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Direct Primary Care - Ever Tried It?

AlaskanAssassin

Well-Known Member
I've been fascinated with the concept of direct primary care since I first heard about it, as an alternative to getting incredibly expensive insurance through my employer. A Direct Primary Care office opened up recently near my home, and I'm considering getting registered there. It's $150/month for my family. Looking at what this subscription provides, it basically covers everything that my family has needed care for over the last decade.........at a fraction of the cost. I'd probably need to get private catastrophic care insurance as well, but even with that, I think I'm coming out miles ahead of where I would be going through my employer. Has anyone tried something like this before? Video below is about a practice in Florida that does this.

 
This is the first I've heard of it. I'd have to look into it a bit but it sounds pretty awesome.
 
This is the first I've heard of it. I'd have to look into it a bit but it sounds pretty awesome.
Sounds like its growing in popularity. I currently have an HSA, and from my research so far, you can't use HSA (pre tax witholdings) to pay for this service. Maybe I'm misinterpreting it though. Would be nice to use HSA money for this.

I'm so annoyed with getting nickel and dimed every time my kid gets sick, needs a checkup, or other small things. My insurance deductible is so high that I end up paying for all of this out of pocket anyways.
 
I used to know some people (20 years ago) that opted out of insurance and instead set up a separate bank account. Every month they would deposit what they had been paying in premiums into that bank account. Then they would pay cash for their medical needs. Well child visit? Doctor bills insurance like $200, but if you offer to pay cash, they’ll do it for like $80. Its a huge gamble on staying healthy, and takes a lot of discipline, but they were making it work.
 
I used to know some people (20 years ago) that opted out of insurance and instead set up a separate bank account. Every month they would deposit what they had been paying in premiums into that bank account. Then they would pay cash for their medical needs. Well child visit? Doctor bills insurance like $200, but if you offer to pay cash, they’ll do it for like $80. Its a huge gamble on staying healthy, and takes a lot of discipline, but they were making it work.
Insurance usually cuts that bill way pay with payment agreements. It's a big game they play.
 
Insurance usually cuts that bill way pay with payment agreements. It's a big game they play.

I know about the insurance payment agreements. If you can put 800-900 a month into savings, and only even half that on medical bills, you’re coming out ahead. Obviously it’s a big risk. Anything catastrophic and you lose big. This family had done it for years and claimed to be way ahead. Obviously I don’t know for a fact. I know they had a kid while doing this and paid for it all.


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I used to know some people (20 years ago) that opted out of insurance and instead set up a separate bank account. Every month they would deposit what they had been paying in premiums into that bank account. Then they would pay cash for their medical needs. Well child visit? Doctor bills insurance like $200, but if you offer to pay cash, they’ll do it for like $80. Its a huge gamble on staying healthy, and takes a lot of discipline, but they were making it work.
Not the craziest idea until you get cancer. Then I guess you could just buy insurance at that point. We spend about 8k a year on insurance premiums. We probably go to the doctor once a year for pretty minor things. Usually just a quick instacare visit. So I imagine we'd be up about $7,500 a year doing that.
 
Insurance usually cuts that bill way pay with payment agreements. It's a big game they play.
So true. One of the biggest issues I have with healthcare in the US is price transparency. It's such a joke.
A couple years ago I asked the Doctor (possibly a PA) how much something would cost. He looked at me like I was insane for asking how much something costs......almost like he was offended. Meanwhile I'm staring back at him befuddled that he or someone on his staff can't answer the question.
 
So true. One of the biggest issues I have with healthcare in the US is price transparency. It's such a joke.
A couple years ago I asked the Doctor (possibly a PA) how much something would cost. He looked at me like I was insane for asking how much something costs......almost like he was offended. Meanwhile I'm staring back at him befuddled that he or someone on his staff can't answer the question.
The problem, partly, is that the answer to that question is: it depends. Prices are so fluid and friends entirely on which insurance you have, what plan with that insurance, if you are paying out of pocket it even varies depending on many factors. It's not like there is a 3 level price guide or anything, like 1) out of pocket 2) basic insurance 3) premium insurance.

I know we have some doctors on the forum who could talk to this better than me, but my second hand info comes from a good friend who is a doctor in phoenix.
 
I know we have some doctors on the forum who could talk to this better than me, but my second hand info comes from a good friend who is a doctor in phoenix.
At hospitals and the larger practices, the doctors don't have a clue how much the facility gets paid, and it's probably better that way.
 
At hospitals and the larger practices, the doctors don't have a clue how much the facility gets paid, and it's probably better that way.
Yeah my friend has been on a rollercoaster through his medical career. He started as a single family practitioner/gastro kind of thing. Then he couldn't compete with the big "corporate" medical groups on insurance negotiation and the like, so he joined one. He made more money but he said it felt like the episode of I Love Lucy where she is in the candy factory with the conveyor belt from hell. He said he once had 50 patients scheduled in one day because another doctor was sick so he was expected to cover both of their patient loads. He finally had enough of that and recently re-opened his private practice, but this time he is part of a coop kind of thing with about another 10 other doctors where they negotiate together with the insurance companies. It allows him the flexibility to work with people who otherwise really couldn't afford care while still maintaining his income and having control over who he sees and when.

Another huge problem is we are severely understaffed with doctors, mainly family practitioners, pretty much nationwide. We have the highest patient to doctor ratio in America among developed nations and it isn't even close. This make it a much heavier load than it should be on doctors, and makes it harder for patients to get into their doctor.

We are lucky here to be part of a medical group that allows their doctors more control over their schedules and who they see and when, and how many patients in a day, etc. So my doctor can squeeze you in fairly easily when needed. But even then to schedule a regular appointment she is 6 weeks out. But here in SoCal that is nothing, many people talk about 3-6 month wait times to get into their doctor for just a standard visit. As a result, urgent-care facilities are over-taxed as well. I went to urgent care a few weeks ago due to increasing pain from my past surgeries (I sneezed and lost use of my left arm for about 10 minutes, while a severe electrical shock/fire kind of pain literally brought me to my knees). When I got there, the waiting room was completely full. On a Tuesday afternoon at about 2 pm. I finally got to see a doctor at 6 pm, and he was obviously frazzled. He actually said, under his breath, something like "finally a case that actually needs urgent care", largely because I imagine a lot of these people are here because they have something minor but cannot get into their own doctor for months.

Our health care system is so broken it isn't even funny.
 
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