Fees and Costs
We understand that navigating the healthcare system can be complicated, so we try to keep our part simple. There are 2 options for patients: Hybrid and Direct Care models.
HYBRID:
Our Hybrid plan works with your insurance to get you excellent concierge primary care. We have a flat $50 monthly membership fee and do not charge you co-pays for visits. We will bill your insurance for services provided in the office, but this allows us to provide longer appointments (up to an hour if needed) and a significant number of services outside of regular office visits. We are working on getting in-network contracts with most major insurers to allow us to offer this hybrid plan to more people and we will update this list as those contracts come through). We are currently accepting the following insurance plans:
- Traditional Medicare
- Aetna - Commercial and Medicare Advantage (starting 16 Sept, 2024)
DIRECT CARE:
Our all-inclusive direct primary care plans are based on how much care you need (not your age) with the following use tiers:
Tier 1 (most people): $65/month (Includes a 1-hour annual visit, up to 3 other in-person or extended video/phone visits a year, basic procedures like ECGs/joint injections, night/weekend consults, case management, nurse counseling and all other emails/texts/phone calls).
Tier 2: $105/month (Includes everything in tier 1 and up to 7 other in-person or extended video/phone visits a year).
Tier 3: $200/month (Includes everything in tier 2 and unlimited visits).
We re-assess your use every 6 months and adjust you up or down tiers as applicable. If you have heavy use for 6 months your tier will be higher for 6 months and then reset back to your baseline after that. Our goal is to give you the care you need when you need it and also give you some control over your costs.
That is it! There are no missed appointment/late fees, no sign-up fees, no additional service costs and no contracts. If you decide that we are no longer a good fit for you we just ask for a month of advance notice (email or on paper) and you won't be billed the next month.
What is not covered:
- Labs, radiology studies, medications (these go through your insurance like normal).
- Specialty care outside of Premonition Health (anyone we refer you to).
- Hospitalizations/ER visits.
We STRONGLY RECOMMEND having your own health insurance for all those other costs since primary care is only a portion of your overall healthcare needs. While our fees are not eligible for HSA/FSA payments and will not count towards your deductible, we designed our service to still save you money overall (see our example patients).
Not sure if this is right for you? Schedule a free, no-commitment 15-minute consult below to see if we're a good fit for you (or, you can email us through the Contact Us section).