DPC for Employers
Frequently Asked Questions
What is Athena Direct Primary Care & Lifestyle Medicine Center all about?
Athena DPC is concierge level care at an affordable price.
We believe having exclusive access to your own personal physician should be easy, convenient and affordable. Therefore, we provide highly personalized whole-person primary care, including the healing power of a strong patient-physician relationship. And because of the conviction that a patient’s health and wellbeing is so much more than the absence of illness, our mission is to cultivate and nurture a long-lasting patient physician relationship to promote lifelong health and wellbeing.
What sets Athena DPC apart from other primary care practices?
Our vision is to create easy and convenient access to highly personalized primary care that is affordable for everyone. We strive to help people live their best lives through evidence based strategies to improve lifestyle and overall wellbeing.
Medical literature shows that up to 80-90% of chronic illness is caused by poor lifestyle. At Athena Direct Care we tackle the root cause of disease to treat and reverse chronic illness through evidence based lifestyle interventions.
Why don't you accept health insurance?
By accepting payment from a third party, physicians also then must accept all the restrictions and limitations how to provide care for you imposed by those other companies. And so it is for this reason, instead of accepting payment from any third party payers, we work for you and you only– the way healthcare should be.
Perhaps the most critical distinction of our practice is that it focuses on a direct, personal relationship between you and your doctor. That directness carries over to our business model as well. We forgo insurance payments in order to save our patients from the arbitrary, intrusive decisions that inevitably come with third-party payers.
What is Direct Primary Care? Why can't you just take my insurance?
Under the Direct Primary Care (DPC) model, the patient (you) receives comprehensive primary health care directly from their personal physician. The patient pays for this care through a reasonable monthly fee, paid directly to Athena DPC. That fee covers many primary care services, like office visits, telemedicine, etc.
Because DPC practices do not participate in any insurance or plans, the physician is able to avoid the ever-increasing and costly documentation demands and administrative intrusions that come with accepting insurance. These require staff, time, and money, often amounting to substantial intrusions on patient privacy.
Because DPC physicians avoid these obligations to insurance companies, they are free to spend more time listening to and treating patients instead. And because DPC physicians eliminate the significant overhead costs of participating in insurance, they can pass the savings on to you, the patient– and give compassionate, attentive and timely care at an affordable cost.
We will work for you, NOT some giant only-profit-driven corporation.
Honestly, it allows us more time to build relationships. We believe it’s these relationships that do the real healing work.
You will still use your insurance to pay for medications, lab testing, imaging, specialists and hospital care.
As a patient of Athena DPC, will I still need health insurance?
Yes, absolutely! We recommend that our patients enroll in a medical health insurance plan or medical cost-sharing plan, and a health savings account, thereby ensuring financial help should hospitalization, surgery or referral to a specialist be necessary.
You need health insurance for the big things like surgery, cancer treatment, heart attacks, and car wrecks. We encourage you to have a major medical plan.
Some patients have chosen to enroll in a high deductible plan. This has significantly lowered their monthly premium for health insurance.
Why would I become a patient of Athena DPC if I already have insurance?
We accept all patients: insured, Medicare, uninsured, etc. We just don’t bill these third parties. But just because you have insurance doesn’t mean you still don’t pay twice. Each copay and office visit adds up. With four visits a year you have paid the same amount as a year of our membership!
In fact, the dirty little secret to health insurance is that “employees will pay an average of $2,487 in out-of-pocket costs, such as copayments, coinsurance and deductibles”. So, you may SAVE money if you have insurance and join our practice!
Can I afford membership at Athena DPC?
The monthly fee is very often lower than an average cell phone bill. The yearly amount of the membership fee is less than what most people pay for their deductible alone. Studies show that most people with high deductible plans avoid to seek proper medical care because of their deductible.
However, if you are a member at Athena DPC, you rest assured that up to 90% of your medical needs will be taken care of without extra cost. And you have exclusive, direct access to care whenever you need it, wherever you need it.
Is my membership at Athena DPC considered health insurance?
NO. Your membership at Athena DPC is NOT considered health insurance and does not replace health insurance. Our membership includes all your primary care services provided by our office as stipulated, see all services. We strongly recommend our members to sign up for some type of health insurance plan to cover things like: medications, labs, imaging, hospital stays or specialist visits.
If I have Medicare or Medicaid, can I still join Athena DPC?
Yes! You need only to sign a waiver declaring that neither you nor your doctor will ever directly bill Medicare or Medicaid for our services. Medicare or Medicaid will still cover any laboratory testing, imaging, medications, or hospitalizations prescribed by our offices.
What happens if I need to go to the hospital or see a specialist?
In providing comprehensive care with unprecedented access, we strive to prevent or reduce hospitalizations and need for specialty referrals. In those instances where those types of care are required, we will certainly continue to serve you during your hospital stay or to work closely with any specialist. In some cases, depending on the level of care and the sorts of expertise required, we may rely on those specialized caregivers to manage your treatment.
What about referrals, testing or prescriptions?
Nothing changes. As your personal doctor, I will be able to coordinate appointments and personally discuss your treatment plan with the specialist. When you see a specialist, it will be a conventional visit using your medical insurance or medical cost-sharing plan. We are then able to follow-up with you and your specialist about the visit. Any studies are ordered and set up just like in a regular practice. Your prescriptions go to the same pharmacies you choose. It it that simple and seamless.
Will I still benefit from Athena DPC even if I don’t require frequent medical attention?
Of course. In fact our focus is to work closely with you to help you live your best possible life through the principles of Lifestyle Medicine. We want to partner with you and work on preventing and reversing disease before it becomes active with symptoms. We strongly believe in pro active care rather than sick only visits. We will develop a personalized lifestyle care plan for you and partner with you to achieve your goals. We will meet you where you are in your lifestyle change journey and help you in a personable, non-judgmental manner to positive change.
Is my membership to Athena DPC tax deductible?
Please consult with your tax consultant to clarify tax consequences in your particular circumstances.
Can children become members of Athena DPC?
No, Sorry! We only can accept patients 18 years old and older.
Can I contact my physician after hours? And how?
By all means, yes! Because illness and injury do not respect regular clinic hours, you may call your physician any day, at any hour for urgent matters. You may also use secure text or email to contact your physician directly for non urgent matters. We will make every effort to reply within 24hours. Always call 911 for medical emergencies!
What if I need medical attention while I’m away from home?
Naturally we provide such care– yet another freedom we enjoy together as a result of our independence from the restrictions of third-party payment. Because we know you well, we can streamline your care when you’re sick away from home. In the age of telemedicine, some illnesses can be diagnosed and treated with a simple conversation by phone or webcam. We’ll locate the nearest pharmacy and order the medications most appropriate for your present circumstances.
Are my medical records ever shared with insurance carriers or pharmaceutical companies?
We maintain scrupulous standards of privacy. We are never obligated to provide any third party with a copy of your records, unless you specifically ask that we do so.
How will I know if Dr. Petrescu is the right doctor for me?
We encourage you to schedule a free, no obligation “Meet and Greet” visit with Dr Petrescu. It’s the only reasonable way to begin what, we trust, will be a long, productive, altogether healthy friendship.
How does insurance work in all of this?
You should have some type of medical insurance or medical cost-sharing for any ancillary testing, imaging, medications, specialist consultations or hospitalizations that you may require. You may continue to use the same pharmacy, laboratory or imaging center that you like and accepts your insurance. We will order all medications or imaging that we medically necessary for you the same way the traditional primary care practice does.
What hospitals can I use?
You will go to the hospital of your choice. We will then stay in close contact with you and the hospital staff during your hospitalization.
Does my monthly fee apply to my insurance deductible or can it be made tax deductible?
Your monthly fee does NOT count toward your medical insurance deductible. Some patients have Health Savings Accounts or Flexible Spending Accounts which may allow for your monthly fees to be paid with pre-tax dollars. You should check with your specific plan to find out if this applies.
Do you make house calls?
We do make limited house calls for those who are acutely ill and circumstances make it such that they cannot come to the office. We do not care for totally home bound or nursing home patients. Feel free to inquire more about this. Our house call fee is $150.
Can I cancel anytime?
There are no commitments and you may cancel at any time. We do not want you to have to stay with us if you don’t like it. However, if you choose to join again, there is a $200 re-activation fee.
This is all very new and different stuff. I want to check things out with my insurance, but what do I ask them?
Dr. Petrescu will be considered an out of network provider. You’ll want to ask if an out of network provider orders labs, imaging, referrals or medications, will that service still be covered.
If you want to describe what the type of practice this is, you can describe it as:
- Direct Primary Care
- an affordable Concierge Practice
- a Membership Model Practice
By participating in this practice, does this count toward ACA requirements?
Unfortunately, no. Being a member of this practice will not count toward the ACA requirements. You can consider getting a low premium, high deductible plan to pair with our practice for the most economical way for your overall care.
Is there a limit to the number of patients you'll accept?
Yes. We strive to provide each member with personal attention and care they deserve. Dr. Petrescu is only one person. There is a balance of what one human can do to provide optimal care. So in order for Dr. Petrescu to have time and flexibility for each patient, enrollment will be limited to 400 patients.
You may choose to stop your membership at any time and be removed as an active patient. If you choose to rejoin, you will be placed on the waiting list for new patients if the panel is full and there will be a $200 re-activation fee.
What if Dr. Petrescu is on vacation?
Unless there is an emergency, we will notify you ahead of time when upcoming vacations and away-times are, so that you can plan to be seen and have all your needs addressed before she leaves.
Did you not find the answer you were looking for? We are happy to answer any other questions you may have. Drop us a line below.