These are some of the mostly commonly asked questions about our practice, the care we provide, and the direct primary care model.
How about health savings accounts (HSAs)?
We believe everyone should have insurance. A HSA is a great way to have catastrophic coverage as well as provide tax-free health savings.
What if I have chronic medical problems such as high blood pressure, diabetes and/or high cholesterol?
Please visit us. We know that if we work hard to control these chronic medical problems, we can provide you with a comfortable, healthy life. If you are worried about the costs, please come anyway and talk to one of the doctors. You may be pleasantly surprised.
How do you keep prices low and transparent?
It is a long and complicated story using insurance industry words like charges, CPT codes, reimbursement, etc.
If you are not interested in all of the complexities, just know that we can set fair prices for everyone by not contracting with insurance companies. We remove the middle man and keep costs and communications between the doctor and the patient, as it should be.
Once again, we believe that everyone should have catastrophic coverage.
Do you see walk-ins?
We reserve time for our members, to care for those unexpected accidents and illnesses.
Do you have lab and x-ray capabilities?
Yes. We are able to draw your labs Monday, Wednesday and Friday mornings. We can refer you for imaging if needed.
Do you see children or provide immunizations?
Yes. We see patients of all ages over 12 months but do not perform routine required immunizations for patients under 5 years of age. The local Health Department has streamlined the process for immunizations. We encourage patients to visit them for routine vaccines.
How do you handle medication refills?
Refills of medications are handled during normal business hours. Please allow 2-3 business days for these requests to be processed.
If you are taking long-term medications for blood pressure, diabetes, cholesterol or more, an examination may be needed to verify that your medications are working and there are no unusual side effects.
Do you provide physicals and sports exams?
Yes. We are happy to offer employer and sports physicals and fill out the appropriate forms as required.
What if I need to be referred to a specialist?
If the need arises for a referral to a specialist, we will be happy to arrange that referral. We will be your advocate and will work with the specialist’s office regarding your care.
Do you manage chronic pain?
Unfortunately, we do not. Chronic pain is a very common and understandably frustrating medical problem. It is best treated by specialists who are trained specifically in this area of medicine. We do not treat chronic pain but are more than happy to help arrange a referral to a pain management specialist.
We do manage acute injuries, aches and pains. We do not have controlled pain medicines in the clinic and prescribe all medications electronically.
What do I do if I have to go to the hospital?
We do our best to keep you out of the hospital, but emergencies and injuries do happen. Please try to notify us if you will be going to the Emergency Room so that we can discuss your medical history with the receiving facility if needed.
How will I pay for hospitals, specialists and imaging?
We advise our patients to have insurance for catastrophic coverage, costly procedures or imaging (similar to car insurance). There are also cost-sharing options to review that provide non-insurance options for high unexpected expenses.
Does Dr. DeCastro see me in the hospital if I get hospitalized?
No, hospitals have their own hospitalists or ones they contract with to ensure inpatients are cared for by inhouse physicians. If needed, we will speak with your primary hospital team and ensure your transition out of the hospital is seamless and you have all of your medications and any referrals addressed. Dr. DeCastro is diligent about reviewing your discharge summary in order to follow up any issues that need to be addressed outpatient.
Direct Primary Care (DPC)
What is Direct Primary Care?
Direct Primary Care, or DPC, is the model of healthcare used at Palmetto Proactive. It helps us put patients first by getting rid of the red tape that constrains traditional practices. How? It’s simple: we don’t accept insurance, and – believe it or not – this actually saves you money in the long run. Learn more about the benefits of Direct Primary Care.
How will this save me money?
You won’t have to pay a co-pay for office visits or routine physicals. Also you’ll be able to avoid many visits altogether by sending your questions directly to us via email and text – something you won’t get from a traditional practice. We’ve negotiated amazing deals for prescription medications, blood tests, X-rays, and MRI/CT scans on your behalf. If we had contracts with insurance companies, we would be legally obligated to charge higher prices.
Does Direct Primary care save money?
Yes, especially if you have high deductibles that you will likely never meet along with high monthly premiums.
Will I benefit from direct primary care if I don’t require frequent medical attention?
Of course. Everyone benefits from a service tailored directly to them. That’s why we offer truly custom healthcare. We’re here for you if you’re sick or hurt, but we also help you proactively maintain good overall health.
Every visit with us will be thorough, relaxed, and as long as you need to address your health concerns. The longer you’re our patient, the more we learn about your health and lifestyle, and the better we can help you maintain that health.
Instead of the monthly membership plan, can I pay per visit?
Yes, we will do our best to accommodate you, but we may not be able to provide the same benefits that our members receive including time, access, & the ability to form a long-term relationship with your physician.
I have a low deductible insurance plan, low premiums & rarely get sick. Why should I join a Direct Primary care clinic where I’ll be paying a monthly fee to you in addition to monthly insurance premiums?
Time and access. Our patient panels are lower than your typical fee for service physician who has thousands of patients. Direct Primary Care (DPC) physicians usually have about 600-1000 patients, allowing us to really get to know our patients and form a long-term relationship with you.
I am uninsured. Can you help me?
We believe everyone should have insurance. However, if you cannot afford coverage, we may be the doctors for you. Since we do not contract with insurance companies, we can charge 50-70% less than other medical clinics.
What types of insurance do you accept?
None. We work directly for our patients and we do not contract with insurance companies. This means you’ll have access to quality healthcare at lower prices that are transparent to our patients, and due at the end of each visit.
There won’t be a second or third bill showing up later in the mail. If needed, we will provide an itemized bill you can send to your insurance company for out-of-network reimbursement.
Specialists and other primary care clinics process insurance.
Why don’t you?
Processing insurance trying to meet all their requirements and completing all their paperwork does nothing but take time away from you, our patient.
As a patient, will I still need health insurance?
Yes. We recommend our patients continue a major medical plan with a high-deductible and health savings account. If you experience a major health issue, you will still need insurance to help cover it. We’re happy to refer you to insurance representatives who can help customize an insurance plan to your specific needs.
If I have Medicare, can I still join?
Yes. You need only sign a one-time waiver declaring that neither you nor your doctor will directly bill Medicare for our services. Even though Medicare will not pay us for any services you receive in our practice, your Medicare benefits will otherwise remain unchanged and can continue to be used for all other medical care received outside of our practice.
Medicare will still cover any laboratory testing, imaging, medications, or hospitalizations prescribed by our offices.
Proactive Patient Program (P3)
The following are questions we often receive regarding membership in our Proactive Patient Program.
How much does membership cost?
We charge a flat monthly fee of $70, and in exchange you get unlimited office visits, wholesale prices on prescription medication, your doctor’s cell phone number, and a whole lot more.
What does the membership fee cover?
The fee covers excellent primary care through office visits with no copay. This includes the following: annual wellness exams, sports physicals, school physicals, chronic care office visits, follow-up visits, basic office procedures and treatment of acute illness or minor injuries, all with minimal wait times in the office.
The fee also covers direct communications with your doctor: phone, text, video chat or email. Our patients will also have access to discounted labs, prescriptions and special procedures not included in the membership fees.
Is the membership fee eligible for HSA or FSA reimbursement?
You may want to check with your human resources department regarding the use of Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) as possible payment options for your membership. If you are unable to use these funds to pay for the membership fee directly, there is a good chance that you can still use your HSA/FSA as reimbursement for certain services provided through our office.
Is the membership fee tax deductible?
Unfortunately, no. Your retainer is not yet defined as a “medical expense” in most states and as such is not deductible. Please confer with your tax consultant to clarify tax consequences in your particular circumstances.
Your Question Not Answered?
If you have a question that hasn’t been covered here, please don’t hesitate to contact us.