Direct Primary Care is not insurance
Direct primary care is not insurance so when you start the process in trying to understand this new model forget all you know about the traditional insurance experience.
There is no 'network' of physicians
Direct Primary care works in a way that is different but smarter than traditional insurance. Since there is no 'middleman' or 'insurance paperwork', the relationship you have is directly with the physicians that choose this model for their service. This means payments are made directly to the physicians or the 'platforms' they work to facilitate their service. Instead of searching for “in-network” doctors, you get direct access to care—simple, flexible, and without the insurance red tape. Just schedule, show up, and get the care you need.
Scheduling an appointment
Scheduling an appointment is also different from the traditional insurance experience. Since there is no network to choose from when you subscribe you get a dedicated Patient Advocacy Line number aka a concierge service. Advocates will take your membership information, provide a list of physicians you can make an appointment with (you choose) and then they ensure you get the service you need.
They will deal with follow ups and any associated questions and scheduling concerns you may have.
Chronic condition management
The physicians in the network can manage most chronic conditions as long as there are no complications. They will work with you to ensure you get the prescriptions and care you need. If your condition needs to be managed by specialists they will refer you to someone. The referral is free but the specialist care is not part of the direct primary care model. You will require additional coverage for specialists.
Virtual care
The DPC program also includes virtual care to fit your schedule. You get the same quality care without leaving your location. This is at no added cost to the plan.
Lab work & prescriptions
A lot of office will have their in office labs as well, so that you do not have to go to any external lab for tests. In case you do there are discount lab options covered in many plan offerings.
Doctors will also prescribe medication for acute and chronic conditions. Make sure your concierge is made aware of any chronic conditions or medications you may be on. This will help them suggest a physician able to prescribe you the medication you need.
"Choosing healthcare that fits your lifestyle and needs isn’t always easy. Vativis isn’t insurance, so our members often take a moment to understand how we work. But once they do, they see how we help simplify decisions and save money."