Question 1

What is Direct Primary Care?

Accepted Answer

Direct Primary Care is exactly as the name implies. It means direct access to your Primary Care provider. You have a direct number to call or text your provider for medical questions, urgent prescription refills, or urgent appointment requests. While the medical record patient portal is preferred for routine prescription refills or appointment requests, direct access to your Provider remains the hallmark of the practice model.

With that in mind, we do ask that you understand our Providers are people too with families and personal lives. While we try to work around the clock for our patients, there may be times when we are not 100% available and there may be some delays in responses.

Question 2

Why do you not take insurance?

Accepted Answer

We understand this is a major limited factor for many potential patients; however, there are a few reasons as to why we do not accept insurance.

First is the cost. In order to operate under the Direct Primary Care (DPC) model where we are more accessible to our patients, it means that we must have fewer patients per provider than a traditional insurance-based clinic. If you combine fewer patients in a clinic with low-reimbursement rates and higher overhead cost for medical billing support staff, it becomes nearly impossible for a clinic to financially survive (which is why most clinics are overloaded with long wait times, short visits, and multiple support staff).

Second is the limitations in patient care. Insurers do not just help pay the bill, but they control many aspects of care. When a provider accepts an insurance plan they must sign a contract with the insurer. If the provider does not hit 'metrics' (i.e. treatment guidelines/mandates) set by the insurer, providers will get reimbursed less and sometimes nothing at all. These treatment 'guidelines' are often heavily focused on pharmaceuticals and surgeries further limiting the role of dietary plans, physical conditioning, herbal therapies, supplements, alternative health devices, community and family involvement, spiritual health, or preventative medicine. If the provider continues to not 'do as they are advised', they may eventually be dropped from the insurance plan completely and unable to see patients under that plan. In order to practice medicine in a way that focuses on truly healing an individual, we need to operate outside of the insurance model at this time.

Question 3

How much does it cost to join/Enroll in the practice?

Accepted Answer

Initial consultation fees are anywhere from $250-$500 at this time depending on the service. Our rates may vary slightly depending on patient volume and complexity of care; however, most Enrollment plans are around $100-$150 per month, per individual, for an annual contract. There are additional costs for some urgent medical procedures, specialty programs, labs, and imaging but all pricing is as transparent as possible so there are minimal to no surprise costs.

Question 4

Am I automatically Enrolled in the practice after a consultation visit?

Accepted Answer

Of course not! The initial consultation visit is exactly as it sounds, a thorough, full History and Physical to gain a better understanding of your health and to experience our practice. There should be a good relationship and a mutual respect between a patient and their provider. If you find that our practice style is not for you, you are in no way obligated to Enroll in the practice.

Question 5

Can I get prescription refills, labs, or imaging after an initial visit without Enrolling in the practice?

Accepted Answer

Generally, no. The reason is because all prescriptions, labs, or imaging need follow-up care and typically close monitoring. For the safety and appropriate care of the patient, and liability protection for the provider, we do not offer these services unless the patient is Enrolled in the practice.

Question 6

Can I use my HSA to pay for membership fees or programs?

Accepted Answer

Most plans will allow for HSA contributions to be used for DPC memberships; however, it is still technically not allowed until January 1st 2026. We advise patients to utilize their HSA for payments and in the unlikely event your carrier denies the payment, you can use non-HSA money until federal payment changes kick in.

Your HSA can still be used for all medical procedures, medications, labs, and imaging.

Question 7

What if I want to leave the practice?

Accepted Answer

Leaving the practice can be done at any time. There is an Enrollment early cancellation fee equal to 3 months of payments if the patient leaves before their annual contract has ended. Re-enrollment in the practice will be based on a case-by-case basis.

Question 8

Do I need insurance if I am a member at your practice?

Accepted Answer

While we can cover a large percentage of your medical needs, we are still an outpatient general practice office and have limitations. For this reason, we advise patients to carry some form of insurance to help cover catastrophic events, hospitalizations, and/or major surgeries. Many patients still carry insurance plans that will also help cover labs, medications, and imaging but choose a DPC to have more time and direct access with their provider in order to have a more vested interest in their health and well-being. We recommend finding a plan that meets your needs while giving you access to an HSA account and limiting your monthly premiums so that you have more to invest into the care you chose.

Question 9

Do you offer vaccines at your practice?

Accepted Answer

At this time no. There are a few reasons, but the primary reason is cost. Vaccines are very expensive to carry/maintain and there is a financial incentive to use the entire supply that the practice has ordered. We currently recommend people go to their local health department to get their vaccines if desired.

Question 10

Do you carry or dispense narcotics or controlled substances from the clinic?

Accepted Answer

No, we do not carry nor dispense any narcotics or other controlled substances in the clinic. While there are a few exceptions to their use (e.g. acute, severe injury, end-of-life care), we are generally strong opponents to even prescribing most of these medications.

Oxford Integrative Health, PLLC