Frequently Asked Questions

It's perfectly normal to have many questions about Direct Primary Care (DPC), as it is a relatively new model within the healthcare system. However, it is rapidly gaining popularity nationwide due to its simplicity, accessibility, affordability, and transparency.

If the information provided below does not address your concerns, or if you have specific questions about how Four Mile Creek Health can support your healthcare goals, please do not hesitate to contact us!

Direct Primary Care

Direct Primary Care (DPC) is a healthcare model where patients pay their primary care provider directly through a membership or subscription fee, bypassing traditional insurance billing.

This model allows for a more personalized and accessible experience, with benefits like longer appointment times, more direct communication, and reduced administrative overhead. Patients pay a fixed monthly fee, which covers most primary care services, helping to eliminate co-pays and deductibles while providing predictable costs and a focus on preventive and comprehensive care.

  • Greater access: In traditional primary care, patients often delay addressing medical questions and health concerns due to the challenges and costs associated with scheduling a doctor’s visit. This can result in less effective healthcare overall. With no additional fees for doctor visits, you are more likely to seek care promptly, ask more questions, schedule follow-up appointments, and focus on preventive care.
  • More Flexible Access: Pay-per-visit models often require patients to come into the office for every issue, limiting convenience. With a membership, you gain more flexible access to your doctor, whether through texting, telemedicine visits from home, or getting care while on vacation. This increased accessibility promotes better overall health.
  • Impartial advice: the direct primary care model frees doctors from the constraints of insurance, allowing us to provide truly patient-centered care. In traditional healthcare, advice can often be influenced by what insurance will cover, which limits treatment options. In our model, you receive unbiased advice tailored to your unique needs without the restrictions imposed by insurance, allowing you to decide with price transparency how to best care for yourself. This approach fosters deeper doctor-patient relationships and empowers us to focus on delivering the best possible care.

In the Direct Primary Care model, our doctors do not bill insurance for their services, and the membership fee is not covered by insurance.

This is a key factor in making DPC work effectively. By removing insurance from routine healthcare, we can lower costs, spend more time with patients, and focus on providing personalized care that truly benefits you.

We strongly recommend maintaining your insurance and you can still use it for things like lab work, referrals, and imaging. However, many patients find that paying out-of-pocket, non-insurance cash prices for these services is more affordable than using their insurance.

For those who rarely meet their insurance deductible, our DPC model can save you money by reducing out-of-pocket expenses. While insurance is valuable for protecting against major medical expenses, we recommend using it for significant health events—similar to how you wouldn’t use car insurance for routine maintenance like an oil change.

As a member of Four Mile Creek Health, you have unrestricted access to your personal physician. Whether you have a quick question or need a more detailed visit, there are no additional charges for services provided by the physician.

Furthermore, members are able to take advantage of on-site testing services, whole-sale priced medications, and negotiated rates for off-site testing and imagining.

A Seca Body Composition Analyzer is free to all members (Seca Body Composition Testing). This device can help with monitoring progress and helping get the most out of your primary care.

Four Mile Creek Health is dedicated to following the direct primary care mantra of full price transparency. Prior to any service or transaction that you are not using insurance for, the physician will go over the costs.

The costs will only be the wholesale costs of the medications dispensed or the materials used in any testing.

Because there are no additional costs imparted to the patient for these medications, products, or materials, members of Four Mile Creek Health can rest assured there are no incentives to prescribing unnecessary testing or services. The health of our patients is paramount and is the one and only priority in our minds.

It is very important to us that you feel comfortable working with us. The best outcomes occur when patients and doctors have open and honest communication. That being said, the best way to determine rapport is by contacting us and having a 15 minute conversation about your goals and how we can help you accomplish those goals.

Contact Us

Though we would be sad to see you go, membership voluntary and you are free to cancel your membership at any time. Please try to give us 30 days notice to close out your account. For monthly memberships, we will just stop payments. For semi-annual and annual memberships, we will refund the prorated amount as soon as possible.

Membership

Medicaid or Medicare

We have a limited number of Medicaid patients and are maintaining a wait list for Medicaid patients, at this time.

Yes, we do take Medicare patients!

At our direct primary care clinic, we strive to provide clear and transparent healthcare. Your monthly subscription fee is designed for services beyond what traditional Medicare covers but cannot be used for services that Medicare does cover. This includes:

  • cutting-edge health interventions like longevity-focused treatments, senolytics, and lifestyle medicine designed to optimize your overall well-being
  • advanced cancer screening options such as cell-free DNA testing
  • tools like the InBody scanner for comprehensive metabolic health assessments
  • personalized nutrition advice
  • weight loss medications
  • continuous glucose monitoring (CGM) prescriptions

This approach ensures you receive a more proactive and holistic level of care tailored to your specific health needs.

No, you do not need an additional primary care doctor. Dr. Fagan can be your primary care doctor with standard Medicare! However, she does not participate in any Medicare Advantage plans. Please reach out if you have questions about this and would like more information.

Dr. Fagan can provide standard Medicare services including regular check-ins, routine services and screenings that are covered under your plan, such as annual wellness visits, vaccinations, and other preventive measures.

Yes

Here’s how it works:

  1. Labs and Imaging Providers: When a DPC doctor orders labs or imaging, the patient can go to a lab or imaging center to have these services performed. These providers can bill Medicare directly for the services, assuming they participate in Medicare.
  2. Billing: As long as the lab or imaging center is a Medicare-participating provider, they can submit the claims to Medicare for reimbursement.
  3. Out-of-Pocket Costs: The patient may still have co-pays, deductibles, or other out-of-pocket costs as determined by Medicare rules, but the services themselves are generally covered by Medicare if they are deemed medically necessary.

Yes, we would be more than happy to discuss your concerns and see if Four Mile Creek Health would be a good fit for you.

We would suggest a 15 minute phone consultation at your convenience. Please contact us at info@fourmilecreekhealth.com

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Become a Premier Member

No commitment or payment necessary to register. Membership fees will only start after your first visit.