Charlottesville Direct Primary Care FAQs

what exactly is direct primary care?
DPC is a movement across the country. It is an insurance-free, membership-based model of care that allows more personalized, accessible, affordable care.  Dr. Neal and Dr. Downey LOVE what they do and feel that a DIRECT relationship with their patients is the only way to provide meaningful care.  

Our low monthly fees are made possible by a lean business model.  No insurance billing (no billing or coding departments necessary) decreases overhead tremendously.  In addition, our patient panels are smaller than in a traditional practice, which allows us the time we need to get to know our patients and to provide prompt care in whatever way necessary (same or next-day clinic visit, email, text, house call, phone call or video chat). If you have insurance, we will help you utilize it in the most cost effective way for you. It's back to good old-fashioned relationship-based care where your doctor knows you and is available whenever needed.
​would direct primary care be right for me?
DPC is ideal for many different groups of people, including:
  • People with lower cost, large deductible insurance policies ("catastrophic plans"), as these products typically do not pay for outpatient visits. These plans are usually paired with an HSA, which you can now use to pay your monthly membership fees.
  • People who value wellness and want to stay healthy. We can see you for lifestyle issues (stress reduction, sleep) without time pressure.
  • People with complex medical histories typically requiring frequent medical visits and needing more time with their physician.
  • People who want to take charge of their own health care, without government or insurance interference.​​ 
  • People without insurance.                                                                                                                                                         
what is included in the dpc membership?
  • Unlimited visits with your personal, board-certified physician.
  • Annual wellness visit & physical.
  • Direct access to your personal physician by phone, email, text or video chat.
  • Same day or next day appointments for urgent needs.
  • Medications at wholesale prices (coming soon!).
  • Assistance in finding the lowest discounted rates for imaging (X-rays, CAT scans, MRIs, etc) negotiated with local facilities.
  • All in-office procedures as needed (EKG, spirometry, mole removal, stitches, breathing treatments, routine fracture care, skin biopsy, cryotherapy, hearing and vision screens, ear wax removal, pap smears, IUD removals, urine pregnancy test, etc). 
  • Much more. Please ask. If it is not listed, it is most likely still included! Email or call us.
are there any income or health guideline restrictions to becoming a member?
No.  We welcome anyone to join no matter what your income, insurance or health status may be.​​​
what does it cost?
Less than you might think!
Please check out the Pricing page to learn more details about our membership & straight-forward pricing.
Why do I need a Primary care physician?
Everyone should have a primary care physician. As noted in the International Journal of Health Services, "primary care is by far the most significant variable related to better health status." 
as a patient here, will i still need health insurance?
Yes. We recommend that our patients continue to carry, at minimum, both a major medical plan and a health savings account, thereby ensuring financial help should hospitalization or referral to a specialist be necessary. Pairing a lower premium health insurance plan with our model can offer significant cost savings while providing excellent primary care services.  ​*** Update *** Direct Primary Care memberships have been approved as an accepted use for Health Savings Accounts (HSA). Use your HSA account to pay your monthly membership fee and get unlimited primary care services. ​
do you process insurance?
No. However, if you need labs, radiology, specialist, emergency or hospital care, they will process your insurance.
why don't you process insurance?
We love taking care of our patients, not the insurance companies. Insurance is best designed to cover big, expensive, unexpected medical costs. There are limitations as to how much insurance will reimburse for a single primary care visit.  In addition to lack of time, this may explain the reason why your doctor may require you to return to discuss multiple issues. Insurance will not reimburse for all services to be addressed in the same office visit. By cutting out the middlemen (insurance companies), Direct Primary Care allows improved access, quality care and value while also improving the health and well-being of both patient and doctor.
I own a business. Can I buy memberships for my employees?
Charlottesville Direct Primary Care helps employers to dramatically improve healthcare quality for employees and their families, while significantly reducing overall health plan costs.  Please email for negotiated rates based on number of employees. The cost of employees' memberships, if paid by an employer, are tax-deductible (please consult your accountant).  We are excited to offer this opportunity for all sized businesses as an added benefit to your employees to supplement high deductible insurance plans. ​*** Update *** Direct Primary Care memberships have been approved as an accepted use for Health Savings Accounts (HSA). Your employees can utilize an HSA account to pay monthly membership fees and get unlimited primary care services. ​
i have medicare/medicaid/private insurance. can you see me?
Yes, but neither Medicare/Medicaid/private insurance can be billed for any of the services that we provide.  Any services that you may be referred to (labs, imaging, sub-specialist consult) as well as ER visits and hospitalizations ARE eligible for Medicare/Medicaid/private insurance reimbursement and will be submitted to Medicare/Medicaid by those providing that service (the lab, imaging facility, specialist, etc).  Our goal is to provide excellent primary care to help avoid unnecessary sub-specialist visits or hospitalization and to help navigate your financial burden within the system. We can reduce your out-of-pocket costs even if you have traditional insurance. Often the savings we can find for you will pay for your monthly fee. 
is my membership tax deductible?
Your membership fee is not yet defined as a “medical expense” in most states and as such is not deductible. The American Academy of Private Physicians, however, is lobbying hard to win rightful deductibility for these expenses. In the meantime, consult with your tax consultant to clarify tax consequences in your particular circumstances.

In the meantime, utilize your health savings account (HSA) to pay your membership fees! ​ *** Update *** Direct Primary Care memberships have been approved as an accepted use for Health Savings Accounts (HSA). Use your HSA account to pay your monthly membership fee and get unlimited primary care services. 
can you manage chronic pain? how about narcotics?
We manage chronic pain. We will try every treatment modality available to manage your pain and more importantly investigate the source to hopefully eradicate your pain.  We have strict guidelines on use of opioid pain medications (.oxycodone, hydrocodone, tramadol, etc.) and prefer to manage these conditions with other strategies and non-addictive medications when possible. We comply with all state regulations including urine drug testing and contract maintenance.
what about mental health? do you manage depression, anxiety, etc?
Yes. Our board-certified physicians are happy to help manage complex health issues, including mental health conditions. If the management requires a specialist, such as a psychiatrist, then we will refer you to one immediately. We have strict guidelines on use of benzodiazepines (sleeping pills, Xanax, Ativan, Klonopin, etc) and stimulants (Adderall, Vyvanse, Concerta, etc) and prefer to manage these conditions with other strategies and non-addictive medications when possible.
do you accept patients with no insurance?
Yes, but we strongly encourage you to keep traditional insurance for catastrophic event and specialist care.
what type of insurance plans pair well with Charlottesville direct primary care?
​*** Update *** Direct Primary Care memberships have been approved as an accepted use for Health Savings Accounts (HSA). Use your HSA account to pay your monthly membership fee and get unlimited primary care services. 

High-deductible insurance plans pair well with Direct Primary Care memberships. Other options include healthcare sharing groups, such as Liberty Healthshare, Medi-Share, Christian Healthcare Ministries, and Samaritan Ministries.

If you have Medicare, Medicaid, or private medical insurance, you may find that the additional service, availability, and quality of care that you receive through Charlottesville Direct Primary Care is worth the membership fee.
​can you help with the cost of lab testing?
Charlottesville Direct Primary Care offers our members significantly reduced pricing for lab testing for those who wish to pay directly for their labs. Members choose whether to use this pricing or have the lab submit a bill to their insurance.  For members who wish to use their insurance for labs, Charlottesville Direct Primary Care will send the insurance information to the lab for them.
can you help with medication costs?
You can use your current insurance to help cover your prescription costs or we can help you find lower cost cash options for medications. At Charlottesville Direct Primary Care, we help you find the appropriate medication at the most affordable price. 
can you help with imaging costs?
Yes! We help you to find the least expensive options available locally, whether you are using insurance or paying cash. If you have insurance, we will coordinate and help you utilize your insurance for your Xray, CT or MRI. 
what if i need specialist care?
You can use your insurance for specialist care.  If specialist care is needed, We will discuss options with you, and refer you to a specialist that best meets your individual needs, We are here to help coordinate that care with you. 

Further questions? Please don't hesitate to ask!