Question 1

Do you take health insurance?

Accepted Answer

No, we don't bill or use health insurance. As a DPC practice, we instead offer personalized low-fee monthly subscriptions.

Question 2

As a patient at OPFMT, will I still need health insurance?

Accepted Answer

Yes. We recommend our patients have health insurance to help cover any major health expenses such as a heart attack or blood clot.

Many patients find that a high-deductible plan and a health savings account are the best way to go.

Question 3

Can I use my insurance to cover lab work, medications and/or imaging studies?

Accepted Answer

Yes. Though we have negotiated significant cash-pay discounts for our members, you may still decide to use your insurance for these services by telling the lab facility/pharmacy/imaging center to submit a claim to your insurance on your behalf.

Question 4

Can I still join if I have Medicare?

Accepted Answer

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.

Question 5

Will I be charged the full monthly membership regardless of when I register?

Accepted Answer

Yes - you will be charged the full monthly membership when you first register.

However, your second month will be prorated - meaning if you signed up on the 25th of the month, your first invoice will include the charge from the 25th - 25th and the second month invoice would only include the prorated charge for the 26th - end of month.

Question 6

Is the membership fee eligible for HSA or FSA reimbursement?

Accepted Answer

We are not qualified to give tax advice, and there is a disagreement among experts.

You should ask your employee benefits manager or account 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.

Frequently Asked Questions

Payments and Insurance

Do you take health insurance?

As a patient at OPFMT, will I still need health insurance?

Can I use my insurance to cover lab work, medications and/or imaging studies?

Can I still join if I have Medicare?

Will I be charged the full monthly membership regardless of when I register?

Is the membership fee eligible for HSA or FSA reimbursement?

Our Memberships and Care

I need an initial evaluation - how do I set this up?

I am fairly healthy and don't require frequent medical visits, should I still join?

If I already had an initial evaluation for gender affirming care, will I need to be re-evaluated?

What if I decide to cancel my membership?

Still Have Questions?

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Outpatient Family Medicine Transformed

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