Frequently Asked Questions

 DPC or Direct Primary Care is a membership-based health care model. DPC practices work outside of the insurance industry and charge an affordable Membership Fee for a variety of primary care services. 

This model of care works to keep the costs down for everyone because everyone is paying every month. This allows the total membership cost to stay relatively low, which allows for the accessibility, long appointments, and minimal waiting. Cash fee-for-service results in volume-driven reimbursement, just like traditional practice. When revenue is no longer dependent on high volume, the volume stays low and access to care remains high.

Many Medicare patients save each month by becoming members of a DPC practice particularly if they are healthy and do not typically have to see specialists. Consider the following. Medicare Part B is voluntary, not required. Only Part A is required (Part A covers you if you are hospitalized). You can keep the amount you pay each month for your supplement, see me for most of your healthcare needs, and if you need to see a specialist or have diagnostic studies, you just pay the 20% out of pocket. Considering most Medicare supplemental insurances cost $2400 to $3600 per year and my plan is ~$1800 a year, you will likely come out ahead, while having the benefits of a DPC practice like accessibility and minimal wait times. For those who feel better having a supplement, you can choose a Plan F high deductible supplement. The premium is often less than $100 per month, and you pay the first $2160 as a deductible if you have to use it. Have a good year and you saved more the difference between your deductible and the $1800 a year membership fee. Have a bad year and you just pay the $2160 that you would have paid for the higher premium supplement anyway. You have nothing to lose; only savings to be gained. ​Read more about Membership Plan Pricing Here.

As more and more people are discovering each year, having insurance and having access to quality healthcare are completely different. As deductibles get higher and benefits diminish, people are getting less and less value for their premium dollar with their expensive insurance plans. Insurance is not health care! With JAG Medical you are paying for the personalized service that is not available in fee-for-service practices, at a fraction of the cost of concierge practices. Read More About the Monthly Membership Fee Here.

Since JAG Medical is not an insurance plan, we still recommend you carry health insurance that covers you in case of an emergency or high-cost health event. Whenever you need labs, x-rays, expensive medications, specialist or hospital visit, you are welcome to use your insurance. If you don’t have insurance or have a high deductible which you don’t expect to meet, I can direct you toward more affordable services. For example, we have negotiated with local labs and imaging facilities to find the most affordable self-pay prices for these services (since paying out of pocket is often significantly more affordable than going through insurance). Even outside the office, JAG Medical will continue to serve as your advocate for your health care needs.

The tax laws regarding the use of FSA and HSA cards are evolving. You can’t use an HSA to pay insurance premiums; prior to the Affordable Care Act, the monthly fee in a DPC practice was viewed in a similar way as an insurance premium. The ACA as well as recent Florida law has specified that DPC doctors are not insurance companies, but the tax laws are evolving more slowly. So you should consult with your accountant before using an FSA or HSA card to pay the monthly fee as the tax laws surrounding their use are expected to change in the near future. We will provide a detailed receipt that outlines the services rendered for the monthly fee in order to facilitate the use of FSA/HSA funds; however it is your responsibility to make sure you are using these tax-advantaged accounts appropriately.

I am happy to get prior approval for any medications or diagnostic studies your insurance requires. However, I am not an in-network physician on any insurance plans, so if your plan is an HMO that requires authorizations to be done only by in-network physicians, I would not be able to do this, and you would need to see the primary care doctor to whom you were assigned, and pay the office visit copay, in order to get an authorization. I am not aware that any insurance plans require that medications be prescribed by an in-network physician in order to cover them, but if you have an HMO you should be sure to verify that. Plan requirements change every year.

Adding JAG Medical to your benefits package could save up to 30% of your total healthcare costs, while saving your employees out-of-pocket expenses because JAG Medical does not charge copays or deductibles, and many services that are otherwise charged in fee-for-service offices are included in the membership fee. This will help your employees stay happy, healthy, and productive. Read more about JAG Medical for Businesses here.

Joining is easy! Click here to go to our secured sign up page brought to you by AtlasMD. At the next business day we will contact you about scheduling your enrollment appointment. We look forward to having you join our family!