Common Questions

Do I need insurance to be a member?

No, we do not require it for membership, but we still recommend having insurance to comply with federal law. Sunny Health DPC does not replace insurance; being a member of our practice covers your primary care needs, but does not cover hospitalizations or major surgery, or specialist care if needed, which is when your insurance is used. Direct primary care pairs well with high-deductible health plans.

What are your prices?

Please review our Prices page on our website

Can I use my HSA/FSA account?

Absolutely, you can!

I have Medicare, can I sign up?

Yes! You will need to sign a one-time waiver declaring that neither you nor our office will directly bill Medicare for our services. Your Medicare can still be used for labs, imaging, medications, and specialist care, as well as hospitalizations.

Is this a 24-hour service?

No, it is not a 24-hour service; however, we do provide after-hours care to our patients.

Is there a sign-up fee to become a member?

Yes, there is a one-time sign-up fee of $100 for individuals and $150 for couples or one family. This is only one one-time fee for opening the accounts. However, this fee is reapplied if the account has been closed and reopened after six months.

What if I decide to cancel?

If you decide to cancel, just let us know. We expect to have an open, honest, respectful relationship with you. There is no minimum commitment. We ask that you give us a 30-day notice if you wish to cancel. If you cancel and then decide to rejoin, you will be asked to pay the enrollment fee again. We only take a limited number of patients, so we cannot guarantee there will be availability. If this is the case, you will be placed on the waiting list.

What medical conditions do you manage/care for?

We can manage many types of acute and chronic medical conditions in pediatric, adult, and geriatric patients.

Can I continue to use my current insurance? Can it be used?

For the services provided by Sunny Health DPC, we do not bill or accept insurance. We will work with you to provide you with the most cost-effective health care. You can choose to use your insurance for labs, imaging, and medications.

Is this concierge medicine?

No, there are similarities between the two models, as both try to improve care and access for patients but the main difference is cost and model of payment. Typically, concierge practices charge an annual retainer along with billing insurance. The typical annual retainer amount is between $1,600 -$2,400 per year. Direct primary care practices are more affordable and generally do not bill insurance for services provided.

What if I get a serious medical illness or need surgery/specialist?

This is the time you use your insurance - hospitalizations or surgery/specialist. We recommend that you have some sort of safety net for unfortunate, unexpected, serious medical conditions that may occur. *HMO insurance plans can be challenging with DPC, as we are not part of insurance plans/networks.

I own a small business. Can the Direct primary care model help me?

Absolutely, we may be able to save you money and provide quality care to your employees. Please contact us if you would like to learn more and discuss options that fit your business's healthcare needs.

I do not see the doctor often, why should I become a member?

Everyone needs healthcare, and it is important to have a doctor who knows "you". In the Direct Primary Care model, being able to call, text, email, or video chat your doctor about any medical questions that may arise is a plus and is convenient and may save you money/time. We can help keep you healthy with routine check-ups and when you do get sick we will be there to guide you.

What does it mean when you say "we are able to provide price transparency"?

No more co-pays, surprise bills in the mail or hidden fees! that you get after the fact and not knowing what was paid for by your insurance. In the Direct Primary Care model, you pay an affordable monthly membership fee and for any additional costs for labs, medications, or procedures that we do, you will know up front before you are charged.

Anymore questions please contact us!