Direct Primary Care or “DPC” means your primary care works directly with you—not an insurance company, healthcare system, or any other outside entity.

You pay a simple monthly membership fee for primary care services such as office visits, communications, and most tests performed in the office.

Medications, outside tests, and referrals can still be covered through insurance, but our practice does not bill insurance for our own services.

DPC is not insurance and does not replace insurance.

DPC membership includes direct access to your primary care for preventive care, chronic condition management, and unexpected illness or injuries - without charging copays or deductibles. Membership does not include services provided outside the practice, such as prescription medications, surgery, specialist or hospital care, or outside testing. Those things may still be covered by insurance, often with an order from your Direct Primary Care physician.

Additionally, health insurance is required by both Federal and Massachusetts law.

Maybe. For some individuals or families, DPC can actually reduce total healthcare spending.

1. You may be able to select a health insurance plan with a relatively lower premium, and instead use that savings toward your DPC membership—where you will not be charged deductibles or copays.

2. Access to high quality primary care can prevent some hospital visits, and may decrease the need for specialists to manage common health conditions. 

The ability to save money with Direct Primary Care will be dependent on your individual health plan options and medical needs.

It should feel that way, and there are many similarities.

Both involve paying recurring membership fees for access to medical services.

One defining feature of Direct Primary Care is that we do not accept insurance payments or bill Medicare or Medicaid, in order to maintain the direct relationship between the clinician and patient.

We can still order medications, tests, and referrals to be covered through insurance, including Medicare. The pharmacy, lab company, hospital system, or specialist will bill your insurance themselves.

If you have an HMO plan, including some Medicare Advantage plans, specialist referrals will still need to be approved by an in-network PCP. In these scenarios, we try to work collaboratively with your in-network PCP to get you the specialist care that you need.

DPC can be a great option for small businesses seeking to provide cost-effective healthcare benefits to their employees. Please contact us if you are a business interested in exploring group rates.

The insurance-based payment system in the US has, over time, created a an environment where primary care often feels impersonal, rushed, and full of distractions—all while actually increasing the overall cost of healthcare.

In addition to practicing as a primary care physician, I have worked for years to understand, navigate, and improve the healthcare system from within organizations.

Eventually, I adopted the growing Direct Primary Care payment model, in order to practice independently and focus on the direct care of patients, without the distractions of complicated third-party payment arrangements.

We can order tests and treatments to be covered by Medicare or MassHealth, but do not bill those programs for our services.

As Lotus Primary Care grows, we hope to be able to provide a limited number of free or reduced-cost memberships for individuals and families who are economically disadvantaged. If you believe you may qualify, please contact us to ask about requirements and availability.