Can direct primary care save you money?

You bet! Let's go over some common scenarios where a DPC membership can save you money.

• #1 You're taking multiple medications. If you're taking multiple medications and paying with insurance for all of them, your co-pays are probably stacking up. Direct primary care practices frequently dispense common medications directly from their offices, so you won't need to do an extra trip to the pharmacy. Plus, your DPC doctor will purchase these medications at wholesale prices from a free-market vendor like Andameds or Henry Schein, and they pass those savings through to you. Some practices add a small markup (say, 10%), others sell these medications at cost. The value of this service depends on which medications you're taking. Often your insurance provider will only cover a drug from a particular drug manufacturer, or they'll require you to use a brand-name version even though a cheaper generic is on the market. If that's the case you can easily be paying hundreds of dollars a month on medications—money you could save as a DPC member.

• #2 You get injured. If you get in an accident, break a bone, need stitches, or require emergency medical care of any sort, you'll probably go to an urgent care or the emergency room. Going to either of these is a surefire way to drain your pocketbook. In the best base scenario, the urgent care center is in your insurance network and you pay a high co-pay—up to $100 in some cases. But that's only if you're lucky. Insurance coverage of emergency care is spotty at best, and urgent care centers are known to mislead patients regarding the true costs of care. Even if you verify multiple times that your insurance will cover your care, you can still get hit with big bills. Often urgent cares don't know if you're insurance is actually valid, or they'll intentionally mislead you.

  Emergency rooms are even worse: you'll often have to pay a co-pay of $1000 or more just to get seen, PLUS the cost of any additional scans or treatments. There are dozens of horror stories online about unwitting patients who we're financially ruined by insane ER bills they thought we're covered by insurance. One bad day can cost you thousands of dollars—enough to cover years of a DPC membership. As a DPC patient, you know exactly who to call when you need help.

• #3 You're overpaying for insurance. If you're on an insurance plan named after a precious metal, you shouldn't be. Health insurance companies have been over-reaching for years—to read more about this, check out our essay on the healthcare crisis. Even the cheapest health plan your employer offers covers WAY more than it should, so don't get conned out of more money by picking a low-deductible "Platinum" plan.

  As a DPC patient, the majority of your healthcare will be taken care of by your DPC doctor. All standard care, wound treatment, blood work, preventative screens, and physicals will either be included in your membership or provided at a fair price by your doctor. If your DPC doctor isn't equipped to deal with a medical issue, it's probably serious. And if it's serious, then you'll very likely hit your out-of-pocket maximum (OOP). (This OOP is what it sounds like: the maximum amount you can possibly spend on healthcare before your insurance plan starts footing 100$ of the bill.)

  Here's the thing: the OOP for the cheapest and most expensive plans don't vary that much. Aetna's cheapest plan costs roughly $600 per year and has an OOP of $6650. Their most expensive plan costs $4200/year with an OOP of $4000. That means you'd be paying a guaranteed $3600 extra dollars ($4200 - $600) to avoid the small chance of paying an extra $2650 (6650 - 4000) on your healthcare. That doesn't make sense! Unless you're expecting to suffer a major health crisis every 9 months, you'll be better off on a cheaper plan. Otherwise, just join a DPC practice and take the cheapest insurance you can find!

Do none of those scenarios apply to to you? Here's one more:

• #4 You care about your health. Here's the thing: direct primary care is the best game in town when it comes to healthcare. Think of it this way: before DPC, only movie stars and the super-rich were able to afford a personal doctor who works tirelessly to keep them healthy. To keep a personal doctor on staff costs around thousands of dollars per month. The rest of us had to a) wait until we were sick before talking to a doctor, then b) schedule a visit weeks in advance just to c) spend 10 minutes with a doctor we'd never met.

  With DPC, everyone can have a personal doctor on speed dial for a shockingly low amount. Having a medical expert at hand to answer questions, keep track of your preventative screenings, advise on your diet and lifestyle, and actually care about your happiness was simply not possible before. Now it is. By splitting hairs over tens of dollars per month, you're missing out on the best deal in healthcare.

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