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What is Direct Primary Care and How Does it Work?

Direct Care · July 31, 2021

If you find yourself worrying about how you can afford necessary healthcare for your family, you’re in the majority. According to a 2021 study, 66% of American adults are unsure if they can afford medical services in the future. Instead of letting money or insurance concerns prevent you from living a healthy life, you can take control with Direct Primary Care. 

In its simplest form, Direct Primary Care (or DPC) sees members paying their provider directly through regular monthly payments. With this payment system in place, insurance covers costs, thus removing one of the biggest hurdles members commonly encounter. The DPC model also provides other non-financial benefits that can lead to higher-quality healthcare overall. 

As the leading family medical center in Yakima, Assurance Healthcare offers Direct Primary Care to our clients. We believe that doing so makes healthcare more affordable, more accessible, and more personable. 

Below you’ll find an outline of how Direct Primary Care differs from the usual system. While focusing on the benefits, we’ve also included some limitations of Direct Primary Care, so that you can be fully informed on how this model works and can benefit you.

Direct Primary Care Explained

When you visit a family medical clinic, mental healthcare clinic, or another provider, you’re probably required to interact with many people before actually seeing your doctor. Besides taking more time, it also makes things more expensive for both you and the provider. In addition, many people work together to handle insurance claims and billing, and the need to fill these positions raises the costs of services.

Direct primary care cuts out this middle-men aspect by operating on a direct payment service. Specifically, clients pay their provider a flat rate every month, not unlike a subscription. In return, members get access to a wide range of services whenever they need them.

On average, Direct Primary Care costs are lower than traditional healthcare services. The result is members feeling more comfortable visiting their provider and receiving services instead of putting them off because they are cost-prohibitive.

Limitations of Direct Primary Care

Every health care program has its limitations, and Direct Primary Care is no exception. While we believe that the benefits greatly outweigh the limitations, it is important that you know what (and what not) to expect. Doing so will ensure that you can experience Direct Primary Care to its fullest and reap all the benefits.

It’s Only for Primary Care

While it’s nice to have your primary care needs met with such a straightforward program, it’s not comprehensive healthcare. If you need to see a specialist or require surgery, for example, that won’t fall under the umbrella of Direct Primary Care, and you’d still need insurance to cover those costs. So, while Direct Primary Care doesn’t require health insurance for billing, it doesn’t completely negate the need for health insurance or an alternative plan to pay for major medical costs, either. 

Membership Isn’t Deductible 

While enrolling in a primary direct care program isn’t a form of health insurance, the IRS classifies it as a healthcare plan. What does this mean? While it won’t affect your access to health services, enrollment costs aren’t considered deductibles.

Benefits of Direct Primary Care

The lower price tag and more straightforward billing get presented as Direct Primary Care’s biggest draw. However, it’s far from the only benefit the system carries. The overall benefits carry far beyond the money members save.

Clear Pricing and Billing

With Direct Primary Care, your monthly fee covers your care costs, with only a few exceptions. There are no estimates or variables, and you won’t be shocked by a bill showing a cascade of costs. While the monthly fee may change from time to time, it’s never sudden, and your provider gives plenty of notice before it goes into effect.

Better Member/Provider Relationship

One of the upsides of providers using the Direct Primary Care model is that they can spend more time with each member. Doing so allows them to know you better and to give deeper, more personalized care. As a result, many members feel more comfortable receiving services and opening up about their health concerns. 

Greater Accessibility

Direct primary care programs almost always allow members to make appointments for the same or next day and give them around-the-clock access to their provider through email, phone, and other forms of communication. A provider will see you much sooner and, as a result, experience greater peace of mind. You’ll have a much easier time fitting appointments into your schedule as well.

Trust Assurance Healthcare & Counseling Center With Your Wellbeing

Your health is the most important thing to you. Trust it to a team of professionals who care about it just as much as you do.

Trust it to Assurance Healthcare & Counseling Center.

With individual, family, and employee membership plans available, we can provide primary care to virtually anyone. With offices open twenty-four hours a day, seven days a week, you can rest easy knowing that we will address your concerns quickly so you can get back to living your life. Reach out to our team now and learn more about membership benefits.

Filed Under: Direct Care

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