FAQ

No, happily. And that’s a bonus for both you and us!

Perhaps the most critical distinction in our model of care is that the patient & doctor are front and center. We do only what is best and right for every patient, without restrictions on medication formularies, networks, or authorizations. When the patient and doctor work together like a TEAM, healthCARE becomes simple. And when all the red tape is removed, healthCARE becomes affordable.

Think of your auto insurance. You use that for emergencies and accidents, right? You don’t expect your auto insurance to cover oil changes and tire rotations. Now apply that same logic to health insurance. Use health insurance for the “big stuff” like surgery or hospitalizations. But primary care… Well, that’s routine maintenance, much like your car’s oil change.

So make it simple and leave health insurance out of the exam room.

Yes. We recommend that you do have insurance to comply with Federal Law. Alive! Lifestyle Medicine is not an insurance plan, nor does it replace insurance. Ideally, we encourage our patients to carry a high deductible, major medical plan, or a plan with a health savings account.

Another option many of our patients use is a Share Plan, like Medi-Share, Zion, or Liberty HealthShare.

Having a high deductible or a share plan ensures financial help should hospitalization or referral to a specialist be necessary.
You should consult with your insurance provider to help you find a plan that works best with our medical model and that will meet your specific needs.

This is a question that has a tough and confusing answer. HSAs & FSAs are a smart way to pay for your health care needs with pre-tax dollars. IRS regulations make it pretty clear that all DPC services are covered medical expenses reimbursable through HSAs and FSAs, but at the same time, the IRS claims that DPC memberships are health plans, and therefore fees are not reimbursable when employees combine DPC with any other “health plan” (like the catastrophic or high deductible insurance most DPC patients need).

It gets even more complicated as the Affordable Care Act and many state laws have clearly stated that DPC plans are not insurance.
The issue is being addressed at the federal level with legislation called the Primary Care Enhancement Act.

In the meantime, the best thing to do is check with your health plan, insurance broker, or employer.

In many ways, patients already are paying twice: co-pays, co-insurance, deductibles, non-covered services, out-of-network charges, and the list goes on… The average family of four pays over $4,000 in out-of-pocket medical expenses over the course of a year.

With Direct Primary Care, like Alive! Lifestyle Medicine, you can save hundreds, even thousands of dollars in out-of-pocket costs. We’ve negotiated some great deals for prescription medications, blood tests, and even XRays on your behalf, and we pass those savings right on to you.

Becoming a member at Alive! Lifestyle Medicine gives you access to the hands-on reversal research protocol that is normally only covered after you have a heart attack, for example, the Ornish or Pritikin Cardiac Rehabilitation Programs. We use this research from the get-go, so we can help you prevent a heart attack.

So get more value for your healthcare dollars and start paying yourself by slashing your risk of cardiovascular disease before an event. It’s like paying yourself twice — saving money later and more importantly, your health. We get you more value for your healthcare dollars.

Since you are getting all this amazing care from us, you can re-think and adjust your insurance premiums. Most DPC patients find a high-deductible, lower-premium insurance plan so they’re covered in the case of a major health issue.

Leave the rest of your healthcare to us. You’ll never pay a co-pay for any office visits, routine physicals, or well-woman exams.

We’ll be there for you! Because you’ll have your doctor’s email and phone number, you can call, email, or text us whenever you need, wherever you are. Many illnesses can be diagnosed and treated with a simple conversation.

We’ll help you locate the nearest pharmacy and order the medications most appropriate for your circumstances. Since we are also enrolled in Quest, even labs can be ordered by us and you can have them done at the many national locations.

If you need to go to the hospital or seek other medical attention while away from home, we can advise you on that as well.

Of course!

Although we like to try and answer most routine questions and calls during office hours, we realize illness and injury don’t always happen between 9am-5pm. We respect your time by removing wait time ensuring that you have adequate time with us. We have family time in the evenings and prioritize down-shifting and relationships, and we will respond as clinically appropriate. You may call, text, or email your physician whenever you need.

Physician access is one of the greatest benefits of the direct primary care model.

Yes, we take care of any patient regardless of your insurance situation. Since we work completely outside of the insurance system, none of what we do here is eligible for insurance reimbursement.

We’re happy to answer any other questions you may have! Feel free to contact us, and we’ll get back to you as soon as we can.