Do you accept insurance?
While we are not in-network, our statements may be submitted for full or partial reimbursement if allowable by your health insurance plan. Please contact your health insurance provider directly to verify amount covered, deductible and co-payments for out-of-network providers by asking the following questions:
- Am I eligible for out-of-network (OON) benefits?
- How much is covered for OON provider
- How much is my deductible and has it been met?
- What is the co-pay amount for OON?
- Are there other out-of-pocket fees I need to be aware of?
What are my payment options?
We offer two payment model options:
- Fee-Per-Visit involves payment of each service separately. Standard rates apply depending on the complexity of the problem and underlying health status.
- Direct Primary Care involves a membership fee paid monthly for primary care services including consults, visits, clinical and laboratory services, care coordination, and comprehensive care management.
How much does it cost?
Services are affordable and fee estimates are provided BEFORE electing a service. We do not perform unnecessary testing or procedures.
- Fee Per Visit Fees range from $150.00 to $350.00 depending on the complexity of the problem and underlying health status.
- Direct Primary Care Fees depends on the membership option(s). Monthly fees range from $99.00 to $275.00 per month.
What exactly is Direct Primary Care?
Direct primary care (DPC) is an affordable healthcare membership model involving a pre-determined package of healthcare services for a monthly fee. Patients receive substantial savings associated with their care without the limitations of insurance coverage, co-pays, or hidden fees. Benefits include a greater degree of personalized care, 24/7 accessibility to physician and staff, flexible appointment scheduling after hours or weekends and integrated services. Click here for an explanation dpcnation.org
Can I just have a visit without becoming a member?
Yes. We’d be happy to show you around and answer any questions. You can also be seen for health related issues without committing to a membership plan. Standard rates apply depending on the complexity of the problem and underlying health status. Although competitively priced, these services do not include the value or conveniences offered with the Direct Primary Care Membership.
Are there any contracts or commitments? What if I decide to cancel?
A minimum of the first month of membership and a registration fee is paid upfront and are non-refundable. If you decide to cancel and have a balance of prepaid membership fees remaining, a pro-rated refund will be given to you based upon date of cancellation.
May I re-start my membership after canceling?
Yes, we do allow for re-enrollment after cancellation, but members will be charged a re-enrollment fee before service can be restarted.
What about lab work and other testing?
Laboratory services include collection of blood and body fluids for onsite analysis or submission to a laboratory. We offer testing for strep throat, COVID 19, pregnancy test, sexually transmitted disease, EKG, uranalysis, breathing tests (spirometry), hearing screen (audiometry) and more. Most health insurance companies cover these fees. For uninsured patients or non coverage by health insurance, we offer significantly discount wholesale prices 50%-90% less than out of pocket cost.
What if I need a specialist, special testing, ER, surgery?
We can order and refer just as any insurance-based doctor can. We can provide many urgent care (stitches, simple fractures, etc.) and office procedures (toe nail removal, skin biopsy, etc) during regular or after-hours to avoid a trip to the ER.
Do I still need insurance if I become a member?
Yes. Direct Primary Care is not insurance and is not a substitute for health insurance. You should still maintain your present health insurance plan or purchase one. The most common and economical approach is a high deductible plan with lower monthly premiums to cover for specialized care, emergency room visits, complex procedures and hospitalization.
Can I use my insurance elsewhere if I join Solstice?
Your insurance plans will continue to operate “as usual” at other doctors, hospitals and pharmacies.
Can I submit visit claims to my health insurance plan for reimbursement?
Fee Per Visit patients may submit visit claims for out-of-network reimbursement. DPC members may submit claims for services not included in the membership (specialized services, tests, labs, and x-rays, etc.) for out-of-network reimbursement.
Can I use my FSA or HSA accounts/cards with Solstice?
Very likely. You may be able to use FSA (flex spending) or HSA (health savings) to pay for our fees. Please contact your FSA/HSA provider to verify eligibility.
What are your regular clinic hours?
Our regular clinic hours are 8:00 am – 5:00 pm, Monday-Friday. However, all members have access to the doctor 24/7/365 by phone and after-hours visits if required.
What if I have more questions?
As a courtesy to interested individuals, we offer a complimentary visit to provide information about our services, pricing and payment options.
Why Choose Solstice Health & Wellness?
For a better doctor/ patient relationship, accessible care, convenience and a stress-free way to get and stay healthy.