Prospective Membership FAQ
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What is Direct Primary Care (DPC)?
Direct Primary Care, or DPC, is a healthcare model focused on putting the patient first. Direct Primary Care medical clinics don’t accept insurance, rather they choose to work directly with the patient by offering them a monthly membership. The DPC membership model gives both patient and provider a meaningful alternative to traditional fee-for-service insurance billing. Instead, a known monthly fee will be charged to cover most of your primary care needs and using insurance as it was originally intended – for unpredictable circumstance and unforeseen serious illness. This approach is a win-win for both patient and provider.
We have returned family practice medicine to its root values of clinical excellence and compassionate knowledge of every patient. With the DPC model, visits will be easygoing in its absolute thoroughness, relaxed in answering your questions and addressing the need of the moment. We want to spend more quality time with our patients and less time buried in paperwork and medical coding. In this patient-centered approach, we promise accessibility, convenience, and affordability. What sets SWMI Health Matters apart from other practices? SWMI Health Matters is dedicated to patient-centered health care that is holistic, trauma-informed and aims to create a healthcare environment free of racism, sexism, homophobia, and transphobia. Our center is open to all people regardless of identity, race, ethnicity, age, gender identity, body type and ability.
Does SWMI take health insurance?
No, we do not accept insurance for our membership fees, but members can often use their health insurance for ancillary testing like lab work, imaging, physical/occupational therapy and referrals to specialists. The most critical distinction in our model of care centers on a direct, personal relationship between you and your provider. That directness carries over to our business model as well. We forgo insurance payments in order to save our patients from the arbitrary, intrusive decisions that inevitably follow with third-party payors. Furthermore, this direct fee-for-services arrangement frees us from the typical contractual agreements that prevent healthcare providers from offering wholesale prices on laboratory tests, imaging, and medications.
As a patient of SWMI Health Matters, will I still need health insurance?
Yes. We recommend our patients continue a major medical plan with a high deductible and health savings account to ensure financial help should hospitalization or referral to a specialist be necessary. We’re happy to refer you to insurance representatives who can help customize an insurance plan to your specific needs.
If I have Medicare, can I still join SWMI Health Matters?
Yes! Anyone eligible for Medicare may enroll in our primary care membership and be eligible for the discounts and benefits!
What happens if I need to go to the hospital or see a specialist?
Can children become members with SWMI Health Matters?
Can I contact my provider after hours?
Can my provider care for me while I'm on vacation or away from home?
Are my medical records ever shared with insurance carriers or pharmaceutical companies?
We maintain scrupulous standards of privacy. We are never obligated to provide any third party with a copy of your records unless we are processing a referral to a specialist, or if you specifically ask that we do so.
How will I know if the provider at SWMI Health Matters is right for me?
The best way to find out is to schedule a free consult with us. During the consult, you’ll get a tour of the wellness center, meet our provider, Jenny Opdycke, PA-C, and get your personal questions answered. You can schedule a free 30-minute consult (in person or virtual) by calling our office at 269.220.0648.
How does a DPC membership save me time and money?
Often times, insurance plans have at least a $1000 deductible per person. An entire year of DPC membership dues is usually well below your out-of-pocket deductible costs. In addition to the cost savings, our membership includes unlimited urgent care visits, an annual wellness physical, discounted lab/medication pricing, and special membership pricing for wellness classes like nutrition courses, yoga classes, meditation retreats, and more. We commit to offering same or next day appointments, relaxed appointments, and the ability to call/text your provider directly. There are so many reasons a DPC membership saves you both time and money!
I’m stressed and struggling with my weight, sleep, pain and other medical problems. Is DPC right for me?
Yes, the holistic DPC model can be very helpful for multifaceted medical problems like stress, weight management, sleep problems, and chronic pain.
I’m on a lot of medications. Is DPC right for me?
Yes, access to wholesale prescription medications (often times for pennies on the dollar) can save you money if you are on a lot of medication. In addition, our holistic DPC model addresses stress, diet, sleep, and exercise which can dramatically reduce the need for medication over time.
Is concierge medicine the same as Direct Primary Care?
The terms are often used interchangeably and essentially refer to the same principles. Direct Primary Care is a healthcare model focused on putting the patient first. That means treating them when they need it, never rushing patients through appointments, and being proactive with healthcare treatment plans. The provider-patient relationship is just as the name suggests – direct. The main difference between concierge medicine and direct primary care is that DPC models are designed to be affordable and available to everyone, not only the rich who can afford a personal doctor.
What does trauma-informed healthcare mean?
Our healthcare professionals seek to understand and respond to the effects of trauma on our patients. We recognize the importance of safety (physical, psychological and emotional) and our healthcare model is founded on non-coercion, choice-making and a shared authentic experience between both patient and provider. We also recognize how important it is to create a safe environment for all patients – especially marginalized communities. We seek to understand challenges faced by diverse communities and aim to create an environment free of racism, sexism, homophobia, and transphobia. Our center is open to all people regardless of identity, race, ethnicity, age, gender identity, body type and ability.
How do I pay for my membership?
Our memberships are monthly agreements and are paid automatically, similar to a gym membership. Members will get an email or text reminder each month a few days before the payment and will be sent a receipt once the monthly membership has been paid.