How is Blue Skies Family Medicine different from other practices?
What is Direct Primary Care (DPC)?
Because DPC practices don’t participate in insurance or health plans, the doctor is able to avoid excess documentation and administrative processing (red tape) required by insurance programs. DPC practices also avoid unnecessary patient data collection which many plans impose. These demands require extra staff and time which increases medical costs and often imposes intrusions on patient privacy.
Because DPC physicians avoid obligations to insurance companies, they can spend more time providing patient care, researching diagnoses, and forming treatment plans. Also, because DPC physicians eliminate the high overhead costs of insurance processing, they can pass the savings on to patients. As a result, DPC doctors are able to give compassionate, attentive, and timely care at an affordable price.
How long does it take to get an appointment?
If you call or email Blue Skies Family Medicine before noon on a normal office day (Monday through Friday), we will make every effort to schedule your visit the same day. If you call after noon, we may need to schedule you on the next business day.
Do you offer after-hours care?
How do you protect patient privacy?
How do I know if Blue Skies Family Medicine and its physician(s) are right for me?
We offer a free “meet the doctor” visit so patients can get to know us and determine whether Direct Primary Care is right for them. Since you are not a patient, we cannot legally give diagnostic advice or address problems during these visits.
Why do you have a membership fee?
The flat membership fee that we charge enables us to provide the majority of a patient’s primary care services for a fixed price. This allows patients to avoid unexpected bills from their primary care provider and helps them budget for annual healthcare expenses.
What medical services are included in my membership?
Will I still benefit even though I don’t visit the doctor that often?
We encourage our patients to become active participants in their overall wellness and prevention. By focusing on wellness, you take steps toward a healthy lifestyle that proactively prevents catastrophic illness. Our practice tailors services and visits to each patient’s specific healthcare needs so you can maintain good health. Even if you only visit our office a few times a year, you’ll receive a good return on your investment. However, as we get to know you, we’ll develop a more intuitive, interactive health program so you might want to visit more often than you expect.
Can children become members?
Absolutely! We’re happy to see children (birth up to age 18) and offer a family rate that helps you save even more money per year.
Can I cancel my membership?
We expect to have an open, honest, respectful relationship with you. If you have voiced a complaint that we cannot satisfy together, you may cancel your membership at any time by phone, email, text, or by postal mail with 30-days’ notice.
Does Blue Skies Family Medicine accept insurance?
No. As Direct Primary Care practice, we do not file insurance and instead, charge a monthly membership fee that covers your 24/7 care. Because we forego insurance, our office will never bill your insurance company, including Medicare and Medicaid, for our services. If you incur any procedure fees beyond what membership covers (click here for a list), payment is expected at the time of service.
Do I still need insurance?
While we don’t require or accept health insurance, we do strongly encourage our members to carry a health insurance policy or health-sharing co-op to cover expensive, unpredictable health problems, hospitalization, or surgery. Insurance protects you against financial disaster from illness, but it’s an expensive way to cover your routine healthcare. After all, your auto insurance doesn’t decide where you get gas or routine maintenance, does it? Health plans that combine Direct Primary Care with wraparound catastrophic coverage are provisions of the Affordable Care Act (section 1301 a3, page 58) and a good alternative for many people. If you do have a PPO-style health plan, you can still elect to use your insurance elsewhere (LABS, specialists, pharmacy, etc.) just as you always did.
Consult with your insurance provider to find a plan that works best with our primary care model and meets your specific needs. Many patients find affordable “wraparound” coverage by pairing a Direct Primary Care membership with their employer’s least expensive insurance option or an ACA bronze or catastrophic high-deductible plan that fits their needs. Another popular option is the health sharing ministries or co-ops (christian ministries, samaritan, sedera, etc). Whether you’re insured or uninsured, you’ll find DPC practices offer low monthly fees for excellent primary care.
If I already have insurance, won’t I pay twice for the same services?
In many ways, patients with insurance already pay “twice” due to copays, co-insurance, non-covered services, out-of-network charges, etc. In fact, the average family of four pays over $4,065 in out-of-pocket medical expenses during a year. With Direct Primary Care providers like Blue Skies Family Medicine, you can save hundreds of dollars in out of pocket health care expenses. Many patients find that our negotiated prices for labs, medication and other services cost less than using health insurance.
Remember, health insurance does not necessarily equal healthcare. With high-deductible plans on the rise, many patients end up paying for healthcare out of their own pocket because they never meet their deductible. Our goal is to help you avoid severe or chronic medical conditions that could trigger high out-of-pocket costs and long-term health problems. We believe that better communication with your doctor leads to better health outcomes.
If I have Medicare, can I join as a patient?
Yes. However, you cannot submit your monthly membership fee to Medicare for reimbursement. Every two years you must sign a waiver declaring that neither you nor your doctor will bill Medicare for your membership fee.
Please note: you do not lose your Medicare coverage for other medical needs when you are a patient of Blue Skies Family Medicine. Medicare and Medicare supplemental insurance will still cover medical costs incurred outside of our practice. This includes prescriptions that you fill at a pharmacy, lab procedures, hospital charges, physical therapy, X-rays and scans, to name a few.
Can I use my health insurance elsewhere if I join your practice?
Yes. Your insurance continues to operate as usual beyond our office, so when you visit specialists, hospitals, pharmacies, labs, imaging centers, and other medical facilities, your insurance would cover those services per your plan.
What if I need to be referred to a specialist?
If you need the services of a specialist, we will happily arrange that referral and serve as your advocate. While membership does not include specialist care, we strive to help you find affordable, excellent specialty care whether you have health insurance or not.
What do I do if I am out of town and need a doctor?
Don’t hesitate to contact us! We can determine the most convenient and expedient approach for your situation. Many illnesses can be diagnosed and treated with a conversation or video chatting.
What happens if I need to be admitted to the hospital?
While your Blue Skies doctor will be available by phone and email, there may be medical situations that require more advanced care than she can provide in our office. In these cases, you would be advised by the doctor to go to a hospital or, in some cases, an emergency room. In the event of a medical emergency, we advise patients to call 911 prior to calling our office. (For a list of typical medical emergencies, click here.)
Your Blue Skies’ family doctor does not directly admit patients to the hospital nor provide direct care while in the hospital. Your care in the hospital will be handled by physicians who specialize in hospital medicine. We will be in direct communication with them throughout your hospitalization so we can continue your outpatient care upon release. If you are unexpectedly admitted to the hospital, please let us know so we can update your medical chart accordingly.