243 Church St., NW 100C
Vienna, VA 22180
(T) 703-255-3067
(F) 703-382-6652
visits About Direct Primary Care (DPC)
DPC is an exciting model for primary care that is an alternative to the traditional insurance model. It offers a solution for what frustrates patients most these days: not being able to access your doctor when you need to, excessive waiting, rushed visits, and unpredictable costs.
DPC is not meant to replace insurance, as you will still need insurance for things like specialist visits and hospital services. You can also use your insurance for labs and diagnostic tests.
Service Advantages with DPC
1. Time saved and improved access to your doctor
In my DPC practice you get easy appointment access (same day or next business day), longer appointments when you need extra time, and short to no wait times in the office. You also gain the option to have consultations by phone call or email when medically appropriate, avoiding the inconvenience of an unnecessary face-to-face consultations, which are normally required in the insurance practice model. Remote consults can be used for the treatment of simple medical problems, fine-tuning established treatment plans, and having general information discussions. The result for you is time saved and access to your doctor in a patient- friendly way.
2. Personalized and unbiased care
Many medical offices have recently taken a “corporate” route in order to survive in the new doctor payment model called Value Based Care. This model was developed by Medicare and insurance companies to financially reward groups of doctors for saving money on the health care costs of large populations of patients.
In the Value Based Care model, the health of a large group of patients is given high priority. In my opinion this sometimes comes at the expense of your individual needs. It is hard to find the right person to talk to on the phone when you call your doctor's office, and often times calls are not returned. ALso your office visit can become less personal and less meaningful, and a corporate third party intrudes into decisions that should be solely between you and your doctor.
My DPC office is privately owned and independent of insurance companies, hospitals, and large medical practice groups, removing conflicts of interest that could negatively impact your care. The result is medicine the way it should be: personalized and unbiased care that only prioritizes your interests.
FAQ
Do I have to pay co-pays or deductible costs for my appointment?
Your membership includes an annual physical and 5 additional visits (in-person or virtual/portal). There is no copay for these 6 visits. If you need more visits than that then there is a $40 copay per visit/portal message exchange.
Can I use my insurance for specialists, labs and other medical services if I want to?
Yes, unless you have Medicaid (government insurance for low income patients). Also most HMO-style insurance plans require you to see an in-network primary care doctor to see a specialist.
Do I need to have insurance?
Yes, you need insurance because a DPC membership only covers primary care consultation services delivered by me directly. You need insurance for things like care from specialists, medical emergencies, and hospitalizations.
Is a DPC membership feasible if I have an HMO insurance plan?
It is more challenging but possible. For HMO plans that require an in-network primary care doctor you will need to maintain a relationship with one in case you need referral to a specialist. In my personal experience this is easiest with Kaiser but I have made it work before with other HMO plans. This issue will be handled on a case-by-case basis.
Is a DPC membership feasible if I have Medicare?
Yes. You will need to sign an agreement stating you understand I have opted out of Medicare and that you will not submit my charges to Medicare for reimbursement. Being a Medicare patient in my practice has no impact on any other aspect of your health care.
What does my membership include?
Please click here for membership details.
Can I pay for my membership with my Flexible Spending Account (FSA)?
This depends on the rules of your FSA as set by your employer. Please contact your HR department to ask this question. We will provide any necessary supporting documentation. In support of the use of FSA funds being used to pay DPC membership fees, an Executive Order signed June 24, 2019 by President Trump states:
"Within 180 days of the date of this order the Secretary of the Treasury, to the extent consistent with law, shall propose regulations to treat expenses related to certain types of arrangements, potentially including direct primary care arrangements and healthcare sharing ministries, as eligible medical expenses under section 213(d) of title 26, United States Code."
Does a DPC membership prevent me from contributing to a Health Savings Account (HSA)?
I recommend asking your accountant or tax advisor, as this involves interpretation of IRS code section 223(c)(1)(A)(ii). This section indicates that in order to maintain an HSA you are not allowed to have a second health plan. In 2017 a law was passed in Virginia specifically stating that a DPC membership is not an insurance plan (See Virginia Code 54.1-2997). However ultimately this is an IRS issue and it is for this reason that I recommend getting counsel from an accountant to answer this question.
Can I pay for my membership with my Health Savings Account (HSA)?
I also recommend asking your accountant about this, to interpret IRS Publication 502 Medical and Dental Expenses. In this manual medical expenses are defined as the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body.
In support of the use of HSA funds being used to pay DPC membership fees, an Executive Order signed June 24, 2019 by President Trump states:
"Within 180 days of the date of this order the Secretary of the Treasury, to the extent consistent with law, shall propose regulations to treat expenses related to certain types of arrangements, potentially including direct primary care arrangements and healthcare sharing ministries, as eligible medical expenses under section 213(d) of title 26, United States Code."
Can I submit a claim to my insurance for my DPC membership fee?
You certainly can check with your insurance plan, but I do not expect they will reimburse you for this.
DPC is an exciting model for primary care that is an alternative to the traditional insurance model. It offers a solution for what frustrates patients most these days: not being able to access your doctor when you need to, excessive waiting, rushed visits, and unpredictable costs.
DPC is not meant to replace insurance, as you will still need insurance for things like specialist visits and hospital services. You can also use your insurance for labs and diagnostic tests.
Service Advantages with DPC
1. Time saved and improved access to your doctor
In my DPC practice you get easy appointment access (same day or next business day), longer appointments when you need extra time, and short to no wait times in the office. You also gain the option to have consultations by phone call or email when medically appropriate, avoiding the inconvenience of an unnecessary face-to-face consultations, which are normally required in the insurance practice model. Remote consults can be used for the treatment of simple medical problems, fine-tuning established treatment plans, and having general information discussions. The result for you is time saved and access to your doctor in a patient- friendly way.
2. Personalized and unbiased care
Many medical offices have recently taken a “corporate” route in order to survive in the new doctor payment model called Value Based Care. This model was developed by Medicare and insurance companies to financially reward groups of doctors for saving money on the health care costs of large populations of patients.
In the Value Based Care model, the health of a large group of patients is given high priority. In my opinion this sometimes comes at the expense of your individual needs. It is hard to find the right person to talk to on the phone when you call your doctor's office, and often times calls are not returned. ALso your office visit can become less personal and less meaningful, and a corporate third party intrudes into decisions that should be solely between you and your doctor.
My DPC office is privately owned and independent of insurance companies, hospitals, and large medical practice groups, removing conflicts of interest that could negatively impact your care. The result is medicine the way it should be: personalized and unbiased care that only prioritizes your interests.
FAQ
Do I have to pay co-pays or deductible costs for my appointment?
Your membership includes an annual physical and 5 additional visits (in-person or virtual/portal). There is no copay for these 6 visits. If you need more visits than that then there is a $40 copay per visit/portal message exchange.
Can I use my insurance for specialists, labs and other medical services if I want to?
Yes, unless you have Medicaid (government insurance for low income patients). Also most HMO-style insurance plans require you to see an in-network primary care doctor to see a specialist.
Do I need to have insurance?
Yes, you need insurance because a DPC membership only covers primary care consultation services delivered by me directly. You need insurance for things like care from specialists, medical emergencies, and hospitalizations.
Is a DPC membership feasible if I have an HMO insurance plan?
It is more challenging but possible. For HMO plans that require an in-network primary care doctor you will need to maintain a relationship with one in case you need referral to a specialist. In my personal experience this is easiest with Kaiser but I have made it work before with other HMO plans. This issue will be handled on a case-by-case basis.
Is a DPC membership feasible if I have Medicare?
Yes. You will need to sign an agreement stating you understand I have opted out of Medicare and that you will not submit my charges to Medicare for reimbursement. Being a Medicare patient in my practice has no impact on any other aspect of your health care.
What does my membership include?
Please click here for membership details.
Can I pay for my membership with my Flexible Spending Account (FSA)?
This depends on the rules of your FSA as set by your employer. Please contact your HR department to ask this question. We will provide any necessary supporting documentation. In support of the use of FSA funds being used to pay DPC membership fees, an Executive Order signed June 24, 2019 by President Trump states:
"Within 180 days of the date of this order the Secretary of the Treasury, to the extent consistent with law, shall propose regulations to treat expenses related to certain types of arrangements, potentially including direct primary care arrangements and healthcare sharing ministries, as eligible medical expenses under section 213(d) of title 26, United States Code."
Does a DPC membership prevent me from contributing to a Health Savings Account (HSA)?
I recommend asking your accountant or tax advisor, as this involves interpretation of IRS code section 223(c)(1)(A)(ii). This section indicates that in order to maintain an HSA you are not allowed to have a second health plan. In 2017 a law was passed in Virginia specifically stating that a DPC membership is not an insurance plan (See Virginia Code 54.1-2997). However ultimately this is an IRS issue and it is for this reason that I recommend getting counsel from an accountant to answer this question.
Can I pay for my membership with my Health Savings Account (HSA)?
I also recommend asking your accountant about this, to interpret IRS Publication 502 Medical and Dental Expenses. In this manual medical expenses are defined as the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body.
In support of the use of HSA funds being used to pay DPC membership fees, an Executive Order signed June 24, 2019 by President Trump states:
"Within 180 days of the date of this order the Secretary of the Treasury, to the extent consistent with law, shall propose regulations to treat expenses related to certain types of arrangements, potentially including direct primary care arrangements and healthcare sharing ministries, as eligible medical expenses under section 213(d) of title 26, United States Code."
Can I submit a claim to my insurance for my DPC membership fee?
You certainly can check with your insurance plan, but I do not expect they will reimburse you for this.