Frequently Asked Questions
How is DPC different than Concierge medicine?
While both DPC and concierge practices charge membership fees, there are two big differences between the models.
First, DPC practices charge a much lower membership fee than concierge—typically $49-99/mo for an individual adult. Concierge practices can charge several hundred or even several thousand dollars a month because they typcially target high net worth individuals.
Second, concierge practices bill insurance and still operate in a fee-for-service model. DPC practices do not bill insurance for their members. However, hybrid DPC practices may still bill insurance for their non-DPC patients.
Do patients need insurance if they have DPC?
Yes. But not for the ~80% of annual healthcare needs covered by primary and preventative care. Patients should carry health insurance for protection against big expenses from unpredictable major medical events, like surgeries, cancer, car accidents, etc.
Many DPC docs recommend pairing a DPC membership with a high-deductible health plan or a medical cost sharing product, like those offered by Sedera and Zion.
Disruptors to the insurance market, like Decent, offer high-quality insurance that is designed to pair with a DPC membership.
What services are typically included in a DPC membership?
It's up to you. DPC gives doctors a new lease on practicing medicine, free from the constraints of the fee-for-service system. For patients, DPC promises more value, better doctoring, and an overall higher-quality patient experience than what fee-for-service can offer.
DPC practices typically include a far more comprehensive range of services in their membership plans than what you'd find in a fee-for-service practice. For example, it's common for DPCs to include 24/7 telemedicine, in-house dispense of generic drugs, x-rays, and basic labs in a monthly membership fee. Other practices include nutritionists, dermatology, and mental health services. Practices often offer additional services for modest cash pay prices.
For services not included in the membership fee and not offered on-site, like advanced imaging or surgery, DPCs usually offer members deeply discounted rates, which they've negotiated with a local network of labs, imaging centers, specialists, and other downstream providers.
A DPC practice might also offer OB/GYN, laceration treatment, casts, wart removals, weight loss management, and a host of other services. What services you offer are up to you.
What can I expect my panel to look like if I go into DPC?
Like most things in DPC, the makeup of patient panels is something that doctors decide for themselves. Most have a mix of patient profiles, but some panels are heavy on the uninsured, and some focus on seniors, while others prefer serving families with young children, and still others only serve the employees of local businesses. It’s completely up to you.
How do patients get labs, prescriptions, inpatient services and other things I can't provide?
Many DPC practices choose to include basic labs and generic drugs as part of their memberships. For things like surgery or specialists visits, doctors will negotiate cash-pay arrangements with local providers or help patients find the best combination of services and pricing for the treatment they need.
Still, it's recommended that DPC members carry medical insurance that covers catastrophic and major medical expenses as well as non-generic drugs.
