Can Direct Primary Care Benefit Seniors?

Despite having Medicare, traditional health insurance, or, in some cases, both, many American seniors say that rising health costs precludes them from getting the care they need. As a result, many routinely look for discounts and other ways to keep the cost of seeing a physician as low as feasibly possible. In that vein, one of the things that many seniors are looking into, and even taking advantage of, is direct primary care.

Direct Care and How It Can Benefit Seniors

Although routinely thought of as one of the wealthiest nations in the world, America is, sadly, also home to thousands of seniors who struggle to make ends meet. To help put this into perspective, we need only look at a study published by Bankrate, an esteemed consumer financial services company in New York City. According to the study, the social security check that the average senior receives each month is just a little over $1,400, and most of those funds go toward housing and groceries. While there are exceptions, many of these same individuals have very little in terms of savings.

In light of all of this, it isn’t difficult to see why so many seniors consider direct primary care (DPC) a godsend.  For those not familiar with it, DPC is an alternative to the fee-for-service (FFS) medicine billing method commonly associated with traditional healthcare and supported by the American Academy of Family Physicians (AAFP). It is also worth noting that this direct care billing model is far more cost-effective for patients when compared to fee-for-service (FFS) medicine.

Current data shows that the monthly fees associated with direct primary care are between $30 to $90. And unlike traditional insurance, there is nothing else to pay for in the way of copays and deductibles. For most people, especially seniors living on fixed incomes, these fees are much more manageable when compared to traditional health insurance premiums.

Additional Benefits Associated with Direct Primary Care

Similar to traditional HMO or PPO plans available through most major health insurance providers, DPC plans allow individuals to choose a primary direct physician that is right for them. Instead of paying fees to a health insurance provider, patients can pay monthly fees directly to the doctor’s office. That aside, most people – particularly seniors – seem to prefer this approach and wholeheartedly believe it allows for a much better physician-patient relationship and an even higher overall level of care.

Further, the $30 to $90 per month that most DPC members pay allows them to see their physician for preventative, wellness, and chronic care and even some medical tests at no additional cost. What’s more, there is no limit. Individuals who partake in direct care can schedule appointments with their physician for these services as often as they would like. Lastly, unlike traditional insurance, the direct care billing model allows patients to continue seeing their physician even if they change employers.

Why More Physicians Are Choosing to Offer Direct Care to Patients

Several studies show that more and more physicians are embracing the direct primary care model. This is likely because, much like for patients, it eliminates the need to file health insurance claims for medical services. Moreover, this more streamlined approach to healthcare billing also allows physicians to learn more about their patients and establish an all-around better rapport.

To put into perspective just how appealing direct care is to physicians across the U.S., we found a study published by the Texas Public Policy Foundation, a conservative think tank located in Austin, Texas. According to the study data, there are some 1,200 DPC-based practices in 48 states. These numbers are only likely to continue growing since direct care is proving to be a billing method that appeals to physicians and patients alike.

Are There Any Downsides to the DPC Billing Model?

Although much of this article has hailed the direct care model as something of a marvel as far as billing and paying for healthcare goes, we want to point out a few downsides – or shall we say hiccups? – for seniors and others who might be considering this route.

First and foremost, individuals who choose direct primary care will still need traditional health insurance to cover the cost of hospitalization, if needed, and the cost of advanced diagnostic testing, procedures, or medication not covered via direct care. Second, individuals with a high-deductible health plan should know that the monthly fees they pay to their physician will not count toward their deductible. For reference, most Medicare supplement insurance plans are considered HDHPs.

Final Thoughts on Direct Primary Care and Direct Physicians

All in all, direct primary care is quality healthcare at an affordable price. More importantly, it makes sense for those who desire more autonomy when it comes to all things related to their health. With that in mind, if you’re interested in learning more or finding a direct physician near you, consider a free consultation with Elevated Health today. Our team of direct physicians is eager to provide personable healthcare to you at a feasible cost.