Is this insurance? Does this meet the Obamacare mandate to prevent the tax penalty?
- No and no.
- This is NOT insurance but rather a premium membership based service that adds value and convenience to primary care.
I have insurance. Can I join?
- We advise patients to have at least a high-deductible major medical plan or health sharing plan for catastrophic and specialty care.
- You may save money and/or time enrolling in Yapha MD in addition to your insurance/health sharing plan especially if you have a high deductible plan.
- Patients value:
- Availability of Dr. Mays
- Same or next day appointments for urgent matters
- Personalized treatment and not being herded like cattle through a typical office setting
- House and/or office calls within 15 miles of the office
- Minimum wait appointments
- Wholesale costs on medications and labs that is sometimes less than their co-pay or deductible would be
- Medication dispensing at the office without having to visit a pharmacy
I don’t have insurance. Can I join?
- Yes, but we advise you to have a major medical or high-deductible insurance plan or belong to a health sharing plan.
Will my insurance reimburse my membership dues?
- No in most cases. In some cases (Medicare, Medicaid, Tricare) this would even be considered fraud. Medicare does NOT cover membership fees for concierge care which includes direct care. https://www.medicare.gov/coverage/concierge-care.html
Insurance is so expensive. Can I drop my insurance and just have the Yapha MD membership?
- We do NOT advise this!
- Medical debt is the #1 cause of bankruptcy in the United States.
- Direct Primary Care does provide most of the care most people need; however, it does NOT insure you against the risk of a major medical disaster.
- Schedule a free 15-minute phone consult if you would like to discuss this further.
What about Medicare or Tricare patients?
- Federal & state law prohibits these patients from paying a participating doctor directly for services that Medicare/ Medicaid / Tricare will cover. Medicare does NOT cover membership fees for concierge care which includes direct care. https://www.medicare.gov/coverage/concierge-care.html
Why charge membership dues? Why would I pay ‘extra’ for health care?
- The membership dues allows us to provide the vast majority of a person’s primary care in an innovative, convenient way for a simple, fixed price.
- Much like Netflix or a gym membership, it allows members to better budget their healthcare finances; without worrying about extra costs, co-pays and deductibles for routine care.
- The membership’s value is in the convenience of an accessible personable doctor, same or next day urgent visits, not having to wait for hours in the ER or doctor’s office, as well as other benefits.
- If you avoid 1 emergency room visit, the annual membership pays for itself.
- Insurance alone does not provide this level of value and care.
Can I just have a visit without becoming a member?
- Not at this time. In order to be available in a timely manner for the needs of paying members, Dr. Mays does not schedule 1-time visits anymore.
- If you’d like to speak with Dr. Mays before joining as a member, you can schedule a free 15-minute online consultation or email ask@YaphaMD.com for more information.
Are there any contracts or commitments? What if I decide to cancel?
- Louisiana law requires a patient agreement.
- You are not committed to a certain period of membership but agree to a 30-day notice of any cancellation.
- Membership dues will continue to accrue until notice of cancellation is received.
- Memberships are ongoing and open but must be paid ongoing in order to maintain service with us.
- A minimum of the first month of membership and a registration fee are paid upfront and are non-refundable.
Is this like “concierge” medicine?
- A little, but without the high price tag . . . or valet parking!
- Concierge practices typically charge a membership PLUS charge the patient’s insurance.
- Direct Primary Care practices like Yapha MD do NOT bill a patient’s insurance.
What if I am healthy and rarely go to the doctor?
- That is great! (Knuckle Bump!)
- Our primary focus is to keep members well and avoid lots of “medical” care. As such, we can dedicate more time to prevention and lifestyle issues to continue to keep you away from the expensive, cumbersome health care system that often leads to costly, unnecessary tests.
Can you provide memberships (virtual visits, etc.) to people “out of state”?
- Dr. Mays only has a medical license in the state of Louisiana and cannot practice medicine in other states. If a member establishes care (has a visit) in-person, we can provide remote monitoring of issues over phone and internet for some period of time. Ultimately, some care (sick visits, etc.) must be provided in-person and so we do not encourage people to join our practice unless they can reasonably visit us in person should we request that.
- Perhaps. Although the movement is relatively small, it is growing as doctors and patients tire of the current inefficient, insurance-based model of care.
- Check http://privatephysicians.com/#
- Check IWantDirectCare.com. Look for a doctor in your area and add your name to the list of patients who want it. Help us prove their is demand for this model of care.
- Check http://www.dpcare.org/practices.
- Look for a Qliance or MedLion in your area.
- Google direct primary care plus your city or concierge medicine plus your city.
Can I use my HSA to pay your dues?
- Consult your tax accountant or lawyer.
- As is typical for anything coming from the feds, different IRS officials give different people different opinions on this issue.
- The Direct Primary Care Coalition has petitioned the IRS to allow HSA dollars to be used for Direct Primary Care. More info here: http://www.dpcare.org/practices#!blank/c1op5