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What is Direct Primary Care?

Direct Primary Care, or DPC, is a model of healthcare that puts patients first by getting rid of the red tape that constrains traditional practices. How? It's simple: we don't accept insurance, and – believe it or not – this actually saves you money in the long run.

How will this save me money?

You won't have to pay a co-pay for office visits or routine physicals. Also, you'll be able to avoid many visits by sending your questions directly to your doctor via email and text – something you won't get from a traditional practice. You’ll also benefit from negotiated deals for prescription medications, blood tests, X-rays, and MRI/CT scans.

More importantly, since you are getting all this amazing care, you can cut way back on your insurance premiums. Most DPC patients couple a DPC Membership with a high-deductible, low-premium insurance plan so they're covered in the case of a major health issue. But you can leave the rest of your healthcare to Direct Care Physicians of Pittsburgh.

Will I still benefit from DPC if I don’t require frequent medical attention?

Of course. Everyone benefits from a service tailored directly to them. That’s why Direct Care Physicians of Pittsburgh offers truly custom healthcare. We are here for you if you're sick or hurt, but we’ll also help you proactively maintain good overall health. Every visit will be thorough, relaxed, and as long as you need to address your health concerns. The longer you're a patient, the more we can learn about your health and lifestyle -- and the better we can help you maintain that health.

Is DPC the same as concierge medicine?

The terms are often mistakenly used interchangeably, but they are not the same. Both DPC and concierge practices charge a periodic fee. However, under the concierge model, this fee only gets you access; that is, it often doesn't include the care provided. Instead, a concierge practice may still bill insurance for your visits. Additionally, concierge practices tend to charge a higher monthly fee than DPC practices.

Under DPC, your visits and other care are included in your fee. Plus, you're provided with other incredible benefits, including wholesale pricing for labs and radiology studies, deeply discounted prescription prices, and direct digital communication with your doctor.

What happens if I need to go to the hospital or see a specialist?

For starters, having such unprecedented direct access to your doctor can prevent hospitalizations and specialty referrals in many cases. However, when those types of care are required, Direct Care Physicians of Pittsburgh will certainly continue to work with your hospitalist during your hospital stay, as well as work closely with any specialist. Depending on the level of care and the sorts of expertise required, we may rely on those specialized caregivers to manage your treatment.

Can children become members, too?

Yes, Direct Care Physicians of Pittsburgh is happy to accept children.

Can I contact my member after hours?

Of course! Member access is one of the greatest benefits of the direct primary care model. Because illness and injury do not respect regular office hours, you may call, text, or email your member whenever you need. The patient agreement, which will be discussed at the time that you join the practice as a patient, will outline this in more detail.

What if I need medical attention while I’m away from home?

Because you'll have your doctor's email and phone number, you can reach out to us whenever you need, wherever you are. Many illnesses can be diagnosed and treated with a simple conversation. We’ll also locate the nearest pharmacy and order medications if appropriate for your circumstances.

Do you accept insurance?

It seems that anytime you go to the doctor in Pittsburgh nowadays, the first question you are asked is "what insurance do you have?" instead of “hi, how are you?”

You might use your auto insurance to fix a smashed fender or other major damages. But you'd never use it to get an oil change (or pay for gas). For some reason, health insurance is currently being used for the equivalent of oil changes for humans -- routine physicals, office visits, simple blood tests, and minor procedures. This just doesn't make sense.

We forgo insurance payments in order to save our patients from the arbitrary, intrusive decisions that come with using insurance. Charging a direct monthly fee frees us from the typical contractual agreements that prevent non-DPC members from offering wholesale prices on laboratory tests, imaging, and medications.

That being said, if you do have insurance, you can use it to pay for vaccines, medications, labs, imaging, specialists visits, hospitalizations, etc., even as a patient of Direct Care Physicians of Pittsburgh. The only difference is that we do not directly bill insurance, and insurance does not play a role in paying the membership to the practice.

As a patient, will I still need to have health insurance?

We recommend health insurance coverage in the event of high-priced medical needs such as surgery.  Patients should research insurance products and purchase the one that makes the most sense for them/their family.

If I have Medicare, can I still join Direct Care Physicians of Pittsburgh?

Yes. You need only sign a one-time waiver declaring that neither you nor your doctor will directly bill Medicare for our services. Even though Medicare will not pay us for any services you receive in our practice, your Medicare benefits will otherwise remain unchanged and can continue to be used for all other medical care received outside of our practice. Medicare will still cover any laboratory testing, imaging, medications, or hospitalizations prescribed by our offices.

Medicare patients tend to save a great deal of money when purchasing medications through the cost-plus pharmacy, Blueberry Pharmacy in Westview, which all members of DCPP are automatically members of, as well.

What if I’m uninsured?

We take care of any patient, regardless of your insurance situation. Since we work completely outside of the insurance system, none of the billing for care here is eligible for insurance reimbursement. However, we recommend that everyone have insurance coverage, which is still important in the event of a major health issue.

Is the DPC membership fee eligible for HSA or FSA reimbursement?

You may want to check with your human resources department regarding the use of Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) as possible payment options for your membership. If you are unable to use these funds to pay for the membership fee directly, there is a good chance that you can still use your HSA/FSA as reimbursement for certain services provided through our office.

HSA/FSA funds can currently be used to purchase medications or pay for diagnostic testing.

Is my membership fee tax deductible?

Please confer with your tax consultant to clarify tax consequences in your particular circumstances.

If I’m an employer, how does a DPC model benefit my employees?

Many small businesses are competing for employees in today's market, and it's key to provide an attractive benefits package that makes you stand out from the rest.

Adding direct primary care as a healthcare option for employees shows that you take your employees' health seriously. By providing affordable and accessible continuity of care for the employee and their family, the doors open for healthier employees, increased productivity, decreased need for prescription medications and hospitalizations, and fewer sick days.

What if I decide to cancel my membership?

We expect to have an open, honest, respectful relationship with you. If you have voiced a complaint that we cannot satisfy together, we will gladly allow you to terminate your membership.