Question 1

What is Direct Primary Care?

Accepted Answer

Direct Primary Care (DPC) is a healthcare model that allows our physicians to offer their services directly to patients without the hassle of an insurance middleman. By eliminating complicated insurance billing, we can offer our patients more personalized care and attention with a range of primary and chronic care services — all for a flat monthly fee.

Question 2

What makes Health Matters DPC different?

Accepted Answer

At Health Matters DPC, your health matters to us just as much as our own. We know excellent medical care takes time to deliver properly. So, we provide our patients with minimal wait times and up to one-hour appointments to cover their needs. Unlike other clinics, we offer same and next-day appointments and direct contact with your physician via email, text, and phone to fully understand results, procedures, and next steps.

We do this by seeing fewer patients. In a fee-for-service or health maintenance organization (HMO) model, a doctor sees anywhere from 1,500 to 3,000 or even more patients. At Health Matters DPC, we care for a much smaller number of patients, allowing us the flexibility to provide a service we are proud of and spend more one-on-one time with you. You will feel the difference right away.

Question 3

This sounds too good to be true. How can you charge so little for so much access?

Accepted Answer

This is one of the most frequently asked questions we get when we discuss our practice with others! The answer is surprising, but simple: using health insurance for primary care inflates the cost of your care! You wouldn't ask the gas station or your mechanic if they take your car insurance for routine maintenance. If you did, things would be way more complicated and expensive. By eliminating the insurance companies from the process, we have also eliminated a large portion of the costs of running a clinic, including paying for expensive records and billing systems as well as the staff to perform these tasks. And more importantly, we have taken these other entities out of the conversation - now we get to focus on what matters: you and your health.

Question 4

Do you provide mental health services?

Accepted Answer

Like all primary care physicians, we definitely treat common mental health concerns including depression and anxiety. Dr. Anand specifically has obtained more training in this field and is comfortable providing care for more complicated presentations of these illnesses.

Question 5

Do you provide pediatric care?

Accepted Answer

Yes! At this time, we see children  starting at age 7. The main reason for this is we do not have capacity to provide immunizations which are an important part of routine care for children from birth to 6 years of age.

Question 6

Do you provide weight loss management?

Accepted Answer

Yes! We provide treatment for weight loss, with or without medication as medically appropriate. We are happy to discuss what options exist for you through your insurance or out-of-pocket, based on your personal situation.

Question 7

Is this an insurance plan? Do I still need health insurance?

Accepted Answer

Health Matters DPC is not an insurance plan. We absolutely recommend that everyone carry insurance to cover the unexpected such as emergency department evaluation, hospitalization, or surgery. Various insurance plans are available; the best one will depend on your and your family’s unique needs. Since the majority of your needs can likely be managed through our practice, you may wish to consider a lower-cost, high-deductible health plan to save money while maintaining coverage for the unexpected. However, even with a top-tier insurance plan, most patients can still save money by seeing a DPC physician.

Question 8

Can I pay for your services using my FSA or HSA plan?

Accepted Answer

You can pay for our services using an FSA plan. Paying for services using an HSA plan may be possible. However, you should verify with your benefits representative and your accountant.

Question 9

Do you take my insurance?

Accepted Answer

We are proud to say that we can serve any patient regardless of their insurance coverage. HMO, PPO, Medicare, Medicaid, it’s fine. We just won’t be billing your insurance. Instead, we cover a range of care within our flat monthly memberships. This means no copays, no deductibles, and no surprise bills for our patients. For more information, please refer to this blog post.

Question 10

Do you accept Medicare?

Accepted Answer

While we will not be billing your Medicare insurance for our services, you may be able to use your benefits to cover prescriptions and other health costs throughout the year. This is entirely up to you, and it may be the case that simply paying cash is cheaper than using your insurance for many things.

Question 11

Do you accept Medi-Cal?

Accepted Answer

We see any patient regardless of what insurance they have, or even whether they have insurance or not. We just do not bill insurance for our services. You can choose to use your insurance to pay for services we order or refer you for (like labs, imaging, medications, and seeing specialists). For many of these, however, you may find it cheaper to simply pay cash. We will ALWAYS be transparent about how much a service is likely to cost; we are passionate about avoiding hidden or unexpected fees.

Question 12

What if I have an HMO?

Accepted Answer

We can still work with you if you have an HMO insurance plan. Our patients who have HMO plans are happy to work with physicians who can take the time they need to discuss their health.

Though in some cases we may not be able to order services (like imaging, labs, or referrals) to be provided within your HMO system, we are happy to provide details justifying any services we recommend to your HMO provider so they can help expedite your care.

Question 13

What can I use my insurance for?

Accepted Answer

Some of our patients chose to use their insurance to pay for services for which we refer. This includes labs, medications, imaging, and referrals to specialists. We do find frequently that paying cash for many of these services is cheaper. Here are a few examples:

One patient treated with two antibiotics (provided from our office at a very slight markup) for pneumonia paid less than $7 for medications. This was less than the copay for even ONE of these medications.

Another patient needed a CT scan of their sinuses. The cost of their copay was $400 for the imaging, but the cash price was $350.

Yet another patient had annual labs drawn and wished to use their insurance. We quoted $18 for the cost of their labs. Their copay for a lab visit turned out to be $70 - for the same labs.

Finally, a patient with osteoarthritis in their knee received a corticosteroid ("cortisol") injection. The only extra cost was the $4 for the steroid. The visit and the procedure itself (which can run in the hundreds of dollars when done in a specialist's office) were provided at no extra cost.

While paying cash for services may not always be cheaper than using insurance, it definitely can be. We are committed to transparent discussions about the cost of services to help you make the right decision, medically and financially.

Question 14

What happens if I need a specialist?

Accepted Answer

One of the best things about our style of practice is we have the time to be real doctors - not simply a referral mill. In the event that we feel you would be best served seeing a specialist, we are more than happy to help you find one and provide the information they need to continue your care.

Question 15

What happens if my condition requires hospitalization? Will you manage my care during my hospital stay?

Accepted Answer

Our preventative-care model aims to reduce hospital and urgent-care visits as much as possible. If you need to undergo treatment at a hospital, we can assist you through preoperative evaluations and follow-up care. Though we cannot directly manage your care during hospitalization, we may (depending on availability and location) visit you and discuss your care with your managing team. We encourage you to have your team contact us if you are hospitalized so we may discuss any pertinent aspects of your care and provide support.

Question 16

Is it easy to sign up for a membership?

Accepted Answer

Signing up for a membership is easy. If you feel ready to join now, please visit our signup page and we'll contact you once the process is complete!

We do also offer a free 15 minute meet-and-greet appointment for anyone who would like to discuss our services further. You can simply click here to schedule that with either Dr. Anand or Dr. Heikens.

We love doing these meet-and-greets and can't wait to see how we can help!

Question 17

Do you provide urgent care services?

Accepted Answer

We provide urgent care-style services to current members of our practice. Treatment typically starts with you calling to discuss what's happening, and if an office visit is recommended we will arrange it. This would include things like urinary tract infections, respiratory infections, and physical injuries, among others.

We cannot provide such services to patients who have not yet joined our practice, as our practice style is based upon knowing you as a patient before anything like this occurs.

Question 18

Can I see you without a membership?

Accepted Answer

Direct primary care is all about developing a relationship between you and your doctor. We can only see patients who are enrolled in our practice.

Question 19

Do you offer memberships for college students?

Accepted Answer

In addition to our standard memberships, we offer customized plans for enrolled college students. These discounted plans work in tandem with patients’ doctors back home, and our team is here to ensure their academic journey is healthy.

Question 20

I’m pretty healthy. Do I really need this?

Accepted Answer

Good health is a blessing and an investment, so keep it up! It is a good idea to still have regular visits with a doctor you know and trust. We can also help with questions you may have via email, text, or over the phone. In addition, urgent situations do come up, and urgent care visit costs can easily add up to more than the annual cost of a membership.

Question 21

What if I decide to cancel my membership?

Accepted Answer

Not a problem. We do ask for 30 days notice so we can help ensure a safe transition to your next physician. If you paid annually, we will refund the prorated remainder.

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