What Is Direct Primary Care?

Direct Primary Care, DPC, is a revolutionary new model of health care where the member and the doctor form a direct relationship without the red tape and interference from insurance. The DPC model allows us to maintain the highest quality care at an affordable cost. The Direct Primary Care model allows us to keep the practice small, so that we can provide accessible, high quality, personalized primary, integrative and preventive care.

Is Direct Primary Care the same as Concierge Medicine?

No. Most Concierge Medicine practices charge an annual fee for access to the practice, but also continue to bill insurance for services as usual. Direct Primary Care focuses on keeping your costs low. Your monthly membership fee not only covers your access to Dr. Velez but also includes the majority of your care without any additional co-payments or insurance billing. By keeping costs low, Direct Primary Care can be affordable to anyone regardless of insurance status.

What Is Included In My Membership?

Most everything you have come to expect from Dr Velez is included as part of your membership. Dr Velez practices Integrative Family Medicine and integrates holistic treatment such as lifestyle modifications, and supplements to optimize your health when appropriate. No co-pays, and no surprise bills!

• A personal relationship with your doctor
• Well Visits, sick visits, chronic disease management, injuries, sports/school phsyicals, and common office procedures.
• In office lab testing such as pregnancy tests, urinalysis, rapid strep/flu.
• Same day or next day sick care
• Save time with Televideo, e-mail, texting, and phone calls
• 30-60 minute unrushed appointments
• Coordination of care with specialists and hospitals
• Access to discounted labs, imaging, and medications
• Access to discounted supplements
• Discounted rates on Velez Family Health's Lifestyle Programs such as Group Metabolic Detox, First Line Therapy, and Body Composition analysis

What are other benefits of Direct Primary Care?

• Increased privacy- we will not release any information without your consent, especially not to an insurance company.
• No insurance hassles or claim denials
• Reduced healthcare costs
• Dedicated time with your doctor
• Better health outcomes
• Patient and Doctors chooses best plan of care not the insurance company
• No surprise bills
• Multiple ways to communicate with your doctor directly including e-mail, text, phone, and televideo.
• Direct Coordination of care with specialists and hospitals

Do you take my health insurance?

We will see any member regardless of health insurance status. We will never bill insurance and are out of network for all insurance plans including Medicare beginning January 1st, 2021.

Why would I pay for this when I already have health insurance?

Direct Primary Care (DPC) membership ensures fast access to personalized care and saves money for our members. Insurance is important to cover emergencies, and unexpected expenses. Utilizing health insurance for primary care, actually makes primary care much more expensive, and affects the quality of care. Would you use your car insurance to put gas in your car or get an oil change?

Dr Velez and staff, at Velez Family Health, can help negotiate and find the best rates for labs, imaging, medication, and even coordinate the care with specialists and hospitals. We have been able to save our current patients a significant amount and expect to see even greater savings via the Direct Primary Care model especially when pairing with a high deductible health plan or Health Share.

Who does this membership plan work best for?

Everyone can benefit from the Direct Primary Care model at Velez Family Health.

This model works especially well for:

• Members who take pride in their health and are motivated to make changes for a healthier and more vibrant future.
• Members who want a direct relationship with their doctor.
• Members who want more time with their doctor.
• Members who want to investigate and work on the root cause of illness.
• Members who would like to explore ways to decrease the amount of medication they take or prevent needing to take medication in the future.
• Members who would like to focus on wellness and prevention.
• Members who are self-employed, un-insured, under-insured or have high deductible plans.
• Self-insured small businesses wanting to provide high quality, cost effective healthcare and wellness for their employees.

Can I still benefit from Direct Primary Care if I am healthy and rarely see a doctor?

We focus heavily on lifestyle and prevention to help keep you healthy in the long-term. Routine wellness visits can help keep you healthy and prevent disease before it starts. Together we can create a personalized plan to help you achieve and maintain optimal health. By using diagnostic testing and risk stratification we can identify risk factors and health issues before they cause disease. This ultimately will save you money, time, and higher costs in the long run. In the Direct Primary Care model we have the time to really focus on your goals and deliver comprehensive primary and preventive care.

Life can be unpredictable. Being a member of a DPC practice means you will be taken care quickly and efficiently in the event that you were to get sick, injured, or any other unexpected medical issues. When an unexpected event arises you can contact your DPC and get help via a same day visit, or telemedicine visit. Often times this can save an urgent care or emergency room visit that can be very expensive. The cost of an emergency room visit is much higher than the cost of a one year membership to our practice.

What is a health share and how is it different than traditional insurance?

A health share plan is not considered "health insurance", and is an excellent alternative to health insurance for some people. They provide financial protection for families that are looking for ways to decrease their health care costs and help cover expenses of unexpected medical issues. You become a member of a health share community and share medical expensies with other like-minded members in order to keep eveyrone's health care costs low. Some health shares give you a discounted "share amount", or amount you pay monthly, if you are a member of a Direct Primary Care practice. They know that members of DPC practices have better outcomes and spend less on healthcare in general due to having excellent primary care. Some of my favorite health shares are Sedera, Zion, and Christian Healthcare Ministries. Unlike, Affordable Care Act approved health insurances, health shares may not cover some pre-existing conditions within the first 12 months. Every plan is different so it is best to compare your options.

Should I still have health insurance coverage if I am a member?

Yes. Direct Primary Care is not a health insurance program. It is important to have some sort of health insurance or Health Share to help cover more expensive, unpredictable, specialized care you may need such as hospitalization, surgery or emergency care. This type of coverage is sometimes called “catastrophic” coverage. Most people can save money by choosing a higher deductible, lower premium plan or joining a health share combined with a Direct Primary Care membership. Each individual’s situation is different and we recommend you make a decision based on your own circumstances including coverage for any pre-exisiting illness or injuries. You may also use insurance for lab testing, imaging studies, medications, and specialist appointments.

Utilizing health insurance for primary care, actually makes primary care much more expensive, and affects the quality of care. Our goal is to have members who have long term sustainable health with good quality primary and preventive care. With Direct Primary Care we do not have to abide by the rules and regulations of insurance companies and can focus directly on you. We will never bill insurance. By not billing insurance the DPC model results in significant savings due to reduced paperwork, time, and overhead. This savings is passed on directly to you and keeps membership at a low affordable cost for everyone.

What if I have an HMO insurance?

We will see any member regardless of insurance status or type of insurance they have. Many times we can help you get discounted rates on labs, imaging, and medications without the need of going through your insurance.

Please keep in mind that HMO plans typically require a referral (prior authorization) for a specialist visits and some HMO’s also require an authorization for all orders such as imaging from an in-network primary care physician. Since, we are no longer in network with any insurance plans as of January 1, 2021, we will be unable to get this authorization for you. We recommend that you have an in network PCP that maybe able to provide this for you if you would liek to utilize your insurance for such things. You may still be a member of Velez Family Health practice regardless of insurance.

Can I be a member if I have Medicare?

Definitely. As of January 1, 2021, I am opted out of Medicare. We will never bill Medicare. As part of your agreement you will sign a Private Contract stating you understand that we will never bill Medicare, and you will also not submit any claims related to our practice to Medicare for reimbursement. You may still use your Medicare coverage to cover other things such as your lab testing, imaging studies, medications, durable medical equipment and specialist appointments.

The Direct Primary Care model allows more time with your doctor which works particularly well to be able to handle some of the more complex issues affecting our older members including chronic diseases and medication management.

What if I have to see a specialist?

Direct Primary Care allows more time with your doctor. This allows for more comprehensive evaluation and management of problems. Many problems that are referred in a traditional insurance based practice can be better managed in a Direct Primary Care practice. This model also allows more time for Dr Velez to research and consult other physicians about your particular case. In the event that you are referred to a specialist, we will coordinate your care by helping you find the appropriate specialist. Prior to your visit with your specialist, Dr Velez may even call the specialist and speak to them directly. This allows a more efficient and comprehensive visit when you arrive to your specialist office.

If you have insurance coverage you may choose to use your insurance to cover specialist visits. Please keep in mind that HMO plans typically require a referral (prior authorization) for a specialist visit from an in-network primary care physician. Since, we are no longer in network with any insurance plans as of January 1, 2021, we will be unable to get this authorization for you.

What happens if I need Urgent Care?

If you have a life-threatening medical emergency, you should call 911. A family member or loved one can call our office to alert us so that we can be in contact with the doctors in the hospital if needed.

For things that are not emergencies, you may contact the office. We will provide an after-hours line in the event that you need urgent care after hours. We will also provide to our best ability same day or next day visits for any acute needs. When appropriate, a phone call, or visit with Dr Velez can many times save an ER or urgent care visit and help save you time, energy and money.

What to do when the doctor is on vacation?

As a member of Velez Family Health, there will always be a doctor available. Since many concerns can be addressed via phone, e-mail, text, or televideo, a visit in the office is not always necessary and means that no matter where Dr Velez is she can be available for any urgent needs. Anytime Dr Velez is on vacation, there will always be a trusted Physician colleague available to assist you with any urgent matters.

How do I become a member?

We like to have a free "Meet & Greet" call with any prospective members to make sure that the Direct Primary Care Model is a good fir for you and your family. You will then receive the enrollment instructions. To schedule your Meet & Greet, you may click on the button above, or you may call/text the office at 407-530-6591.

What Is My Commitment? Can I Cancel My Membership?

We strive to provide the best quality care by building a long term relationship with our members. We hope to have members that have the same commitment to their own health as we do. At enrollment you will sign a patient agreement that contains specifics about what the membership model. You can cancel at any time with 30 days’ notice. Any pre-paid membership fees will be pro-rated and returned to you. Re-enrollment will be considered on a case-by-case basis if space allows, and subject to a re-enrollment fee (per signed agreement) or the lapsed months, whichever is lesser, within the 12 month term of original agreement. The registration fee or re-enrollment fees are non-refundable.