Medicare

We welcome patients that have Medicare!

Our Doctor is Fellowship trained in Geriatric medicine and is therefore a specialist in treating patients over the age of 65. For a small enrollment and monthly membership fee, you can join our clinic, and get all the benefits of affordable and convenient access to specialized medical care. Let us be your specialist and primary care physician (PCP). Get expert guidance regarding all your medical care.

Direct Primary Care (DPC) which is offered at our clinic is simple, clear and transparent specialized medical care provided by a board-certified physician. It is not an insurance plan, and not meant to take the place of insurance. Since we are not insurance agents, this is not advice on which plan to choose. But here are some examples of how our current members are utilizing our DPC membership at Premier Direct Care with their Medicare plan.

Why should I join when I already have coverage?

Because coverage does not always equate to care.

Traditionally you call and make an appointment. This appointment is typically weeks in advance. You arrive at the office, fill out paperwork, then wait in waiting room for a long time. Once you are with the doctor, they sometimes only have time to address one issue and many a time spend most of it typing into a computer. At Premier Direct Care, we do things differently. Our Doctor keeps the schedule open for same day and next day appointments. The Doctor also schedules appointments in one hour and thirty-minute intervals depending on what is required for that visit. Also, you don’t have to come into the office to get your health concerns answered most of the time, since you will have access to the doctor by telephone, text, video or email ( this is also called Telehealth).

See the same doctor every time you visit. 

Yes, you heard correctly. Our Doctor will get to know each patient individually. Like the old-fashioned family doctor used to do. You won’t get the run around with a different provider every time you visit.

House Calls. 

For those that are home bound, or recovering from a surgery or hospital stay, Dr. Perez makes home visits and visits to assisted living and nursing facilities.

No Hidden Fees. 

Our prices are transparent. One flat monthly fee for all the services provided within our office. By signing up for a membership, an estimated 80-90% of all of your health needs can be addressed within our office, making your monthly budget for healthcare more predictable.

Discounted generic drugs. 

Some patients have been paying for a Part D plan that “covers” their generic medications. Truthfully, many times the cash price for those medications is MUCH LESS than the cost of the premium for the Part D plan. We would be happy to give you an estimated cost for purchasing your medications directly through our office’s wholesale medication program. Feel free to call us to discuss your individual situation. We have in some cases been able to save patients more than their monthly membership fee just with the reduction in medication cost alone.

Discounted lab test. 

Labs drawn in our office are charged at wholesale cost or billed through your insurance, whichever you prefer. For example, a complete metabolic panel and complete blood panel currently costs $6.90. This may be less than the bill you receive for your portion after Medicare pays.

Which Medicare plan pairs best with membership at Premier Direct Care?

 

Original Medicare This is your “standard Medicare” which includes Medicare part A (Hospital insurance) and Medicare part B (Medical insurance) and usually covers 80% of the cost associated with these medical services. Most of our Medicare patients at our practice have this as their coverage for outpatient services. Why? Because as mentioned above, with your membership, you get 80-90% of all of the services you will likely need included with your membership and all other services covered by standard Medicare. Your Medicare Part B would only be used for tests done outside our office, or for specialist visits. Talk to your insurance agent to discuss what may be best for your individual situation.

Medigap or Part F Supplement Is a private health insurance policy that helps pay for the items original Medicare does not pay for, such as: copayments, coinsurance and deductibles. So for example: for every $100 billed for services, Part B covers $80 and your supplement should cover the other $20. This type of plan also helps if you see a lot of specialists. Our current members vary on whether or not they utilize Part F plans. Talk to your insurance agent if you think you would need a Part F supplemental plan. 

Medicare Part D This is prescription drug coverage. If you take generic medications, we may be able to save you significant amounts on prescription drugs. Our office could fill these medications for less than the cost of your part D insurance premium per month in some cases. Feel free to ask us about your individual situation to see how much savings you may find. Some of our patients have been able to save the full cost of our membership fee with the medication savings we have been able to provide.

Medicare Advantage Plans These plans take the place of Part A, B, D and F. In order to provide all these services under one health plan, they require that you must seek all care within a defined network and thus limit your freedom of choice in selecting which specialist, lab, imaging you prefer to use and usually if and when any of these can occur. If you have an HMO type of Advantage plan, you are designated a “participating primary care provider” who then would need to do a referral for any testing or specialist visits you need which is them approved or denied by the HMO administration. This does not work well with a DPC membership since we are not affiliated with these medical companies. However, some of our Medicare members do have a PPO type of Advantage plan, and this works well for them and our membership since it allows for freedom of choice while covering parts A, B, D and F of Medicare. Talk to your insurance agent about your options.

In Summary

Having a Primary Care Physician/Geriatrician who is available to you, responsive to your needs, and makes the time available to communicates with you and your family is essential as we mature and develop more complex health care needs and conditions. Unfortunately, under the current Medicare and Insurance billing system, it is difficult for physicians to find the time to truly get to know their patients. This is not the case when you have a Direct Primary Care physician from Premier Direct Care, since most our Doctors time is devoted to patient care and not satisfying the Medicare and Insurance participation and billing requirements. Consider joining or clinic and experience what it like to have a physician dedicated to you and your health.

OUR PRACTICE

We are a Direct Primary Care or DPC practice. DPC removes insurance and bureaucracy from the Doctor/Patient relationship .