Answers to our most asked questions!
What is Direct Primary Care?
Direct Primary Care (DPC) is a model of healthcare where a patient pays their PCP a monthly fee directly for comprehensive primary care and no bills are sent to the patient's insurance. Providers save time not having to spend hours on tedious insurance-related coding and billing. That time can now be spent caring for patients in a more direct & accessible manner. DPC patients still carry insurance for specialist, emergency & catastrophic care. Uninsured and underinsured patients (i.e. high deductible plans) can engage in preventative healthcare and health maintenance at an affordable, transparent cost without the fear of unexpected bills.
Direct Primary Care (DPC) is a model of healthcare where a patient pays their PCP a monthly fee directly for comprehensive primary care and no bills are sent to the patient's insurance. Providers save time not having to spend hours on tedious insurance-related coding and billing. That time can now be spent caring for patients in a more direct & accessible manner. DPC patients still carry insurance for specialist, emergency & catastrophic care. Uninsured and underinsured patients (i.e. high deductible plans) can engage in preventative healthcare and health maintenance at an affordable, transparent cost without the fear of unexpected bills.
How is Direct Primary Care at Weatherly Different from Concierge Medicine?
DPC is often considered the same as Concierge but it is a very common misconception. Both charge a periodic fee, however when you have a visit at a concierge practice, insurance is still billed for your visits. At Weatherly, there are no copays or hidden additional bills. Your monthly membership fee covers not only your access to your provider, but also your visits and care in the office.
DPC is often considered the same as Concierge but it is a very common misconception. Both charge a periodic fee, however when you have a visit at a concierge practice, insurance is still billed for your visits. At Weatherly, there are no copays or hidden additional bills. Your monthly membership fee covers not only your access to your provider, but also your visits and care in the office.
Why would I have insurance and pay for this?
Insurance only guarantees coverage above a deductible and often still charges co-pays and additional co-insurances.
With DPC, most types of insurances will still cover lab work, imaging, prescriptions and referrals ordered by your DPC provider in the way you are used to. But, since we work directly for the patient, we never bill any insurance companies or programs directly. With higher and higher deductibles, patients are getting more and more bills for testing and visits. While you will pay the predictable monthly fee to be part of Sarah's practice, you will not get any unexpected bills from her for visits or any services she can provide in the office. Many patients find this to be a more predictable and affordable structure as the majority of most patient needs fall within the scope of primary care!
Insurance only guarantees coverage above a deductible and often still charges co-pays and additional co-insurances.
With DPC, most types of insurances will still cover lab work, imaging, prescriptions and referrals ordered by your DPC provider in the way you are used to. But, since we work directly for the patient, we never bill any insurance companies or programs directly. With higher and higher deductibles, patients are getting more and more bills for testing and visits. While you will pay the predictable monthly fee to be part of Sarah's practice, you will not get any unexpected bills from her for visits or any services she can provide in the office. Many patients find this to be a more predictable and affordable structure as the majority of most patient needs fall within the scope of primary care!
Will I benefit from this if I don't have frequent healthcare needs?
Yes! You will have a provider who knows you, you will no longer have to navigate the annoyances and boundaries of the traditional office, and you can reach your provider anytime you need her! Many patients find they access their provider more for preventative care needs and feel like they've gained a real partner in their healthcare journey.
Yes! You will have a provider who knows you, you will no longer have to navigate the annoyances and boundaries of the traditional office, and you can reach your provider anytime you need her! Many patients find they access their provider more for preventative care needs and feel like they've gained a real partner in their healthcare journey.
What is an HMO and PPO Health Insurance and which is best?
An HMO requires you to have an in-network PCP (which Weatherly Direct Care & Sarah McGinley are not). A PPO lets you pick anyone you prefer to be your PCP. An HMO requires an in-network insurance-based referral for specialists and advanced imaging like MRI/CT. A PPO requires no insurance-based referrals (at Weatherly, Sarah will still send referrals with PPO plans, but they will be important clinical information, and not insurance required details). With a PPO you have much more freedom to select the providers you want to see for your PCP and specialty care. If you have an HMO and want to switch to a PPO, you can reach out to an insurance agent or human resources and change plans during open enrollment which runs in the fall to early winter most years! If you have more questions about insurances that work best at Weatherly, please connect with us!
An HMO requires you to have an in-network PCP (which Weatherly Direct Care & Sarah McGinley are not). A PPO lets you pick anyone you prefer to be your PCP. An HMO requires an in-network insurance-based referral for specialists and advanced imaging like MRI/CT. A PPO requires no insurance-based referrals (at Weatherly, Sarah will still send referrals with PPO plans, but they will be important clinical information, and not insurance required details). With a PPO you have much more freedom to select the providers you want to see for your PCP and specialty care. If you have an HMO and want to switch to a PPO, you can reach out to an insurance agent or human resources and change plans during open enrollment which runs in the fall to early winter most years! If you have more questions about insurances that work best at Weatherly, please connect with us!
Does your question remain unanswered?
Email us at [email protected] and ask!
Email us at [email protected] and ask!