What about my Insurance?

We are happy to see patients with any insurance, however our services are billed directly rather than through the insurance industry.  Of course, you may still use your insurance for all outside services such as labs, imaging, medications, specialty consults, hospitalizations, etc.   We are happy to work with you to be sure outside tests or consultations are ordered through your insurance network.

We encourage all our patients to plan for the rare, but potentially high costs of unexpected medical events such as surgeries, hospitalizations, or costly diagnosis that are outside the scope of care in the primary care office.  Many people find that a High Deductible Health Plan (HDHP) is the most cost effective to pair with a DPC Membership.  Choosing this through your employer or on the Marketplace can save you enough money on premiums to pay for a DPC membership.  Another increasingly popular option is Medical Cost Sharing.  It is a non-insurance option that helps individuals and families manage the unexpected healthcare needs that might occur.  It can often save a family 40% or more on their annual healthcare expenditure.  To learn more about one that we recommend, click on the Sedera link below to be taken to their website.  If you sign up for a Legacy DPC Membership, Sedera will give you an additional 14.5% discount of their coverage!   https://sedera.community/LegacyMedServices

The complexity and frustration of dealing with health insurance has driven many people away for accessing the care they need and deserve.  These burdensome costs, inefficiencies and restrictions built into working with insurance are staggering for both the patient and the physician.  By eliminating our dependence on insurance and instead contracting directly with our patients, we reduce our overhead and our administrative burden by 50% and pass that savings and simplicity on to you! 

Transparent Costs   –    Flexible Payment Options

In order to keep offer our consistently high standards for level of service, access and quality, we’ve calculated an Annual Cost of Care ** for each member.  It equates to  ~ $89/month for an adult and $49/month for a child.  Simple & reasonable cost for comprehensive, unlimited medical care.  Below are 4 different ways to pay for this: 

  1. Direct Pay Membership: monthly payment plan through auto-withdrawal from your bank or credit/debit card. Simple, predictable and our best value, but currently not tax deductible.
  2. Membership with HSA/FSA: set up monthly payment plan as above, but with the option to use your HSA/FSA card to pay each time you receive care. These fees are credited, dollar for dollar, toward your annual membership cost.  Once you’ve paid your Annual Cost of Care, the rest of your visits that year are covered at no charge!  This allows you to take advantage of pre-tax dollars for your healthcare expenses.
  3. Pay for Individual Services: non-members may choose to pay individually at the time of each service, but the annual costs can be much higher. For greater savings, many choose to purchase a package that includes a comprehensive health evaluation and 3 follow up visits.  Either option allows you to use HSA/FSA for the fees.
  4. Employer Payment: many employers are seeing the downstream benefits and are choosing to fund this option for their employees. As above, we have multiple options for employers to structure this benefit to take advantage of pre-tax savings.

** Our Annual Cost of Care for 2021 is $1068 per adult, $588 per child, with a maximum of $3000 for a family of any size.