Major Medical Solutions
You can save money AND receive care that ranks in the 95th percentile nationally!
Financial Assistance + DPC
State-law-incentivized financial assistance has led to some robust patient assistance / charity programs that are more inclusive than you may think. Individuals and family members who make less than 500%… that’s right… 500%… the Federal Poverty Level can qualify for 70% discounts on hospital, ER, advanced imaging, and specialist care. To put that in perspective, 75% of the Spokane population would qualify for at least a 70% discount according to the 2020 Census.
Those who make less than 300% the Federal Poverty Level qualify for a 100% discount on hospital, ER, advanced imaging, and specialist – about 30% of Spokanites! Throw in a few other benevolent local programs and screenings for mammography and cervical cancer can also be covered in full!
These assistance programs do come with coverage limitations and application requirements. For example, ambulance rides and anesthesiology are not covered. You have to go to locally selected ERs, hospitals, and specialist to get the amazing discounts – you can’t go to just any provider. Additionally, you must re-submit your financial status to these programs every 180 days.
The good news is, you don’t have to navigate these financial waters alone. Direct Primary Care’s SPOCARE membership allows us to partner with you in ensuring you cross your “T”s and dot your “I”s. We’ll help you understand what is and isn’t covered, and utilize assistance when appropriate and cost effective. Side note – you can still have non-state health insurance or cost-sharing and still qualify for many of these benefits!
Learn more about DPC’s SPOCARE Membership and qualification criteria for the financial assistance
Review Other DPC Pairing Options Below
Cost Sharing + DPC
Direct Primary Care (DPC) can help manage and care for 70-90% of the care most individuals will need in their lifetime. However, what if something catastrophic occurs? What if someone needs to utilize the ER? What if someone needs a major surgery? These are services that are not offered within the DPC membership and thus members could be vulnerable to large ER, hospital, and surgical bills. In light of this vulnerability, DPC has found a potential solution that pairs well with a DPC membership.
The major medical solution is called a COST SHARING MINISTRY. Fundamentally, these are a group of people nationally that believe in God and have agreed to share one another’s medical bills. Their monthly membership costs are typically 20-60% less than traditional insurance, you can sign up at any time (don’t have to wait for open enrollment), and a member’s out of pocket responsibilities for major medical expenses can be less than most insurance deductibles.
To be clear, these ministires are NOT HEALTH INSURANCE and, therefore, they don’t have to abide by Affordable Care Act laws such as guaranteeing coverage, accepting pre-existing conditions, and covering preventative care. Because of their terms, anyone on a brand name medication or someone who needs frequent specialty care may not be able to share these medical expenses among the group.
Additionally, many people who belong to a cost sharing ministry prefer to know that their monthly payments are going to other members in need and not to overpaid administrators or services that they may ethically object to. (~9% administrative fee versus a 20% administrative fee of a typical health insurance plan)*.
For anyone that doesn’t have active pre-existing conditions, or ones that can be managed by a primary care provider, cost sharing ministires can be a very reasonable alternative to health insurance.
**DPC has no financial ties with any cost sharing ministries**
Learn more about how Cost Sharing Ministries work and how it has benefited others by watching the videos below.
Review Other DPC Pairing Options Below
High Deductible Health Plan + DPC
High Deductible Health Plans (HDHP) help an individual save money on their monthly premium at the cost of having a higher out of pocket responsibility. Unfortunately, most expenses accrued in the year (outside of one preventative exam) will “go towards the deductible” meaning the insured person will pay out of pocket for those services. Most of the time a person utilizes the healthcare system for an office visit, labs, imaging, prescriptions, surgeries, you name it, there is a large out of pocket cost. So, let’s face it, a qualified HDHP with a $5,000 – $6,500+ deductible IS CATASTROPHIC HEALTH COVERAGE.
Those with HDHP tend to avoid seeking proper medical care and treatment because they are vulnerable to out of pocket costs and, due to the lack of price transparency, most consumers won’t know the cost of services until they are billed months later. There is a better way.
A membership with Direct Primary Care (DPC) helps individuals keep their out of pocket costs low. While the addition of a monthly membership fee with DPC appears to be increasing the HDHP owner’s out of pocket expenses, the result of adding DPC is about a 30% decrease in out of pocket expenses annually.
With DPC, there are NO CO_PAYMENTS OR DEDUCTIBLES. All care within DPC is provided within the monthly membership fee.
DPC never bills insurance for our services in clinic. Need an EKG? No extra cost. Sutures for an open wound? No extra cost. Strep test for a sore throat? No extra cost.
Members also get the option to take advantage of DPC’s discounts. Most often our discounted rates are much cheaper than billing insurance and paying toward a deductible. Our out of house labs are 85% less than insurance billed pricing, we dispense generic meds in house for 80-90% off retail pharmacy pricing, and xray imaging is 50% off insurance based pricing.
Direct Primary Care help members navigate the healthcare system in a fiscally intelligent way in order save costs and utilize their HDHP appropriately. Does it make sense to get an MRI on your spine in December, bill it to your insurance, and pay $3,300 because of an unmet deductible? Or, should a member pay a cash pay price of $800, don’t bill insurance, fully knowing your deductible is going to reset January 1st irregardless?
Direct Primary Care is TRULY PATIENT-CENTERED. Not only are we advocating for our patients health and well-being, we are also advocating for their financial health and well-being by helping our members navigate an often confusing medical system in a fiscally responsible manner.
**You cannot sign up for a HDHP through DPC, however, we can get in touch with a licensed health insurance agent who can**
Contact DPC directly to learn how Health Savings Accounts (HSA) can be used for most DPC expenses.