Question 1

What is Direct Primary Care?

Accepted Answer

Direct Primary Care (DPC) is an innovative model of health care that does not bill insurance. Patients pay a monthly fee and in return receive individualized, full-service primary care from their chosen doctor. Care includes preventive exams and management of most acute and chronic conditions. Patients have a direct line of communication with their own doctor and can expect same day or next day appointments with little to no wait times. There are no copays or surprise bills.

Question 2

Does Evergreen Primary Care accept insurance?

Accepted Answer

We do not bill insurance for our services. This is what makes it possible for us to keep our expenses low and provide the kind of care we believe in and you deserve (see Services and Pricing page).

Question 3

Do I still need insurance?

Accepted Answer

This is a very important question, and the answer is yes. A membership with us should cover most of your primary care needs. Insurance is still needed for services we do not directly provide such as specialty care, ER visits, expensive tests, hospitalizations, and surgery.

Question 4

Won't paying for a membership in addition to insurance be too expensive?

Accepted Answer

Not usually. Particularly if you have insurance with a high deductible, receiving primary care through a DPC clinic saves money. There is also research showing that people who have a DPC doctor have fewer ER visits, see specialists less often and have fewer hospitalizations, which saves on copays even for those with good insurance. Many conditions for which time-strapped primary care doctors refer to specialists, can be managed just as well if not better and more cost effectively by a primary care doctor who has a relationship with you and importantly has the time that is required.  Many urgent care and emergency care visits can also be avoided with a call to your Evergreen doctor, who will be able to assess the situation and often see you right away.  Another way we can save you money is by contracting directly with labs, imaging centers, and specialty clinics to help you get lower prices, often at a fraction of what they are through the traditional insurance-based system.

Question 5

What if I have Medicare or Medicaid?

Accepted Answer

The same applies to Medicare and Medicaid as with other forms of insurance. Our membership fee is not covered. However these programs will continue to cover any other medical services such as lab testing, imaging, physical therapy, specialty care, ED, surgery, hospitalization and prescription medications, etc. For legal purposes, our Medicare and Medicaid patients will be asked to sign a form acknowledging that billing for the services we provide will not be submitted to Medicare or Medicaid.

Question 6

Can I still see my specialists?

Accepted Answer

Absolutely!  As long as they are covered by your insurance plan, this part of your care will work the same. If you do not have insurance or you are seeing a specialist that is not covered, we can often work with them to negotiate a more affordable price for care. In addition, as DPC physicians, each of us care for a much smaller number of patients, and are freed up from the time spent on insurance related tasks. This means we are able to provide exceptional and often time intensive care coordination with your specialists.

Question 7

How are labs and other testing handled?

Accepted Answer

You have options. Certain annual labs such as a cholesterol panel, basic metabolic panel, Hba1c, and TSH are included in the monthly fee. For other labs, we can draw the sample in our clinic and send it to our lab for a heavily discounted cash price or ask our lab to bill your insurance. If you have insurance, we can also send an order to your preferred lab. Similarly, for other tests such as xrays, CTs, MRIs, sleep studies, stress testing, etc, the facility that does this testing can bill your insurance directly. If you have a high deductible or do not have insurance, we can work to negotiate a lower cash price for you.

Question 8

What about kids under 12 years old?

Accepted Answer

There are several direct care pediatricians in the Twin Cities:
Dr. Michele Peterson at Complex Care Pediatrics.
Dr. Michael Hobbs at Lakes Pediatrics.

Frequently asked questions