Frequently Asked Questions
What is direct primary care (DPC)?
Direct primary care (DPC) is a practice model that gives primary care physicians and their patients a meaningful alternative to fee-for-service insurance billing, and is typically based on a monthly, quarterly, or annual fee that covers all or most primary care services. At the heart of DPC is a commitment to building trusting, enduring, and collaborative relationships with each patient. A second key element of DPC is easy and direct access to your physician by email and phone, and same day or next day visits when acute problems arise - your physician, available to you when you need them most.
Is this concierge medicine?
Although the terms DPC and concierge medicine are sometimes used interchangeably, there are some general philosophical differences. Concierge or ‘boutique’ practices tend to charge larger monthly or annual fees and continue to bill your insurance, which limits the affordability of these practices for many people. DPC practices are designed to offer many of the same benefits of a concierge style practice, but at a more affordable price - one simple fee, no co-pays, no deductibles.
Why choose to join a DPC practice?
By serving a smaller number of patients and eliminating the administrative barriers created by third party payers, DPC practices are uniquely positioned to offer affordable, convenient, and highly individualized primary care in a private and compassionate environment. Imagine unhurried office visits, same day or next day sick appointments, and direct email and phone access to your physician. You deserve the complete and undivided attention of your doctor, whether you are acutely ill and need to be seen promptly, or are facing a major health issue. DPC practices are also able to place a greater emphasis on preventative medicine, weight management, and other important but often neglected issues such as end of life planning and care.
Is DPC insurance?
No, DPC is not insurance. The monthly membership fee is simply your payment for ongoing primary care services offered by the practice. Having health insurance is still recommended and necessary for care beyond the office (specialists, diagnostic studies, ER or hospitalization, etc.). Direct primary care, coupled with a high deductible “wrap around” policy, is often equivalent to the cost of traditional health insurance.
Will you file claims with my insurance company?
No, the new practice will not submit claims to any insurance plans, including Medicare, with the exception of Medicaid (see below).
What about Medicare?
Medicare-insured patients are welcome in the practice. As of October 1, 2016, Dr. Renzulli will no longer be a participating provider with Medicare. Federal regulations prohibit patients from seeking reimbursement for payments they make to a physician who has opted out of Medicare (I.e. you can't get paid back by Medicare for care delivered in a DPC practice), but Medicare will continue to cover your non-primary care needs such as specialist visits, hospitalizations, tests, and medications.
What about Medicaid?
We will continue to accept Medicaid for all existing Medicaid-insured patients. If you are a current patient of Dr. Renzulli's and you have Medicaid, you can continue to see her just as you always have. Your insurance will be billed for your visits and you will not be charged a membership fee.
What if I have an HMO?
Unfortunately, the very nature of an HMO type plan makes joining a DPC practice difficult to impossible. HMO plans require that you have a primary care doctor that is 'in-network' with your insurance company.
What will the membership fee cover?
Your membership fee covers a yearly comprehensive physical, sick visits, chronic disease management, specialist care coordination, DOT physicals, sports or work physicals, pre-operative evaluations, simple office procedures such as EKG, and simple skin procedures. You can find a comprehensive list of services here.
Do I have to commit to an annual membership?
No, there is no long-term contract. You simply pay your monthly fee and may cancel at any time. You will be asked to sign an agreement outlining the practices policies, but that is simply so we have a mutual understanding of how the practice works. Medicare beneficiaries will also sign a one time agreement required by Medicare to ensure that they understand that the practice fees are not covered by Medicare.
Who can join?
Anyone is welcome to join the practice, regardless of insurance status. Existing patients are encouraged to join before September 1, 2016 to receive a one year discount. It is the policy of Well Primary Care to not discriminate with regard to race, color, religion, national origin, age, sex, sexual orientation, gender identity or expression, or disability.
I’m interested, but want to learn more.
We are happy to answer any of your questions in person, by email, or by phone. You can also join the Well Primary Care mailing list by emailing us at firstname.lastname@example.org to stay informed of practice news.
I’m interested, how do I join?
Great! We are so excited to welcome you to the new practice. Please stop by the office (102 Sleepy Hollow Drive, Suite 200, Middletown, DE) to pick up an enrollment packet,or give us a call (302-449-0070) or use this contact form and we will give you a registration packet. We look forward to providing care for you!