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OIC In Wash. State: “In our state, direct health care practices must register with us. Each is different, but all …”

Direct health care practices

By OLYMPIA, Wash. – Office of Insurance Commissioner, Washington State

A direct health care practice is a medical practice (also called a retainer, concierge or boutique medicine) that charges you a monthly fee and, in return, provides unlimited access to doctors for primary-care services.

How they work

In our state, direct health care practices must register with us. Each is different, but all:

  • Serve as your primary care provider for all routine and preventive-care services.
  • Include a set monthly fee.
  • Don’t involve insurance, so there are no extra charges, deductibles, copays, or insurance billing.

What to consider before you sign up

  • Direct health care practices are not considered qualifying coverage under the Affordable Care Act.
  • Direct health care providers offer only primary health care services.
  • They don’t include coverage for hospital stays, prescription drugs or dental care.
  • If you join a direct health care practice, consider also buying a high-deductible health plan, in case you need more costly medical care.

Know your rights

Direct health care practices can’t:

  1. Charge you more based on your health status or gender; or
  2. Change the monthly fee more than once a year.

Direct health practices may charge you an additional fee that’s not part of your agreement if they notify you before you receive the service.

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