Frequently  Asked Questions

Have any questions? We are here to answer!

The Basics

  • Direct Primary Care, or DPC, is a model of healthcare that puts patients first by getting rid of the red tape that constrains traditional practices. How? It’s simple: we eliminate the need for insurance billing, and – believe it or not – this actually saves you money in the long run. This model offers personalized and comprehensive care, including preventive services, chronic disease management, and basic urgent care, all for a flat monthly free of any contracts or long term commitments. Think Netflix or your gym membership, for your healthcare.

  • Direct primary care is a practice model that is as old as the profession of medicine itself, but took shape in its current iteration nearly two decades ago. Today, over 2,400 direct primary care clinics care for over 1 million patients across the United States. The model has been so successful that even leading healthcare systems such as Johns Hopkins, Jefferson Health & Cooper University Health Care offer this model to their employees and communities. We hope that this model of practice continues to grow and becomes the new standard of care for how Americans receive their primary care.

  • You won’t have to pay a co-pay for office visits or routine physicals. Also you’ll be able to avoid many visits altogether by sending your questions directly to us via email and text – something you won’t get from a traditional practice. We’ve negotiated amazing deals for prescription medications, blood tests, X-rays, and MRI/CT scans on your behalf. If we had contracts with insurance companies, we would be legally obligated to charge higher prices. More importantly, since you are getting all this amazing care from us, you can cut way back on your insurance premiums. Most DPC patients find a high-deductible, low-premium insurance plan so they’re covered in the case of a major health issue. But leave the rest of your healthcare to us.

  • The terms are often mistakenly used interchangeably, but they are not the same. Both DPC and concierge practices charge a periodic fee, however, under the concierge model, this fee only gets you access; that is, it doesn’t actually cover any of your care. Instead a concierge practice still bills insurance for your visits. Under DPC, your visits and other care are included in your fee, plus you’re provided with other incredible benefits like wholesale pricing for labs and radiology studies, deeply discounted prescription prices, direct digital communication with your doctor, and all the rest.

    Take a look at this chart for a visual comparison

  • Of course. Everyone benefits from a service tailored directly to them. That’s why we offer truly custom healthcare. We’re here for you if you’re sick or hurt, but we also help you proactively maintain good overall health.

    Chronic issues such as poor diet, high blood pressure or inadequate sleep are unseen or untreated for years before they have serious consequences. For example, hypertension (high blood pressure) is known as the “silent killer,” with no symptoms until a stroke or a heart attack occurs. But if high blood pressure is detected and addressed promptly, that catastrophic event can often be prevented entirely.

    Every visit with us will be thorough, relaxed, and as long as you need to address your health concerns. The longer you’re our patient, the more we learn about your health and lifestyle, and the better we can help you maintain that health.

  • We are by appointment only. Fortunately, members have access to same day or next day appointments based on availability.

Membership

  • Our practice offers high quality primary care services through a membership model where you are charged a low cost monthly fee to belong to our practice. The membership fee allows us to provide the vast majority of a person’s primary care in an innovative way for a simple, fixed price. It allows members to better anticipate and budget their healthcare finances without the extra costs, co-pays, and deductibles.

    See our prices on our pricing page. We charge a flat monthly fee, and in exchange you get virtually unlimited office visits, wholesale prices on prescription medication, your doctor’s cell phone number, and a whole lot more.

  • Our membership offers high quality primary care through office visits with no copay. This includes the following: annual wellness exams, sports physicals, school physicals, chronic care office visits, follow-up visits, basic office procedures and treatment of acute illness or minor injuries, all with minimal wait times in the office. The fee also covers direct communications with your doctor: phone, text, video chat or email. Our patients will also have access to discounted labs, prescriptions and special procedures not included in the membership fees.

  • As a Direct Primary Care practice, we strive to be the medical home for all your “Primary care” needs. We treat a variety of common everyday problems like colds, flu, strep throat, rashes and injuries. We also treat more complicated long term medical problems like diabetes, high blood pressure, high cholesterol, thyroid disorder, etc. For most people, primary care is 80-90% of all their medical needs.

  • For starters, having such unprecedented direct access to your doctor will help prevent hospitalizations and specialty referrals in many cases. However when those types of care are required, we will certainly continue to work with your hospitalist during your hospital stay as well as work closely with any specialist you require. Depending on the level of care and expertise required, we may rely on those specialized caregivers to manage your treatment

    • Emergency services: We do our best to avoid these cases but sometimes you may need emergent care they we cannot provide. These instances include things like heart attack, stroke, pulmonary embolism, and major trauma. This is why we encourage all our members to have health insurance.

    • For all true emergencies, such as unstable chest pain, difficulty breathing, uncontrolled bleeding, and serious injuries, we recommend you call 911 or go to the nearest emergency room.

    • Hospital-based care: Unfortunately if you are admitted to the hospital, we will not be allowed to be your treating physician. However, we are allowed to contact the physician caring for you while in the hospital and assure you are getting the care you need. We make sure they know your conditions and that you are getting the care you deserve. We also love visiting our members while they are in the hospital, talking to them and their families to assure everyone's questions and concerns are addressed.

    • Major surgeries and procedures: We leave the surgeries to the surgeons. Examples include joint replacement, abdominal surgeries, or cardiothoracic surgery. Although we won’t be in the operating room, we can discuss your case with the surgeon and help choose a surgeon that is best for your needs. We can also help guide you after your surgery with any questions that arise and focus on preventing the surgery when we can!

    • Prenatal care, labor, and delivery: While we do provide family planning counseling, pregnancy tests, and can answer most questions or concerns that come up during your pregnancy, we do not provide primary prenatal care or deliver babies. We are trained in prenatal care, labor, and delivery and therefore will still be here for you throughout the journey to answer questions when your OBGYN may be unavailable. This comes in very handy when there are urgent questions after hours.

    Chronic opiate therapy: Chronic pain is a complex disease process that requires a multidisciplinary approach to care that we unfortunately cannot offer at this time. We do not carry opiates or narcotics in our office due to federal and state regulations.

    • In-house Vaccination: Vaccines are not currently offered, but we hope to in the future. In the meantime, your local pharmacy and the health department are great places to have these done.

    • Home/Worksite visits: Care given by providers outside of our practice in the form of home visits is available for an additional fee.

    • Prescription Medications: Medications are not covered but are offered at steeply discounted wholesale prices.

    • Laboratory testing: While some in-house point of care testing is included, send-out laboratory testing is not covered, but our in house testing is offered at a steeply discounted wholesale price.

  • Of course! We are happy to accept the children of our enrolled clients, and offer discounts on multi-member households. Please inquire to learn more!

  • Of course! Because illness and injury do not respect regular office hours, we are pleased to offer direct access to your physician when you need them the most.

    We are available after hours by phone for urgent matters and via email and text for non-urgent matters. You can expect a reply via text or email within 24 hours if you choose to communicate that way. We do have office hours and ask you to contact us during working hours with questions that are less than urgent. We will be able to see you on weekends and evenings in the rare event your medical issue cannot wait until the next business day.

  • Because you’ll have your doctor’s email address and cell phone number, you can reach out to us whenever you need, wherever you are. Many illnesses can be diagnosed and treated with a simple conversation or short virtual visit. We’ll also help locate a nearby pharmacy and order the medications most appropriate for your circumstances.

  • Charges will be applied to your preferred method of payment at the time of collection/completion.

  • No hard feelings! We expect to have an open, honest, respectful relationship with you. You are always welcome to cancel your membership. We kindly request 30 days notice for transition of care.

  • We believe that controlled substances, including narcotics (Lorcet, Lortab, Norco, Oxycontin, Percocet, Vicodin, etc.), benzodiazepines (Ativan, Klonopin, Valium, Xanax, etc), and stimulants (Ritalin, Adderall, etc) have a limited role in primary care and therefore our practice prescribes them rarely and only very sparingly. We believe chronic pain requiring narcotics is best managed by a pain management specialist, but we are happy to work with you on non-narcotic options for your pain and to manage your other medical conditions. We do not treat anxiety with benzodiazepines, but are happy to offer other medications and techniques often successful in treating anxiety. No controlled substances are kept in the office.

  • Many small businesses are competing for employees in today's market, and it's key to provide an attractive benefits package that makes you stand out from the rest.

    Adding direct primary care as a healthcare option for employees shows that you take your employees' health seriously. By providing affordable and accessible continuity of care for the employee and their family, the doors open for healthier employees, increased productivity, decreased need for prescription medications and hospitalizations, and fewer sick days.

  • There was an executive order signed in 2019 asking the treasury department to look into allowing you to use your HSA for the monthly fee.  The IRS has yet to officially adopt it in its language.  FSA's may be used depending on the employer's FSA criteria so check directly with your accountant, employer or plan administrator.  

Insurance-related questions

  • Thankfully no, for both you and us.

    Hear us out.

    You might use your auto insurance to fix a smashed fender or other major damages. But you’d never use it to get an oil change (or pay for gas!).

    For some reason, health insurance is currently being used for the equivalent of oil changes for humans – routine physicals, office visits, simple blood tests, and minor procedures. This just doesn’t make sense.

    Here’s our business philosophy:

    • We forgo insurance payments in order to save our patients from the arbitrary, intrusive decisions dictated by insurance companies.

    • Charging a direct monthly fee frees us from the typical contractual agreements that prevent your average doctor from offering wholesale prices on laboratory tests, imaging, and medications.

  • Yes, we take care of any patient regardless of your insurance situation. Since we work completely outside of the insurance system, none of the billing for care here is eligible for insurance reimbursement. However, we recommend that everyone have insurance coverage, which is still important in the event of a major health issue requiring the need for hospitalization or surgery.

  • At Keystone Direct Health we offer high quality healthcare, convenience, accessibility and transparency that cannot be replicated in the current insurance-based healthcare system. Have access to your doctor’s cell phone number, access to same day or next day appointments, spend more than 15 minutes with your doctor, and know exactly how much your healthcare will cost you.  

  • Yes. We recommend our patients continue to have health insurance coverage in the event of high-priced medical needs such as surgery with a high-deductible and health savings account. If you experience a major health issue, you will still need insurance to help cover it. We’re happy to refer you to insurance representatives who can help customize an insurance plan to your specific needs.

  • Yes. You need only sign a waiver declaring that neither you nor your doctor will directly bill Medicare for our services. Even though Medicare will not pay us for any services you receive in our practice, your Medicare benefits will otherwise remain unchanged and can continue to be used for all other medical care received outside of our practice. Medicare will still cover any laboratory testing, imaging, medications, or hospitalizations prescribed by our offices.

Do you have any remaining questions?
We’d love to hear from you.

Build your foundation with Keystone Direct Health

We’ll be with you every step of the way.