As health care grows more complicated and insurance prices continue to rise, some patients are turning to a different model for routine medical care: direct primary care.
Healthcare is complicated, and insurance prices continue to soar. Now, there’s a wave of physicians going out on their own, offering direct primary care. It’s an alternative to typical insurance coverage, and for some, it’s a cheaper option.
Dominique Spagnola was postpartum with her daughter when she started having some medical issues and had trouble getting in to see her primary care physician or specialists.
“So I reached out to Dr. Megan, asked if she would work with me and she immediately got me right into these specialists that I needed to see,” Spagnola said.
In Albany, Dr. Meghan Montie runs Heirloom Family Medicine, a direct primary care practice that does not require insurance or full-coverage insurance. Instead, patients pay a monthly membership fee — ranging from $250 to $600 — for what Montie describes as concierge-style primary care, including 24/7 access by phone, text or email, same- or next-day appointments and longer visits.
“It really just allows me to go much deeper with my patients and really get to know them not only as their medical diagnoses and their medical history, but also about them as people too,” Montie said.
Within months, Montie helped Spagnola get specialized testing that confirmed a diagnosis of primary aldosteronism, a condition in which one adrenal gland malfunctions. “Something that I started looking into in 2022, I now within two months have an official diagnosis and a pathway to a cure, which is really cool and really nice to have gotten those answers so quickly,” Spagnola said.
Spagnola and her daughter both see Montie. Spagnola also keeps health insurance through work and pairs it with the monthly Heirloom membership — an approach Montie said is common. “Health insurance is still very important for catastrophic events,” Montie said. “Some patients are opting for a higher deductible plan with lower healthcare premiums and pairing that with the direct primary care,” she said.
Montie also said some patients have found cash-pay pricing can be more affordable than insurance-based pricing, leading to hundreds, if not thousands, of dollars in savings for some families.
“The monthly membership is something I don’t even notice,” Spagnola said. “I would say that if I had started with working with heirloom, I would have probably saved about $2,000,” she said.
Montie said direct primary care can also reduce weekend trips to urgent care. She said it can be a good option for people with nontraditional jobs who do not have insurance, as well as people who change jobs frequently and do not want to switch providers every time their insurance changes.