Visits that feel different.
Longer appointments, room for real questions, and a plan you actually leave with.
How our model works
On your side, not caught in the middle.
Most primary care practices are built around volume — seeing as many patients as possible to stay profitable. We're built differently. Here's why that matters for you.
Options explained clearly.
We walk through insurance fit, membership structure, and what to expect — before you commit.
A conversation, not a transaction.
Care planning starts by understanding what matters to you and what's actually going on.
The problem with the current model
Why your doctor always feels rushed.
It's not personal. It's math.
Most doctor's offices get paid per visit — and they get paid significantly more for four 15-minute appointments than for one hour-long one. That creates constant pressure to see more patients, faster. The average primary care doctor carries 1,500 to 2,000 patients and runs a schedule built around moving people through, not understanding what's going on.
Insurance makes it worse. Payments are routinely delayed, denied, or reduced — sometimes months after the visit. So practices have to keep volume high just to cover the uncertainty. The patient ends up caught in the middle: paying more, waiting longer, and getting less time with their doctor.
We built Premonition to break that cycle.
Our model
Steady income lets us slow down.
Instead of billing per visit, we charge a flat monthly membership — $65 for most patients, or the Medicare APCM fee for Medicare patients. That gives us reliable income that doesn't depend on insurance paying quickly or completely.
Because we're not chasing volume to stay afloat, we carry 500–700 patients per provider instead of 1,500–2,000. That's what makes longer visits, same-week appointments, and real follow-through possible. Not because we're a luxury practice — because the economics actually work.
It also means we don't need to fill every slot on every day to make payroll. Which means we don't charge late fees or missed appointment fees. Life gets busy — we can flex to that. Many visits can be converted to a phone call or video appointment if coming in doesn't work. We reschedule without penalizing you for it.
We do ask one thing in return: be considerate of other patients' time. If you're more than 20 minutes late, your visit will be shortened so the next patient isn't kept waiting. And patients who repeatedly miss without notice will find it harder to book ahead — they'll fill in where gaps exist. That's not a fee. It's just fairness to everyone in the practice.
- 500–700 patients per provider vs. the industry standard of 1,500–2,000
- No late fees. No missed appointment fees. Ever.
- Virtual and phone visits available across all plan types
Insurance
We still bill your insurance. Here's exactly how.
The monthly membership fee is not covered by insurance — but insurance still pays for your visits and procedures, and we handle that billing on your behalf.
Here's how it works in practice: when you come in for a visit, we submit the claim to your insurance. Whatever they pay goes directly back toward your monthly membership fee. So if your insurance pays $120 on a visit, your next month or two of membership is covered or reduced. Whatever insurance doesn't pay still counts toward your deductible.
This means your out-of-pocket cost is often lower than the $65 membership fee suggests — and you keep all the benefits of your insurance. We can accept any insurance that will contract with us and give every patient the same care, because our income doesn't rise or fall based on what any one insurer decides to pay us.
"We can accept any insurance that will contract with us and give every patient the same care — because our income doesn't rise or fall based on what insurance decides to pay."
Medicare patients
Medicare works a little differently from our other plans, but the goal is the same: predictable, affordable care with no surprises.
We bill Medicare for two things: the Advanced Primary Care Management (APCM) fee — a covered monthly care management service — and standard visit charges for each appointment, just like any in-network provider. Medicare covers both, and most patients end up with out-of-pocket costs that stay under $75 a month when you add everything together.
For patients whose bills run higher in a given period, we offer payment plans — and at the end of the year, we write off whatever balance remains so that cost never becomes a reason to avoid care.
If you have both Medicare and Medicaid, your out-of-pocket costs for covered services are zero.
Medicaid patients
We accept Medicaid, and by law we accept what Medicaid pays — which is less than our cost of care. We're honest about that: we limit Medicaid patients to about 10% of our practice so the clinic stays viable, but we keep that capacity because these patients need good primary care too. There's no monthly membership fee for Medicaid patients, and no out-of-pocket costs for covered services.
There's typically a waitlist — call us to ask about current availability.
Find your fit
Which path is right for you?
Works alongside your insurance.
$65/mo
Often reduced or covered by insurance payments
- Designed to work with most commercial plans
- Insurance payments credited back toward your monthly fee — many months cost you little or nothing
- No co-pays or co-insurance charged
- Longer visits and direct access included
- No late fees, no missed appointment fees
How it works in practice: You come in for your first visit and pay $65 that day. If your insurance pays $120 for the visit, that credit goes toward your next months of membership. Your next month is fully covered; the one after is $10. You still get credit toward your deductible. No co-pays. No surprise bills.
Simple, flat-rate primary care.
$65/mo
No insurance billing — just a predictable monthly cost
- Primary care for a flat monthly fee
- No per-visit charges within your plan
- No late fees, no missed appointment fees
- Virtual and phone visits available when appropriate
- A straightforward option if you don't have insurance or prefer to keep things simple
Clinical oversight, clear medication pricing.
From $130/mo
Medication pricing varies by dose and delivery method
- Structured follow-up and side-effect support
- Semaglutide and tirzepatide options — full pricing on the Weight Loss page
- Medication costs reviewed clearly before you start
- Medicare patients: APCM fee billed through Medicare instead of the $65 membership fee
- Already a primary care member? Add weight loss for the cost of medication only
Not sure which path fits?
Tell us your insurance situation and we'll point you in the right direction.
Select an option above to see your recommended path.
Compare Your Options
Select plans to compare side by side.
| Feature | Hybrid | Direct | Medicare | Medicaid | Weight Loss |
|---|---|---|---|---|---|
| Base monthly cost | $65/mo | $65/mo | ACPM billed to Medicare (usually $40-$60 covered) | No out-of-pocket for covered services | From $130/mo |
| Insurance use | Yes, works with commercial plans | No insurance billing | In-network Medicare billing | In-network Medicaid billing | Varies by plan and medication path |
| Best fit | Commercial insurance patients wanting extra access | Self-pay patients wanting predictable monthly cost | Patients on Medicare coverage | Patients on Medicaid (waitlist may apply) | Patients seeking clinician-guided weight loss |
This usually costs less than it looks.
- One ER visit can cost more than a full year of membership. Faster access means we can handle a lot of things in clinic, by phone, or over video that would otherwise send you to urgent care.
- We avoid unnecessary referrals because we have time to work things out ourselves.
- Cash-pay labs run $3–10 each — often dramatically cheaper than going through insurance before your deductible.
- Flat monthly fee — no co-pays, no surprise bills, no per-visit charges.
- No late fees or missed appointment fees — ever.
You'll know the cost before care is delivered.
- Flat monthly fee: No co-pays, late fees, or add-on charges.
- Upfront cash-pay pricing: Labs, imaging, and medications are priced clearly before care is provided.
- Insurance credited back: When applicable, insurance payments reduce your membership fee and still count toward your deductible.
- Medicare and Medicaid: Billing follows standard in-network rules. Payment plans available, with year-end write-offs for Medicare patients who need them.
- After-hours support: Some after-hours phone access on nights and weekends.
Still have questions about how it works?
Call or text us at (316) 789-6049. We're happy to walk through your specific insurance situation before you commit to anything.