Frequently Asked Questions
Why do I need to pay a monthly fee to see the doctor?
This model, often called “Direct Primary Care” (DPC), offers patients the full range of comprehensive primary services (including routine care, regular checkups, preventive care, and care coordination) in exchange for a flat, recurring retainer fee that is billed to patients on a monthly basis. DPC clinics do not bill insurance companies, government programs or other third-party payers for their services.
How is this possible?
By paying the physician/NP directly and eliminating the paperwork associated with insurance companies or government agencies, some overhead costs (estimated at 40% of a typical fee-for-service care model) can be eliminated. The typical DPC practice has 600-1000 patients per physician rather than 2000 (or more) in a fee-for-service model. Thus the doctor has more time to devote to each patient.
Direct primary care practices bypass insurance — thus the term “direct.” Patients who choose to see direct primary care doctors still must buy health insurance — to cover the costs of any serious illness and to comply with the federal Affordable Care Act. Patients should pay separate fees for primary care while saving the insurance for emergencies and big expenses. It is similar to how you use car insurance: pay out-of-po
What are the differences between Direct Primary Care & Community Care?
Direct Primary Care patients will utilize the HOPE staff physician and/or nurse practitioner. Community Care Patients will continue to be treated by the volunteer healthcare providers and enjoy an increased number of services by having the staff physician at the clinic.
How do I join?
Those interested in becoming a Direct Primary Care patient will fill out an application and pay a one-time, $99 enrollment fee per household. Monthly fees must be paid using a credit, debit or ACH recurring payment.
Why should I sign up?
The subscription model provides longer medical visits (up to 60 minutes), quicker appointment scheduling, increased access to the doctor (via phone and email), and savings on lab work, imaging and prescriptions medications. HOPE Direct Primary Care patients also know they are helping our Community Care patients being seen by volunteer healthcare providers to get access to quality medical services.
Why should I sign up to be a Direct Primary Care Patient when I can be a HOPE Community Care Patient?
HOPE Direct Primary Care Patients will have shorter lead times for appointment scheduling. Patients under this model have longer patient visits (up to one hour), increased access to the doctor (by phone and email), and quicker appointment scheduling.
What does the monthly fee cover?
The covers most primary care services including clinical and consultative services, and care coordination and comprehensive care management. Because some services are not covered by the retainer, HOPE suggests that patients acquire (at the least) a high deductible wraparound policy to cover emergencies. A $20 per visit fee is charged at the time of the clinic visit.
Is this insurance?
No. HOPE contracts directly with you, the Direct Primary Care Patient, to provide primary care services for a low monthly fee. The monthly fee is not insurance and does not meet eliminate the need for a qualified plan as defined in the Affordable Care Act. Patients need health insurance to cover larger expenses, catastrophic events and those services outside of primary care. We recommend everyone have health insurance. Primary care often accounts for 80-90% of an individual’s health care, and Direct Primary Care patients at HOPE can have their primary care needs met through this direct relationship with the physician.
Aren’t I just paying twice for my primary care if I have medical insurance?
You already are, in most cases. Higher deductibles and co-pays have most patients paying for their primary care services out-of-pocket before the insurance coverage begins.
Can I pay for the monthly fee with my insurance?
No, and HOPE does not bill insurance. There are health insurance companies recognizing the DPC model of care and developing wrap-around policies. Please consult your health insurance provider. In most cases, you may submit expenses (labs, radiology, etc.) on your own to your insurance company.
Can I use my Health Savings Account or flex spending dollars to pay for the monthly fee?
Not currently, to our understanding. Federal and state laws are changing to accommodate this model of primary care delivery. Please check with qualified tax and healthcare benefit specialists as to what expenses can be paid through your HSA.
Can I be a Direct Primary Care Patient even if I do not have health insurance?
Yes, but we encourage everyone to have health insurance (or a health sharing plan) to cover large medical expenses outside of the scope of primary care. If you have a high deductible health insurance plan or no insurance, we can often save you a lot of money. The reduced cost from lab tests and imaging services can save you more than our fees for an entire year!
I only go to the doctor once per year, why should I join?
We might ask, “Why do you only go to the doctor once per year?” This model provides a relationship with a doctor to work to keep you healthy. Also, many conditions, when diagnosed and treated early, can greatly reduce the negative effects on your health and reduce the cost of treatment and/or cure.
Does Hendricks County need another doctor’s office?
Recent county data shows Hendricks County to have a higher ration of population to primary care providers (1749:1) than the overall ration of state of Indiana (1518:1). There approximately 19,000 adults in the Hendricks County (and HOPE serves patients residing outside of Hendricks County) between the ages of 18 and 65 that do not have health insurance (2014 data). This model allows us to serve both those community residents with and without health insurance in greater numbers.
Do I need to be a Christian or a member of a church to become a Direct Primary Care Patient at HOPE?
No, the clinic is open to anyone of any faith, or no faith.
How much are the monthly fees?
- Age 19-25 – $25
- Ages 26-45 – $35
- Ages 46-64 – $40
- Age >=65 – $50
- Dependent children ages 2-18 – $20 for first child; $15 for each additional child
- Family max rate is capped at $120
Are there other fees?
- A one-time enrollment fee of $99 is due with the completed application.
- A per visit fee of $20
- Lab and imaging service fees are billed separately (at significant discounts)
- A re-enrollment fee of $200 is charged for patients who discontinue their subscription and wish to re-apply.
What about dental services?
Dental services will remain only available to those without health insurance of any kind, and will be performed by licensed dental professionals volunteering their time.
Enrollmentone-time fee due with completed application
Per Visiteach patient visit
Re-enrollmentpatients who discontinue and wish to re-apply
Lab/Imagingbilled separately @ significant discounts
Learn More About Direct Primary Care
Contact us by phone or email to learn more about Direct Primary Care
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