Combine a Colorado Direct Primary Care with a DPC DIRECT Healthshare Plan

In Direct Primary Care, patients skip the bloated and inefficient major medical insurance plans. Instead, they contract directly with primary care physicians and their practices. 

Instead of insurance premiums, DPC patients pay a flat “subscription” to the practice for primary care services – typically $85 to $110 per month per person, with discounted rates available for families and group sponsors.

In return, they receive unlimited primary care services at no additional charge. No copays, deductibles, or additional fees.

The primary care physician handles routine, predictable services like checkups, medication adjustments,vaccinations, doctors’ notes, scrapes and bruises, stitches, and other minor issues.

Colorado Direct Primary Care is also a natural match for healthsharing: A more affordable alternative to the traditional health insurance plans available on the Colorado Affordable Care Act exchange website – especially where the patient doesn’t qualify for a large subsidy under the Affordable Care Act.

Healthcare plans, including DPC DIRECT, are typically available at less than half of the cost of an unsubsidized traditional ACA-qualified health insurance policy. 

As the name implies, Direct Primary Care only focuses on primary care. It’s not designed or intended to function by itself. It doesn’t include things like ER visits, specialist care, or surgeries. It’s designed to be a complement to a catastrophic health plan, such as a healthsharing plan or a major medical insurance policy.

So in addition to Direct Primary Care, Coloradans need to have a plan that picks up right where their Direct Primary Care plan leaves off.

The challenge, of course is to do so without having to effectively pay twice for primary care access.

That’s one of the many problems with Affordable Care Act-qualified policies: The law requires ACA-qualified plans to provide ten essential coverages – whether the customer needs the coverage or not!

And one of those ten essential coverages is access to primary care.

Meanwhile, the insurance bureaucracy – the massive administrative effort to justify, document, and bill insurance companies for the care provided – represents a huge amount of resources devoted to primary care.

And it provides little benefit to patients!

For routine, frequent, low-cost doctor visits, Direct Primary Care is far more cost efficient. Members pay a low monthly subscription fee for as many visits as they need. And that’s it.

That’s where the DPC DIRECT healthsharing plan comes in.

To join DPC DIRECT, you must join or already be enrolled in a Direct Primary Care plan.

The two are designed to work together to provide a broad spectrum of protection for Colorado residents: 

For things like routine doctor visits, checkups, screenings, medication adjustments, doctors’ notes, immunizations, and other frequent events, you would use your direct primary care plan. You’d pay a flat, affordable monthly fee, and get all the access you need.

No deductibles, no copays, and no coinsurance.

With most DPC plans, you also get unlimited access to telehealth visits. So you don’t need to take a half day off work for a primary care doctor appointment.

And your doctor can spend more time with you. So they can address the root of the problem instead of just treating symptoms.

For specialist visits, emergencies, surgeries, and catastrophic care, you would use your DPC DIRECT healthsharing plan.

You pick the initial amount you can afford to pay out of pocket in the event of a major medical event. That’s your initial unshared amount.

When you or a family member incurs an eligible medical expense not covered by your DPC membership, you submit the bill to DPC DIRECT for reimbursement.

You pay the initial unshared amount for the year. DPC DIRECT pays the rest.

All for a much more affordable monthly cost compared to an unsubsidized Connect For Health Colorado plan. It’s even more affordable than the “Colorado Option” health insurance plan on the state Marketplace, before accounting for subsidies.

And because DPC DIRECT doesn’t need to share expenses for anything already covered under your DPC plan, the savings compared to other healthshare plans and traditional health insurance can be significant.