Direct primary care an option for self-pay patients

The AARP reported earlier this week on a growing trend among doctors opting out of insurance contracts and simply accepting cash payment for services. Known as direct primary care, this trend is a tremendous boon to self-pay patients.

The Doctor Will See You but Not Your Insurance

by Sid Kirchheimer, AARP, August 6, 2013

Fed up with waiting weeks for a medical appointment — and then getting only a few precious minutes with your doctor? The unnecessary tests and referrals to a specialist? Insurance hassles, red tape?

So are doctors. And a small but growing number are refusing to accept their patients’ medical insurance. Instead, doctors are running their practices on a “membership” model that they claim allows them to spend more time with their patients and to provide better care… 

Patients pay a monthly membership fee — typically $50 to $80. In exchange, they get a more generous allocation of appointments, sometimes for the same day or the day after they called. Appointments usually last longer than the average seven minutes per insurance-based visit. Doctors are often accessible via phone, email or Internet chat and some even make house calls.

At some practices, there are no additional copays. Routine tests and procedures are included. At others (usually charging a lower membership fee), certain services are provided at a significantly discounted rate, or a small fee may be charged if patients request more time with the doctor. Privately insured patients may seek reimbursement for such costs on their own.

Whether joining a direct primary care practice is right for you as a self-pay patient will depend on a number of factors, including how frequently you or members of your family need to visit the doctor. If it’s fairly frequent, at least once every month or two, then finding a direct primary care practice to join might be a good way to not only save money and get the medical care you need, but actually get better access and care than the insured!

To find out if there is a direct primary care practice near you, the web site Direct Primary Care provides a search tool.

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6 Responses to Direct primary care an option for self-pay patients

  1. Pingback: Cash-only doctors provide quality, affordable healthcare for self-pay patients | The Self-Pay Patient

  2. Pingback: Deal of a lifetime offered by direct primary care practice in Kansas | The Self-Pay Patient

  3. You are 100% correct Sean. Direct primary care / concierge is actually cheaper than Obamacare. I am logged into the TN exchange now and just did a comparison. Even my direct primary care company (Medical Access USA is cheaper than Obamacare!

    I unfortunately know too much about Obamacare as I used to be a health policy intern for the physicians on the U.S. Senate HELP Committee and I witnessed the drafting of it.

  4. eldrdge1 says:

    Matthew, can we really compare Direct Primary Care costs directly with Obamacare (or any traditional insurance for that matter)? Direct Primary Care options don’t cover specialists, surgery, hospitalization, off-site lab work, emergency rooms, or prescription medication. However, Direct Primary Care plus something like Healthcare Sharing Ministries (HSM) would be a fair comparison with traditional insurance or Obamacare Exchanes. I’ve used HSM in the past and looked at direct primary care. But, my historical actual costs for primary care visits just didn’t justify the monthly fee.

    • seandparnell says:

      Direct comparisons are tricky, but I think comparing a direct primary care practice plus a HSM with a high personal responsibiity amount to an Obamacare policy is reasonable, at least for people who might expect to have regular primary care needs. But you’d probably need to add the deductible for the Obamacare policy to the premiums paid when making such a comparison. And you’re right that direct primary care is probably not the best value for people with modest primary care needs, but for many others its definitely the right choice.

  5. Vincent says:

    What about the low income to poverty level income that don’t qualify for one reason or another for Obamacare. ? We tried to lower our mortgage payments and did not qualify. We tried to modify, still did not qualify. ! What can we do about it ? It’s always the little people who get hurt and lose out the most. Why is that ?


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