Direct Primary Care: How You Can Use It to Advocate for Your Health

by | Oct 27, 2017

In our last post, we introduced a new practice method that more doctors are adopting in an effort to reduce their expenses and increase quality of care for their patients. This relatively new, but increasingly popular model allows doctors to focus their resources where it matters: their patients.

Direct primary care (DPC) memberships seem like a dream come true to those who want to advocate for their health care. But how do you find one? And how does a DPC membership fit with your current health navigation plan?

Find a Direct Primary Care Provider to Give Yourself Another Health Advocacy Tool

One of the biggest challenges of using a DPC is finding one in your area. The movement is growing, but still small. There are only around 700 practices in the United States that use this model. Virginia, however, has a concentration of practices in the Northern Virginia and D.C. areas. To see if there is a DCP near you, check out the DPC Frontier directory and the MyDPC directory.

If you don’t see one near you on those directories, it doesn’t mean that there are none in your area. Do some research yourself, or contact Values Based Patient Advocates for assistance.

Primary care doctors are not the only ones moving to a no-insurance, flat rate or subscription model. Some specialists, like physical therapists, chiropractors, and midwives, are providing lower cost direct care in exchange for avoiding the insurance billing process. In some cases, you can even submit these medical expenses to your insurance provider yourself as claims for reimbursement or contributions towards your deductible. You will need to contact your insurance provider for their specific policies, and Values Based Patient Advocates can help you figure out how to handle care paid by cash with your insurance.

How a Direct Primary Care Membership Fits Into Your Health Advocate Toolbox

Because DPCs only cover the medical treatment that the particular primary care physician provides, it is a good idea to keep your traditional insurance for catastrophic events. While it will vary on a case-by-case basis, most people end up saving a lot of money by combining a high deductible health plan (HDHP) with the membership fees of a DPC. A HDHP will not only cover you in case you have a catastrophic health event or need to see a specialist, but it will also prevent you from paying the tax penalty under the Affordable Care Act (ACA).

Direct Primary Care memberships are a relatively new phenomenon, so they are in a state of uncertainty when it comes to their tax classification. Some states classify it as a service, which keeps individuals with HDHPs eligible for health savings accounts (HSAs). However, other states leave DPCs unclassified, which prevents some individuals with HDHPs ineligible to contribute to their HSA while simultaneously subscribed to a DPC. Because of this classification under the tax code, the IRS also currently prevents individuals from using HSA funds to cover the DPC membership fees.

For more information on how to balance DPC with insurance and tax regulations, contact Values Based Patient Advocates for more information.

Direct Primary Care Providers: Filling a Need to Make Healthcare Easier to Navigate

Direct Primary Care providers are filling a need in today’s world of rising health care costs and skyrocketing premiums. They allow doctors to put their patients first, instead of having to devote their resources to the complexity of insurance billing. As a result, they are typically lower cost and higher quality than the traditional model.

Be your own health advocate, and look at the costs and benefits yourself to see if a DCP is right for you. If you need help, contact Values Based Patient Advocates! We will help you examine your insurance options and the availability of DCP providers in your area to come up with the most cost effective medical care for you!

Our Patient Advocate Office is ever just an email or phone call away: 703-222-1300 – we’re happy to help! A phone call is free and it could save a life or reduce a large hospital bill.

Free eBook: My Health Guide

Whether you’re going in for a routine checkup or need to keep track of medications: the following documents will help you prepare for your hospital visit, track medications, and keep on top of follow-ups.