Most people are tired of not being able to contact their doctor with minor medical concerns, or being told to come in six weeks later for an office visit. At a Direct Primary Care office, you have direct access to your doctor. Meaning, you are able to text, email, Skype, or call your doctor directly. Also, since we are not required by insurance to make you come in for an office visit, you can choose whether you’d like to make an office visit for minor ailments. Not to mention, our DPC office appointments are guaranteed within 72 hours.
A DPC practice offers you the luxury of building a personal relationship with your doctor. Your doctor has more time to spend with you because he or she caters to a smaller number of patients. It is that simple.
We will never keep you waiting. We will never rush you out.
In the current insurance payment system, your company pays only for the visit(s) you have with your doctor. Your doctor doesn’t get paid for the continuous access, you as a patient, most likely need to maintain after a visit. Outside of the patient visit a doctor may need to; answer follow-up questions, refill your medications, order tests, and/or review your labs, to name a few. Traditional clinics need to generate extra revenue by seeing large number of patients in order to cover the fees for these added services. This is the premise behind the current model of the 15-minute visit. With this 15-minute revolving door system of seeing patients, both physicians and patients can suffer. Physicians risk burn-out and patients can become frustrated.
The DPC model, based on a membership fee, allows the clinic to provide these services by generating enough revenue without having to sacrifice services or quality of care with patients, or by having to see large number of patients.
No. The average salary of a DPC doctor is the same or less as a non-DPC doctor. DPC doctors prioritize a healthy work-life balance.
There are several reasons why you might want to choose a DPC even though you have insurance.
- You have an established relationship with a doctor from a previous practice and that you don’t want to lose.
- You want a doctor who can spend an hour with you or the length of time you feel is adequate to address your health need(s).
- You value the relationship with your doctor and want a doctor you can access at almost any time, by phone, text, email and/or Skype.
- You will save money. If you carry a high deductible on your health plan, becoming a member of a DPC practice can save you money.
- A DPC membership is a good complement to a catastrophic insurance plan.
- You like the idea of being more than a patient and want to be part of a caring community.
No. DPC is a direct contract that you establish with your doctor for primary care services only. You choose your membership plan, you are in control of how much you spend on your health care. For example: think about your cable company, you sign a contract for services and you agree to pay a monthly fee, regardless if you watch TV. These services are available 24/7 with your contract and you can call anytime for questions or repairs.
Under Massachusetts law, you still need to carry a health insurance policy to avoid a tax penalty.
We are not contracted with any insurance networks, so we may refer you to any specialist without restriction.
However, finding out if your private insurance will cover the specialist is a bit more complicated. Coverage of specialist visits depends on your specific insurance provider, your specific health plan, and whether they accept our referrals from Out-Of-Network* primary care physicians.
*Currently, we are considered In-Network for Blue Cross Blue Shield and Tufts Commercial.
Plans which DO NOT need referrals to specialists:
(This means we can refer you without hesitation if your insurance will cover the specialist visit)
- Masshealth Standard
Masshealth Standard that is NOT associated with other insurance providers such as Boston Medical, Tufts, or other organizations.
- PPO [Preferred Provider Organizations] (Applies to all PPO Plans )
PPO plans do not require a referral to go to a specialist.
Plans which may need referrals to specialists depending on insurance provider**:
- HMO [Health Maintenance Organization]
Most HMO plans require you to choose a primary care physician who will refer you to the specialized providers that are within their network.
- EPO [Exclusive Provider Organization]
EPO plans do not require you to choose a primary care physician or obtain a referral to see a specialist within their network. However, EPOs do not pay towards any out-of-network specialists.
- POS [Point of Service]
Most POS plans require you to get a referral from your primary care physician for specialized providers that are within their network. Even though they are similar to HMOs, POS will cover out-of-network specialists in certain circumstances unlike HMOs.
**NOTE: You will need to contact your specific insurance provider to obtain a more detailed answer on whether they will accept a referral specifically from WholeCare, LLC. This is a broad overview of insurance plans and may be different per Insurance Provider.
Each membership includes:
- A set number of visits according to the rate you choose.
- Direct access by phone, text, email and/or Skype.
- Same day or next day appointments.
- Discounts on in-house labs.
There are three membership options from which to choose. These are based on the number of visits you anticipate you may need in a one-year period. Additional visits are available for purchase if you reach your plan limit or it expires.
3 Visits a Year – $30/month (only available to those <30yo)
6 Visits a Year – $55/month
12 Visits a Year – $75/month