Primary Care Partnership, Westport, MA
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How Insurance Works in the Practice

 

Do you bill insurance plans?

We have chosen not to. Our practice is unencumbered by the constraints and limited reimbursement from insurance plans so that we may better serve and care for our patients. There will be no charge for office visits or co-pays. You only pay the membership fee. 

Our model results in significant savings: money, paperwork and time. The membership fee allows us to keep our overhead low and our practice small, and work for our patients, not the insurance company!

Can you see me if I have Medicare?

Absolutely. Our practice is well suited to handle the more complex medical issues often associated with older patients. We can spend the time necessary to manage chronic disease and the use of medications, and work together to optimize your health and wellness.

As we have opted-out of Medicare, it means neither our practice nor the member can submit a claim to Medicare for reimbursement for primary care. However, Medicare payment will continue according to your specific plan, without change for medications, blood work, imaging tests, specialty referrals and care, or hospitalization.

 

Do I still need to have health insurance?

Yes, you do. Our medical practice is NOT a health insurance program. It is very important to maintain insurance (and/or Medicare) to cover outside testing and specialists, as well as expensive, unusual and unpredictable events such as surgery, emergency care and hospitalization.  BUT NOT for everyday preventive primary care. By providing you with extraordinary and connected primary care, your plan use can often be reduced.

The current insurance-based system makes primary care MORE expensive and difficult, and less effective too. Our practice does the opposite.

By charging a set fee, we can spend more time with you and focus on your individual health needs to maintain and improve your health. We want you to see us as often as you need to, because our goal is healthy and happy members.

 

What if I have an HMO insurance plan?

If you have an HMO and are interested in joining Primary Care Partnership, please call us at (508) 636-7893 to discuss how membership may work for you.

Many people find they can lower the cost of their total medical care by combining a high deductible health plan with a membership practice. Doing so makes joining this practice quite beneficial. Our type of practice is also a good fit for those who have no insurance.

Studies show that direct primary care can lead to:

  • Less dependency on medications
  • Fewer specialty referrals
  • Fewer emergency and hospital visits
  • Savings on labs and imaging
  • Less need for expensive test ordering

You won't have any hidden costs or bills that come to you after-the-fact from the office or insurance company. By switching to a higher deductible, lower premium plan, patients may save money.

 

Will I still benefit from membership even if I don’t expect to need frequent medical attention?

Absolutely. Besides acute care and chronic disease management, our focus at Primary Care Partnership is on screenings and risk assessments, and lifestyle modifications. We want to concentrate our efforts on your long-term health and wellness. We listen carefully to you to understand how your life, work and family may be affecting your health. Together we create a personalized plan to achieve and maintain your optimal health. Advanced diagnostic tests can help us identify risk factors and health issues before they cause disease, saving you money, time, suffering and higher costs in the long run. Unlike the traditional practice environment, we have the time to deliver this type of comprehensive and detailed care. 

Is there a limit to how many patients can join Primary Care Partnership?

Yes. One of the most important aspects of personalized membership medicine is limiting the practice size to be able to devote more time and energy to each patient. Therefore, once we have reached our ideal practice size, we will establish a waiting list. If you join as an existing patient of Primary Care Partnership you will receive the reduced Founder’s rate.

 

What if I want to cancel my membership? 

You are welcome to cancel your membership after 3 months with 30 days notice. We will refund memberships paid for the full year at a prorated rate.

Primary Care Partnership
A Division of Prima CARE, PC