What is Direct Primary Care
Direct Primary Care basically means the Primary Care Provider (The Doctor) you choose at a clinic utilizing EverMed DPC membership services will receive a monthly fee for the services offered with that primary care provider. *Your health insurance is not billed for these services.
How Does Direct Primary Care Work
Direct primary care is an alternative to paying for healthcare on a fee-for-service basis. It’s not so much a new system as it is a throwback to former days.
There was a time you went to see the doctor with the expectation of receiving care. More recently the healthcare system has turned a visit into a kind of commodity. Systems are trying to produce a billable event, which can only be achieved by hitting specific items on the checklist. The items may or may not be what you’re expecting, but if you are expecting care, your insurance might not pay for that. An insurance company wants to generate as much revenue as possible in specialty care, expensive testing and surgical procedures. The company will not profit from someone listening to you. It will not profit from someone expressing sympathy. It will not profit from someone trying to understand where you’re coming from. Instead, insurance pays for the checklist that produces a billing code.
Most doctors want to do a good job. They want to feel like they are doing the right thing for the patient and not chasing the bureaucratic whirlwind. However, they also need to make a living. Unfortunately, physicians often find themselves working for hospitals and multi-specialty groups that require them to see 20 and 30 patients a day, practicing medicine with one hand tied behind their backs. There is no time to listen; there’s no time to do the right thing, or to figure things out, or to discuss alternatives. At the end of the seven minute visit, all these doctors can do is refer the patient or prescribe a pill. A lot of the ills of the healthcare system can only be cured with the one thing the doctors are not given: time.
So along comes direct primary care. This is a system that allows doctors to work for patients and ignore the interests of insurance companies and multi-specialty groups. In direct primary care, the goal is to generate the greatest value for the patient. Sometimes that means rapid access to specialty for a serious problem recognized by the primary Doctor; sometimes it means watching and waiting according to the priorities and values of the patient; sometimes that means a patient becomes equipped to maintain their own health.
Patient Direct Care is purchased by the patient directly and so the doctor answers only to the patient. We are here to do the right thing and do our best not to put you at risk. In many instances, our patients are very fortunate to have an employer purchase the option on their behalf because that employer has understood and recognized the advantages for the health of their employees. Regardless of your payment plan, we hope you understand the impact direct primary care can have on your total health. Thank you for letting us serve you!
Is this considered health insurance or a health insurance plan?
No, it is not an insurance plan or agent for any insurance company, and we do not offer insurance plans. Patient Direct Care is a monthly subscription membership for primary care services at our clinic. Your subscription to Patient Direct Care works best when combined with a major medical plan.
Can I become a member if I have a pre-existing condition?
Yes, you will be welcome. We will not deny membership for age or pre-existing conditions.
Can I still join Patient Direct Care if I have Medicare or Medicaid?
Unfortunately, no not at this time.
Can I become a member if I don’t have insurance?
Yes, Patient Direct Care is open to everyone, regardless of whether they have insurance or not.
I have health insurance. How does that work with my Patient Direct Care subscription?
A subscription with Patient Direct Care works best with a high deductible insurance plan. Your insurance plan may cover all the outside testing, referrals to specialists and hospitalizations that may be required outside of your membership with DPC.
What services are provided?
Primary Care Visits
Urgent Care Visits
Annual Wellness Exams
Well Child Exams
Tele-medicine (Email, Phone, Remote – Portal Consults)
Urine Pregnancy Test
Rapid Strep Test
Alcohol and Substance Abuse Screening
PPD (TB Test)
Injection Fees (medication costs may not be covered)
Immunizations (Medication costs may not be covered)
Skin Lesion Excision and Biopsy (pathology fees not included)
Sking Lesion Removal/Destruction (skin tag, wart, other)
Uncomplicated Wound Suture
Liquid Nitrogen Procedures
Smoking and Tobacco Cessation Counseling
Will my office visit result in a fee?
No, your membership covers all office visits. There is no copay when you come in for an office visit. *The only time you will pay a fee is if we provide and/or order a service not listed. Please check with your Primary Care Provider for to see if a service may result in a fee. We often have negotiated prices for referrals and/or services not covered by your membership.
Do I need to inform a staff member when I arrive that I have a Evermed DPC membership?
Yes, your Evermed DPC membership is specific to “A” clinic.
I need to go to the hospital. Will my membership cover hospital visits and/or emergency room visits?
No, your Patient Direct Care membership does not cover these visits. We recommend you have an insurance plan in place to cover these major medical expenses.
Is my membership tax deductible?
Unfortunately, no. Your monthly membership is not considered a medical expense in most states and is not deductible.
Will my medical information be shared with insurance carriers or pharmaceutical companies?
No, we never share your information with outside parties unless you, the patient, request information be shared.
Do you perform sports physicals?
Yes! We are happy to offer sports physicals and fill out appropriate forms as needed.
Are immunizations included in my membership?
Patient Direct Care will post a list of covered immunizations.
Do you see children?
Yes, Patient Direct Care is open to people of any age.
Can each family member see a different provider at Patient Direct Care?
Yes, however, currently we only have one physician availble.
I’m an employer. How do I enroll employee’s mid-end month to ensure they are active?
Employers have 2 options:
1. Employers can log onto their account via the link received upon registration and view employee’s active under their membership. Employers can add, edit and remove members (employee’s) from their own account.
2. Employers can contact firstname.lastname@example.org or call: 1.800.377.6099 and request an up-to-date employee roster as well as make changes to their employee’s/dependents. A membership change notification will be sent via fax or secure email to reflect any changes made.
Your directory shows clinics in Oregon and Washington. Can I select a clinic in Washington if I live in Oregon?
Yes, members my select a clinic in either state given their employer/residence status.