chat, or even texts.
  • At the time of need, patients can get same-day consultations and visit a medical clinic rather than having to wait for a scheduled appointment day.

2.      Direct Primary Care vs. Concierge Medicine

There is a huge difference between direct primary care and concierge medicine. Even though both models have been devised based on the concept that the patients more often or in some cases the employer pays the membership fee to get access to basic medical care. However, in concierge medical practice, the approach deals with higher-income clients and also accepts health insurance besides taking concierge fees. Whereas, direct primary care tends to rely solely on membership fees submitted by the patient.

3.      How Much Does Direct Primary Care Cost?

Direct primary care mostly costs between $50 to $150 per month. This membership fee is lower in the case of children and higher in the case of adults and families. The membership fees in the DPC model can be covered by the patients themselves but employers can also make contributions on behalf of their employees.

Patients do not have to spend a single penny on the services covered under the direct primary care model. However, the significant thing is to comprehend what is covered under this membership and what is excluded. Prescription medication and some lab services or imaging might cost you an additional fee.

4.      Membership Does Not Involve Insurance

Irrespective of the fact that how much primary care services are being provided under the DPC model, medical services that lie beyond the ambit of primary care won’t be covered under this umbrella. Specialty care, inpatient care, surgery, emergency care (including emergency transportation), etc. are the items that lie outside the scope of a direct primary care plan.

Due to the rise in inflation things can easily become unaffordable for a normal person. Therefore, DPC models generally recommend their members have major medical health insurance coverage as well.