Direct Primary Care

Direct Primary Care

Direct Primary Care is a better way to provide for basic healthcare needs. Direct Primary Care is a move to the past and a concept gaining rapidly in popularity because it can address the majority of primary care needs while dramatically reducing the cost of healthcare for individuals, families, and businesses. Patients begin by signing a membership agreement. (See Kaysville Clinic Direct Care Contract.) An initial registration fee of $75 applies. (Fee waived for current patients.)  Your bank account will be debited on the first day of each month as follows:

Membership fee structure for Direct Primary Care

0-17   Years             $29/mo*

18-65 Years            $49/mo

65 and older             $69/mo

*Must have at least one full paying adult membership.

Additional family members starting with the 6th are free.

(Fees subject to change without notice.)

For a family of five the initial registration fee would come to $375. This is a one time fee. The monthly membership comes to $243 or $2916 for a full year. Visit fees of course are additional, but at $10 per visit you will pay less than most insurance copays. No insurance hassles or exclusions. Where else can you find this kind of primary care coverage? The answer is nowhere. Typical insurance coverage for a family of 5 now exceeds $1500 monthly and growing.

If this hypothetical family selected a high deductible, catastrophic plan and paired it with the above Direct Primary Careoption and an HSA, it could still save several hundred dollars monthly. Ongoing coverage for additional years would not include the $75 registration fee resulting in $375 in reduced costs in future years. Also remember that the registration fee is waived for current patients. It may be possible under Obamacare for businesses to offer this to their employees to satisfy the employer mandate.

Routine office visits are arranged in blocks of 15 minutes. The fee is simply $10 for each 15 minute block of time. If a member wishes to be seen for a whole hour the charge would be $40. Minor surgeries and procedures are $20 per 15 minute block. The increased cost is to cover surgical supplies. This is vastly cheaper than traditional insurance. The start date for the new practice is set for April 1, 2014. Additional information can be found under Frequently Asked Questions.

Kaysville Clinic will continue to accept insurance for those patients who are established. If you have a high deductible plan you may want to seriously consider becoming a member of the Direct Primary Care plan. Just a few visits to the emergency room may cost you more than a full year’s membership. If you are a cash paying patient you may also want to consider Direct Primary Care as the monthly membership fee is less than a single cash pay office visit.

Kaysville Clinic will be capping the Direct Primary Care plan to the first 1000 registered patients. This limited volume will allow the clinic to provide better access and better care. Additional benefits will include a patient portal which will allow patients to make their own appointments and access their own records and lab results. As a member of Direct Primary Care, patients may also have access to Dr. Kamalu who may conduct a patient portal visit in lieu of a face to face office visit at just $10 per visit.

To register for Direct Primary Care, click and print the following forms. Unfortunately, we do not offer Direct Primary Care to our Suboxone patients at this time. Read each form thoroughly, sign and date, then bring signed contracts to our clinic and we will formally register you as a member of the Kaysville Clinic Direct Primary Care.

Direct Primary Care FAQ

Direct Primary Care Frequently Asked Questions

Memberships

Why charge membership fees?

The membership fee allows us to provide additional services without charging for every little thing we do.
More importantly,  it provides members with low prices for visits and other services provided at or near cost.

What is the purpose of the registration fee?

We need to appropriately identify, inform and consent each member regarding their Direct Primary Care benefits.
This consumes time.  Additionally it serves as a deterrent to “gaming” the system by joining and then immediately
after services are provided requesting cancellation and reimbursement of fees.  In order to reinstate a membership
once a refund has taken place a patient would need to repay the registration fee.

Do I need to be a member to be seen in the clinic?

No.  The clinic continues to maintain a self pay schedule and continues to bill for insurance at this time.

Isn’t it cheaper for me to just pay for each visit rather than for a monthly membership I might not use?

Maybe,  as long as you are completely healthy, never have an injury, never have wellness visits and never have any
questions about your health.  Remember that the monthly membership fee is less than the cost of a single self­pay visit.

What if I decide to cancel my membership?

Members may cancel at any time.  Cancellations will take effect on the first day of the following month after the request is made.

How is this different from Concierge Medicine?

Concierge medicine tends to have higher fees and cater to a wealthier population.  Their services tend toward a
significantly higher portion of the physician’s time.  Direct Primary Care is an attempt to make the concept of Concierge
Medicine more available to the average patient. Fees are lower and more affordable.

What about pre­existing conditions?

Kaysville Clinic does not discriminate members on the basis of pre­existing conditions.  All patients are treated equally in that respect.

Fees

Are there any hidden fees?

No.  Our prices are simple, upfront and available online.  We negotiate discounted fees with outside labs for your benefit.

What about lab work and other testing?

We have negotiated discounts with other labs and imaging centers and pass those along to you.

When and how do I pay my fees?

Membership fees are automatically deducted monthly from your checking account, saving account, or debit card.
Patients are able to pay cash as well through arrangements with our billing office. We expect visit fees to be paid at the time of service.

Insurance

What if the government creates universal health insurance

Government provided universal health insurance will never come close to offering the same benefits.
Additionally, Direct Primary Care Medical Homes are included in the new Patient Protection and Affordability
Act (Obamacare).  When combined with wraparound major­medical insurance plans, Direct Primary Care will
actually compete with higher­ priced traditional insurance plans. This will offer consumers an affordable, competitive option.

HSA FAQ

Using a health savings account to supplement your current health insurance coverage is a great way
to save money on your health care costs. Along with saving money on your health care costs, your
HSA can get your money working for you by earning interest. And, you can save your HSA money
tax­free.

Top 10 Health Savings Account, HSA Frequently Asked Questions:

1. How do I start a HSA?
First, you have to have a qualifying health insurance plan. A qualifying
health insurance plan is one that carries a high  deductible . Each year what is considered a
high­deductible health insurance plan changes, but generally it would be a deductible that is not
considered in the normal range for a health insurance plan. If you think you have a
high­deductible health insurance plan then you can contact your employer, health insurance
company, or a number of privately insured banks and credit unions locally or online to find out
about setting up a HSA. Sometimes employers help contribute to HSAs so make sure to see if
yours does.

2. What if I switch jobs, do I lose my money?
No. The health savings account is yours.
Whatever money you contribute to your HSA you keep, just as you would in a savings account.
Even if you don’t use all your HSA money in one given year, the money will just roll­over to the
next year for use.

3. Do I pay taxes on the money before it is put into my health savings account?
No, the  money goes into your HSA account tax­free if your employer will set­up paycheck deductions for
you. If not, then when you prepare your federal income taxes you will be able to take a deduction
for the money you contributed to your HSA that year. When you withdraw your health savings
account money to pay for any qualifying expenses, it is withdrawn tax­free.

4. Can I have some examples of HSA qualifying expenses?
Here are some examples of HSA qualifying expenses: prescription medicines and eye glasses, office
visit co­pays, chiropractors, dentists, orthodontists, over­the­counter meds such as aspirin and antacids,
birth­control (over­the­counter or prescription), and laser eye surgery to name a few. There are many more
things that you can use your money for so when you get a HSA plan, you will need to ask for a list
of covered expenses.

5. What happens if I  lose my health insurance?
Once you have money in your HSA, you can continue to use it even if you do not have a high­ deductible
health insurance plan anymore, but you cannot keep contributing money to your health savings account.

6. Can I use my HSA money to pay for my health insurance premiums?
You can use your HSA money to pay for your health insurance premiums while you are collecting federal
or state unemployment benefits. You can also use your HSA money to pay for  COBRA  premiums.

7. What if I need  medical care in another country … can I use my HSA money there?
Yes, your HSA money can be used for the same medical expenses anywhere and in another country.

8. How much can I contribute to my HSA account?
That changes yearly but as of 2007 a single person could contribute up to $2,850 per year and a family
could contribute up to $5,650 per year.

9. Can my HSA money be invested?
Yes. Your health savings account money can be invested similar to a 401K.

10. When I die, do I lose my HSA money?
No. You can name a beneficiary to receive your health savings account money.

2017 Kaysville Clinic