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Frequently
Asked Questions
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What is direct primary care (DPC)?DPC is a new way to get high quality, comprehensive healthcare from a doctor who cares, all for a flat monthly fee. DPC doctors ditch the broken healthcare system, leave their hellish hospital jobs, and start providing care at reasonable prices. It’s that simple. No insurance, no corporate health system, no middlemen. Just doctors and patients.
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What are the benefits of a direct primary care membership?Put simply: your DPC doctor is there when you need them. YOU GET ACCESS! Typically you can book a same-day or next-day appointment directly through the practice’s office staff, virtually, or even through the Physicians themselves. Often you’ll have access to your doctor’s email or phone number to text or call, so you’ll be able to call or text them any medical questions as needed. Some simple diagnostics (e.g., urinalysis, fecal occult blood tests) may be performed in the office for a small additional charge (or no charge at all). Your doctor will help coordinate specialist referrals or hospital care if you have a major issue. Below is a comprehensive list of services provided by most direct primary care practices. Most of these services are provided as an included perk of membership; others are often provided for a small additional fee. Talk to the DPC practices near you to understand exactly what their memberships include. Treating common everyday problems like colds, flu, strep throat, rashes, burns, joint injuries, and other wounds. Keeping you up-to-date on all recommended preventative screening, like colonoscopies, pap smears, and EKGs. Managing chronic conditions like obesity, asthma, diabetes, high blood pressure, high cholesterol, or thyroid disorder. Your doctor will work with you to formulate a long-term personalized management plan. Performing minor procedures. If you need a minor procedure like a mole removal, joint injection, stitches, or a simple cosmetic procedure like Dysport or Botox, your primary care provider may be able help with that. When joining a practice, ask your doctor what procedures are in their scope of practice. Providing a slew of additional services. A growing number of practices offer cne or skin treatments, sleep disorder treatments (at home sleep studies and CPAP), minor cosmetic procedures, allergy testing and treatment, migraine treatments, osteoporosis tests (bone density testing), and athletic performance testing (VO2 max). These services are often offered for an additional fee that has been negotiated by the physician. Managing your specialist care. If you have a medical issue that can't be handled by your primary care physician, you'll be referred to a doctor that can continue your treatment. And your DPC doctor won't just shoo you out the door; they'll work closely with the specialist to make sure there is seamless continuity of care. Providing an annual full-body physical and checkup. Often, your doctor will do a comprehensive review of systems at your very first in-person appointment.
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How much does direct primary care cost?The typical monthly fee is about as much as your cell phone bill or a twice a month mani-pedi. That's a small price to pay for a level of care you literally can't get anywhere else. Imagine asking your hospital doctor for their personal email or phone number—they'd probably laugh out loud. Or call your local hospital and ask to schedule an appointment for tomorrow—not likely. Those things—any many more—come free with a DPC membership. Not to mention: the membership fee can often pay for itself. Most DPC practices have an established relationship with local laboratories and radiology centers. That means you can get blood tests, pathology screens, X-rays, MRIs, and more for low cash prices. Most DPC practices dispense medications in-house at near-wholesale prices, or even delivered straight to your door, so you can both save money and avoid extra trips to the pharmacy. Plus, as a DPC member, you may be able to save a lot of money on insurance by switching to a high-deductible plan. In short: being a member of a DPC practice is like having a doctor in the family. Your doctor will always be in your corner, working to keep you as healthy as possible. It’s an amazing feeling.
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Can direct primary care save you money?You bet! Let's go over some common scenarios where a DPC membership can save you money. #1 You're taking multiple medications. If you're taking multiple medications and paying with insurance for all of them, your co-pays are probably stacking up. Direct primary care practices frequently dispense common medications directly from their offices, so you won't need to do an extra trip to the pharmacy. Plus, your DPC doctor can (when available) purchase these medications at wholesale prices from a free-market and they pass those savings through to you. The value of this service depends on which medications you're taking. They will even give samples when they can. Often your insurance provider will only cover a drug from a particular drug manufacturer, or they'll require you to use a brand-name version even though a cheaper generic is on the market. If that's the case you can easily be paying hundreds of dollars a month on medications—money you could save as a DPC member. #2 You get injured or sick. If you get in an accident, break a bone, need stitches, or require emergency medical care of any sort, you'll probably go to an urgent care or the emergency room. Going to either of these is a surefire way to drain your pocketbook. In the best base scenario, the urgent care center is in your insurance network and you pay a high co-pay—up to $100 in some cases. But that's only if you're lucky. Insurance coverage of emergency care is spotty at best, and urgent care centers are known to mislead patients regarding the true costs of care. Even if you verify multiple times that your insurance will cover your care, you can still get hit with big bills. Often urgent cares don't know if you're insurance is actually valid, or they'll intentionally mislead you. Emergency rooms are even worse: you'll often have to pay a co-pay of $1000 or more just to get seen, PLUS the cost of any additional scans or treatments. There are dozens of horror stories online about unwitting patients who we're financially ruined by insane ER bills they thought we're covered by insurance. One bad day can cost you thousands of dollars—enough to cover years of a DPC membership. As a DPC patient, you know exactly who to call when you need help. #3 You're overpaying for insurance. If you're on an insurance plan named after a precious metal, you shouldn't be. Health insurance companies have been over-reaching for years—to read more about this, check out our essay on the healthcare crisis. Even the cheapest health plan your employer offers covers WAY more than it should, so don't get conned out of more money by picking a low-deductible "Platinum" plan. As a DPC patient, the majority of your healthcare will be taken care of by your DPC doctor. All standard care, blood work, preventative screens, and physicals will either be included in your membership or provided at a fair price by your doctor. If your DPC doctor isn't equipped to deal with a medical issue, it's probably serious. And if it's serious, then you'll very likely hit your out-of-pocket maximum (OOP). (This OOP is what it sounds like: the maximum amount you can possibly spend on healthcare before your insurance plan starts footing 100$ of the bill.) *This is subject to change as prices increase: Here's the thing: the OOP for the cheapest and most expensive plans don't vary that much. Aetna's cheapest plan costs roughly $600 per year and has an OOP of $6650. Their most expensive plan costs $4200/year with an OOP of $4000. That means you'd be paying a guaranteed $3600 extra dollars ($4200 - $600) to avoid the small chance of paying an extra $2650 (6650 - 4000) on your healthcare. That doesn't make sense! Unless you're expecting to suffer a major health crisis every 9 months, you'll be better off on a cheaper plan. Otherwise, just join a DPC practice and take the cheapest insurance you can find! (This is what most DPC doctors do themselves, getting catastrophic or Bronze-level coverage reducing financial burden tremendously.) Do none of those scenarios apply to to you? Here's one more: #4 You care about your health. Here's the thing: direct primary care is the best game in town when it comes to healthcare. Think of it this way: before DPC, only movie stars and the super-rich were able to afford a personal doctor who works tirelessly to keep them healthy. To keep a personal doctor on staff costs around thousands of dollars per month. The rest of us had to a) wait until we were sick before talking to a doctor, then b) schedule a visit weeks in advance just to c) spend 10 minutes with a doctor we'd never met. With DPC, everyone can have a personal doctor on speed dial for an amazingly low amount. Having a medical expert at hand to answer questions, keep track of your preventative screenings, advise on your diet and lifestyle, and actually care about your happiness was simply not possible before. Now it is. By splitting hairs over tens of dollars per month, you're missing out on the best deal in healthcare.
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Why is direct primary care a monthly membership?If it seems like everything is a subscription these days, that’s probably because it is! And with good reason: subscriptions are the best way for a business (of any kind) to offer high-quality service and support over a long period of time. If you long for the days when software cost hundreds of dollars and came in a box, DPC might not be for you. The alternative would be itemized, "usage-based" pricing—the exact pricing scheme used by the traditional healthcare system. And that didn't work out so well for anyone. There are a hundred little perks of being a DPC patient—check out a comprehensive list of benefits here. Frankly, the benefits of being a DPC patient are too varied and rich to be broken down into a "menu of services". Paying your DPC doctor for everything they do would be like paying Netflix for every episode of TV you watch. Sounds awful.
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Is direct primary care the same as concierge medicine?You may have heard of a similar model called "concierge medicine". While there are similarities with DPC, the two are different in some fundamental ways. For starters, concierge practices often bill your insurance in addition to a monthly fee (though some don't—which makes them DPC practices!). This means they're still a part of the insurance industry's ridiculously complex reimbursement system, so they have to hire administrators to handle all the paperwork. This gets reflected in your monthly fee; the average concierge practice bills $200-300 per month. By comparison, DPC memberships cost approximately as much as your cell phone bill. Concierge was a step in the right direction, but it didn't go far enough. To bring sanity back to primary care, you need to cut insurance out of the picture entirely.
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Do I still need insurance as a direct primary care patient?Yes, you'll still need insurance, though you may be able to reduce the amount you pay. Your DPC membership is not an insurance plan; you'll still need insurance if you have a major health problem. (But when those problems arise, your DPC doctor will be next to you to guide you through the system and coordinate your care.) That said, you may be able to save money on your insurance! Since all routine care is covered by your membership, you can switch to a "high-deductible" health plan that costs less per month. Recently, some alternatives to traditional insurance companies have been gaining in popularity. You may actually be able to save money by joining a healthcare cost-sharing community. To learn more about how these communities go hand-in-hand with DPC, check out this article by Sedera Health.
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Should I join a direct primary care practice if I'm healthy?Absolutely! To be sure, your DPC doctor will always be there for you if you're get sick or hurt. But they also work proactively to keep you healthy, happy, free of preventable diseases, and living a good lifestyle. It's hard to break out of the mindset of the insurance-based healthcare system. In "the system", everything is centered around treating illness. It's very hard for a doctor to get paid by an insurance company for detecting early warning signs of diabetes or encouraging a lifestyle change to decrease risk of heart disease. Doctors just aren't rewarded for encouraging all-around good health. By being in constant contact with your DPC doctor when you're healthy, you'll be able to stay that way. By the time you're being treated for a chronic disease, it's usually too late. But if you spend your healthy years under the watchful eye of a doctor that cares, you'll be able to stay out of the hospital for years to come.
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Are Telehealth/Virtual visits Available?Yes! While some visits do require an in-person evaluation, we LOVE and encourage Telemedicine (we embrace the future, here’s looking at you AI!) here at Misra Wellness as it allows Dr. Misra to provide for quicker communication (especially same-day) and triage when necessary and even allow for comprehensive care in-between visits. Some programs can be done completely virtually such as our Misra Wellness Medical Weigh Loss Membership or Men’s Health Membership.
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Does Misra Wellness offer Individual A-La Carte Visits?While DPC is membership based and DPC members get benefits and discounts, Dr. Misra does see people for individual appointments starting at $399 per visit + any additional service.
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Do you take (my) insurance?No, we do not take any insurance and will not directly bill any insurance company nor provide a super-bill. This is what allows us the freedom to be unique and more personal. Insurance is still needed for the services outside of the scope of our primary care practice however. Check with your tax expert or human resources department regarding the use of health savings accounts or flexible spending accounts. There are several different types of health plans out there and direct primary care practices can combine well with them to allow for improved patient care.
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Does Misra Wellness accept Medicare/MedicaidCurrently (and due to CMA laws) Misra Wellness does not accept Medicare or Medicaid. Feel free to reach out to your congress-person.
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What if I need blood work or labs?Dr. Misra has been able to negotiate affordable cash-pay prices on labs and imaging. You may be able to utilize your insurance for these, but at times Misra Wellness’ negotiated prices can beat the co-payment of insurance. Crazy, huh?
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Will you limit your practice size?Dr. Misra will limit the practice size so Dr. Misra can provide optimal care to her patients. A waitlist is available for interested potential future patients. If demand is high enough, Dr. Misra may attempt cloning (or more likely will add another physician to the practice who shares her passion for medicine and healthcare). You can expect more jokes like this as a patient.
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What if I am Hospitalized?If you are hospitalized, we will work closely with your hospital team and arrange for quick follow up after you are discharged from the hospital to allow for a seamless transition and most importantly to prevent you from returning to the hospital. Your membership to Misra Wellness does not include services by any other doctors or hospitals, and those costs would have to be paid by you or your insurance company.
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What if I have more questions?We understand this is a cutting-edge innovative way of providing healthcare and questions will arise. We welcome them! Please call the office at 818-431-5511 or email admin@misrawellness.com with your inquiries!
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