11/19/2025
💥 You know it! Myth #5 BUSTED ...
❎ Some people think DPC clinics are like traditional fee-for-service, insurance-centered clinics except YOU have to do the work collecting payment from insurance.
✅ DPC is actually a very simple idea. One monthly membership fee = unlimited primary care. No office fees. No hidden bills. Nothing to send through a traditional fee-for-service, insurance-centered system for you (or the clinic).
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This myth makes DPC feel very complicated. 😫😫😫 If doctors & hospitals hire teams of people to understand insurance billing, why would we expect you, the patient, to feel comfortable doing that?? Instead, DPC is trying to SIMPLIFY primary care.
The fact that DPC is a new concept to most people makes it feel complicated. BUT.... once you understand DPC, then traditional, fee-for-service, insurance-centered primary care will be what actually seems crazy complicated!
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** Side Note: 🤔🤔🤔 The "what if??" insurance question...
"What if" my insurance pays for everything (e.g. Medicare), and I want to take advantage of that benefit?
- Zero is ZERO whether it's Medicare, or you, paying for the office visit. Annual wellness visit = $0. Diabetes follow up = $0. 1-hour lifestyle-based weight loss consult = $0. Sinus infection = $0. ... you get the idea.
- But the membership fee?? A DPC membership fee is predictable & proactive. The insurance industry is designed for unpredictable & reactive. Therefore, insurance is simply not designed to pay membership fees. Instead, they ARE designed to help with the unexpected ER visit or hospitalization.
- What about the "extras" like - Labs, Imaging, Medications, and specialist consults?? DPC doctors order these things wherever patients want - like a traditional clinic. Those third party facilities (e.g. a pharmacy) can bill you/insurance at the rates they have negotiated with your insurance. Or, we also have negotiated rates with a lab company, imaging company, and wholesale pharmacy so you can choose those instead. You choose!
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