Memberships & Credentials: American Academy of Family Physicians (Boarded) • DPC Alliance • OH AAFP

Understanding the true cost of healthcare involves more than just insurance premiums. This analysis reveals how Direct Primary Care (DPC) significantly reduces overall healthcare expenses and out-of-pocket costs for a single 35-year-old individual across various scenarios.

Let's compare the annual healthcare costs for a single 35-year-old individual who has two urgent care visits, two primary care visits, and regular medication throughout the year.

In this routine care scenario, DPC membership dramatically reduces the "out of pocket max" (green portion) and the "deductible still left over" (yellow) sections. By covering routine services, DPC acts as a buffer against unexpected bills, offering clear savings compared to traditional insurance models where co-pays and deductibles quickly add up.

Now, consider the same single 35-year-old individual, but with the added need for one abdominal CT scan during the year.

This scenario highlights one of DPC's most significant advantages: access to cash-pay pricing for imaging. While DPC doesn't cover procedures like CT scans directly, DPC physicians can order imaging directly at cash-pay facilities, bypassing the typical insurance markup.

An abdominal CT through insurance might cost $2,000-3,000 (applied to your deductible), but cash pay pricing can be as low as $400-800. This substantial difference helps keep the "deductible still left over" (yellow section) dramatically lower for DPC members, as shown in the graphs. This applies to CT scans, MRIs, X-rays, and ultrasounds, often leading to 50-70% lower costs than insurance-negotiated rates.

Families often face higher healthcare utilization due to the varied needs of multiple members, from routine check-ups for children to managing chronic conditions for adults. Direct Primary Care (DPC) provides even greater value for families managing multiple members' healthcare needs by offering comprehensive, accessible, and cost-effective primary care solutions.

Let's compare the annual healthcare costs for a family of 4, assuming 5 urgent care visits, 6 primary care visits, and 1 medication for the whole family during the year.

By consolidating primary care costs into a fixed membership fee, families gain predictability and substantial savings compared to traditional insurance models where co-pays and deductibles quickly accumulate across multiple family members. Yes, it is a bit more expensive, but the value of one provider, with significantly improved access remains.

Now, consider the same family of 4, but with the added need for one abdominal CT scan during the year.

This scenario highlights how cash-pay imaging benefits are amplified for families. When any family member needs imaging (CT, MRI, X-ray, ultrasound), DPC provides access to 50-70% lower cash-pay rates. For example: a family CT scan through insurance might cost $2,000-3,000 (applied toward your deductible), but cash pay pricing can be as low as $400-800. This substantial difference keeps deductibles lower across the board, as shown in the graphs. Over time with multiple family members and varying healthcare needs, these savings compound significantly. DPC physicians order directly at cash-pay facilities, avoiding insurance markup entirely.

Health happens in community. Join monthly social groups focused on topics that matter to you—from the Sandwich Generation juggling young kids and aging parents, to perimenopause and menopause support, to Walking events. You name the topic you'd like to explore with others.

Simple, predictable monthly fees mean no surprise bills. Know exactly what you'll spend on primary care each year. All pricing includes visits throughout the month, messaging, and care coordination.

Cancel anytime, though re-enrollment fee of $200 per person applies if you return.

For those 65 years of age and above and interested in the practice please join our wait list as Medicare Part B would require opting out for Dr. Pomrenke.