A direct monthly or annual payment to a direct care physician can provide health care without involving your out-of-pocket expenses under medical insurance rules.
Thu, 01/28/2016 | BY Kent McDill
There is much being said today about wealthy disparity in America, a perceived divide between the “haves” and the “have nots”.
Recently, a change in medical care in the country has provided a new way to access physician care for a large portion of the population. It is something the “haves’’ have had in the past and now the “have nots” can get it as well.
Known as “direct primary care”, it is the ability of consumers to contract with a physician for comprehensive primary care, including basic medications, lab tests and follow-up visits in person, over email or by phone, for a low monthly fee.
Previously referred to as “concierge’’ medical practices for the wealthy, more doctors are making themselves available for this kind of service, which benefits the patients because they have a medical professional effectively on-call, and it benefits the provider because it cuts out insurance all together.
This new kind of service is the results of the growing frustration among medical providers with the nation’s medical insurance requirements. This is a result of the changes brought on by the Affordable Care Act and is an outgrowth of the changes the ACA was created to bring about.
And Direct Primary Care is legal under the ACA.
The cost of Direct Primary Care can be less than $100 per month, and is often available for a yearly subscription. It is financially feasible to the doctors who spend less on their own practice insurance, spend nothing on dealing with insurance issues, and have a far lower overhead due to lowered expenses.
The Affordable Care Act identifies direct primary care as an acceptable option. It does not replace a health plan for specialists or emergencies, and consumers will still require that. But consumers can get a less expensive insurance plan for emergencies, and the combined cost of the insurance and the monthly fee to their Direct Primary Care is often cheaper than a traditional insurance program that covers primary care.
There are more than 400 Direct Primary Care group practices in the country, with as many as 1,300 physicians participating.
“This is a movement; I would say it is in its early phase,’’ said American Academy of Family Physicians president Wanda Filer to National Public Radio. “But when I go out to chapter meetings, I hear a lot more interest.”
Direct care is an expense that can be avoided by remaining healthy. But for families, it seems to make sense.
There are expansive benefits to Direct Primary Care that go beyond finances. Patients with a Direct Primary Care physicians are more likely to get more attentive care, and are more likely to build a relationship with the physicians. Most physicians in the program promise same-day appointments for non-emergency visits.
Many states that have Direct Primary Care physicians are trying to integrate that care into the Medicaid and Medicare plans, so that physicians can refer their patients without the high cost of being a part of the program initially.