If these promising membership-based health care models have finally caught your eye and convinced you to give them a shot, the next question now is, "How do I choose between direct primary care (DPC) and concierge medicine?"
The first thing to note is that there is much that concierge medicine and DPC have in common – the most important one is that both models offer no-frills, direct patient care that brings doctor and patient together, the way it should be.
As Per Concierge Medicine Today, what DPC and concierge medicine have differently is demography, insurance participation, billing methods, and the number of services offered within a particular subscription.
To establish the difference between both membership-based health care models and identify which one fits your needs best. There are some essential points you should keep in mind.
Here are a few differences between concierge medicine and direct primary care membership models:
The concierge medicine membership fees are usually higher than the membership fees for DPC. Concierge medicine subscriptions typically start around $150-$250 per month and can go up to several thousand dollars a month for very exclusive services, while DPC subscriptions for an individual adult generally range from $70-$150 per month, with variations for children, families, or tiered service levels.
No matter the price range, what is great about many DPC and some concierge medicine subscriptions is that patients have the freedom to end their subscription with reasonable notice, though contract terms vary.
Some Concierge Medicine practices may have an annual fee that can be paid in full or in installments, and the contract might be for a full year. At DPC, members usually pay a monthly fee and can often cancel the program with a typical notice period like 30 days.
However, payment structures and cancellation policies can vary for both models, so it's important to check individual practice agreements.
DPC provides essential comprehensive primary care services, although membership fees typically facilitate access to significantly discounted x-rays or lab tests rather than directly covering their full cost. Concierge medicine includes a much wider range of personalized and premium services and amenities within its higher fee structure.
The patient membership fees cover all Direct Primary Care services included in the DPC agreement. However, Concierge practices still sometimes bill your insurance company for specific covered services that you have incurred, in addition to their membership fee which covers services not typically reimbursed by insurance.
Another major differentiating factor between DPC and concierge medicine is that some concierge medicine subscriptions are still sometimes able to bill your insurance company for specific covered services that you have incurred.
In contrast, all payments made within a DPC subscription for services covered by the membership fee are, true to its name, to be settled directly between doctor and patient only, without third-party billers.
Although both subscription types cover preventive and routine care services, concierge doctors offer a slew of added perks, including (but not limited to) in-depth, personalized executive physical exams, inter-disciplinary communication and coordination for when you need to see other specialists.
It is a feature of some very high-end concierge practices for your concierge doctor to accompany you to specialist visits. This ensures that the treatment you receive corresponds to any pre-existing conditions or ongoing treatments you may already have.
Heavily discounted out-patient services and medication are invaluable perks that patients can take advantage of in their Direct Primary Care (DPC) subscription, which is something unheard of when it comes to your traditional health insurance. Concierge medicine practices that bill insurance for labs and medications typically do not offer these same deep, wholesale-level discounts for those items.
For example, a Complete Blood Count (CBC) test may cost you $50-$60 at a hospital while your DPC doctor's clinic often facilitates access to such tests for as low as $3-$10 (prices vary).
Antihistamine medicine like Cetirizine can cost you up to $14.43 for a 10-mg dosage, while many DPC clinics can dispense it for around $1.08 or similar near-wholesale prices. Your long-term savings from medication through a DPC practice alone can be substantial and may help cover your DPC membership fee.
Direct primary care practices are particularly appealing to a wide range of patients including younger patients, families, and those seeking affordable, accessible primary care.
While concierge medicine historically attracted older, wealthier individuals, its appeal is also broadening, though it generally remains a higher-cost option.
Concierge medicine subscriptions tend to be more focused on providing high-end services and added value to their patients. DPC subscriptions, on the other hand, strive to be more cost-efficient while providing comprehensive primary care.
For patients who require extra attention, say senior citizens or those with chronic conditions, either a DPC or a concierge medicine subscription can positively impact their present and future well-being, depending on their specific needs and budget.
Concierge care has been around for many years, while DPC has only become significant over the past few years. DPC practices are found in diverse settings, including urban, suburban, and rural areas where there may be a shortage of doctors.
People opt for concierge care mainly for enhanced primary care services, often focusing on wellness, comprehensive annual physicals, and a high degree of personalized attention. While DPC also offers personalized care, concierge medicine is typically positioned as a premium primary care service.
Since DPCs do not accept Medicare or any other type of insurance for their membership-covered services (doctors typically opt-out of Medicare), they are not subject to many of the Medicare regulations that concierge care practices that do accept Medicare must adhere to.
It is critical to note that DPC is NOT considered health insurance and does NOT satisfy the Affordable Care Act (ACA) requirement for individuals to maintain minimum essential coverage, although the federal penalty for not having such coverage is currently $0. State laws often clarify that DPC is not an insurance product to avoid inappropriate regulation, but this does not make it ACA-compliant health insurance. Concierge care is also not insurance, and patients in both models typically maintain separate health insurance for non-primary care needs.
It is also important to note that many membership subscriptions are hybrids. A subscription is considered a hybrid when it features a combination of both DPC and concierge medicine characteristics. These days, more and more concierge doctors assume DPC features (and vice versa) as a way of providing their patients with better service.
Choosing a DPC or concierge medicine subscription is a matter of simply assessing which one covers all of your health care needs at a price point you can afford.
To wrap it all up, Concierge Medicine Today makes some pretty imperative points. In both concierge medicine and DPC, people have inherent value. There is no class order, no first-class or second class, no higher or lower premiums, just people for whom doctors serve each day.
They have built clinics for children, families, and sick people. These visionary physicians are drawing attention to healthcare costs across the country and designing ways to be available and affordable for anyone.
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