These are some of the mostly commonly asked questions about our practice, the care we provide, and the direct primary care model.
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 don't accept insurance, and – believe it or not – this actually saves you money in the long run.
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.
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. 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.
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.
Here’s a few articles that profile the Direct Primary Care approach to medicine:
See our prices on our pricing page. We charge a flat monthly fee, and in exchange you get unlimited office visits, wholesale prices on prescription medication, your primary care provider's cell phone number, and a whole lot more.
The fee covers excellent 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 primary care provider: 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.
We treat all kinds of common everyday problems like colds, flu, strep, rashes and injuries. We also treat more complicated long term medical problems like diabetes, obesity, high blood pressure, heart conditions, high cholesterol, COPD, emphysema, asthma, thyroid disorder and many other chronic conditions.
For starters, having such unprecedented direct access to your primary care provider will 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. Depending on the level of care and the sorts of expertise required, we may rely on those specialized caregivers to manage your treatment.
Yes. We are happy to accept the children of our enrolled clients. See our pricing page for details.
Of course! This is one of the greatest benefits of the direct primary care model. Because illness and injury do not respect regular office hours, you may call, text, or email whenever you need.
Of course – this sort of care is "baked in" to the DPC model. Because you'll have your provider's email 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. We’ll also locate the nearest pharmacy and order the medications most appropriate for your circumstances.
We maintain high standards of patient privacy. We will never provide your health information to any third party unless you specifically ask that we do so.
Charges will be added and applied to your preferred method of payment.
We expect to have an open, honest, respectful relationship with you. If you have voiced a complaint that we cannot satisfy together, we will gladly allow you to terminate your membership.
Unfortunately, no. Your retainer is not yet defined as a "medical expense" in most states and as such is not deductible. Please confer with your tax consultant to clarify tax consequences in your particular circumstances.
No, fortunately for both you and us. Perhaps the most critical distinction in our model of care centers on a direct, personal relationship between you and your primary care provider. That directness carries over to our business model as well. 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.
We forgo insurance payments in order to save our patients from the arbitrary, intrusive decisions that come with using insurance. Charging a direct monthly fee frees us from the typical contractual agreements that prevent non-DPC physicians 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 such as heart attack, stroke, surgeries etc.
Yes. We recommend our patients continue a major medical plan 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 one-time 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.
As the Affordable Care Act was being drawn up, several doctors worked very diligently to insert into the health reform bill a clause that allows for Direct Primary Care practices like ours to be a legal option under the health reform bill. Once the health exchanges open in October, many people will understand that a Direct Primary Care practice is an approved option.
In short, the best option for many patients will be an “exchange qualified” major medical type plan combined with a Direct Primary Care provider like our practice. This combination will save the maximum amount of money, while also allowing for a maximum amount of health care for patients.
The Direct Primary Care practices have the ability to decrease the cost of insurance by 30-50%, thus eliminating the need for ObamaCare-style regulation because we can make health insurance affordable again.
You may want to check with your human resources department regarding the use of Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) as possible payment options for your membership. If you are unable to use these funds to pay for the membership fee directly, there is a good chance that you can still use your HSA/FSA as reimbursement for certain services provided through our office.
Unfortunately, no. Your retainer is not yet defined as a "medical expense" in most states and as such is not deductible. Please confer with your tax consultant to clarify tax consequences in your particular circumstances.
Send me an email, kamal@gracehealth.com or call/text me at 314-517-3736 or leave a question on our 'Contact Us' page
Are you ready to become a member? Great! We’re excited to have you on board. Just fill out the form to get the ball rolling and we’ll be in touch.
Still want to learn more about direct primary care or our practice? Check out our FAQ page for answers to many common questions.
Get in touch! We’re happy to chat and meet to answer your questions, at no obligation to you.
231 N Main Street
(The Lodge, 2nd Floor, Ste # 17)
Edwardsville, IL 62025
