FAQs Page

When patients choose a low monthly fee model of direct care that lowers regular medical costs drastically while providing high quality attention to their health, it makes sense that they often elect for a high-deductible, low-premium insurance plan; that insurance plan at a lower premium is then there as a safety net to aid in covering catastrophic, emergency events or for specialist medical care that isn’t available under a direct care model in their area. 

Mountains Meet Medical OPDC follows a direct care model that operates independently of insurance providers and so we are a self-pay practice, insurance-free. This is true for both our member and non-member services. We practice solely according to what is best for the maintenance of your health and your unique needs in accordance with our evidence based, medical expertise. 

If you have insurance it will still generally cover you within the scope of the policy for labs, studies, medications, specialist referrals, and other services performed or provided outside of our practice, though we have no relationship with nor can we guarantee what your policy dictates it has been designed to cover. 

Yes, absolutely! As life goes, it is usually full of surprises, including little ones, and in the health department this is no exception. Maybe you are someone who is visiting WA State temporarily for only a few months or so and therefore not eligible for your in-network nor local insurance. Perhaps you are in the position of being uninsured. 

It is wise to have a physician “in your back pocket” who understands who you are and is ready to care for you. Why not choose that physician to be a direct primary care physician who can make that financially attainable and be able to spend more time improving their skills for you, giving attention to how you and the community are doing, and addressing health maintenance needs? 

Of course, we do still recommend that you secure appropriate insurance coverage for protection in the case of unexpected medical expenses due to emergency and special needs events. 

We are sadly unable to accept Medicare enrolled nor eligible patients as of yet EXCEPT for non-covered standalone Occupational Health Purposes (see our Special Health & Occupational Services Page for a list); the federal government does not allow it until we can fully opt out as physicians. We are working on lifting this barrier in the future, as we would love to take care of you!

The short answer is Yes! We cannot participate with Medicaid in our practice, however, we are able to see Medicaid enrolled patients, as long as it is agreed upon that any service delivered directly by our practice cannot be billed or submitted for Medicaid reimbursement/payment by you as the patient or by us as the service provider. Any service that is NOT personally delivered by the practice our patients can still take to Medicaid for reimbursement as they would normally cover (such as labs or imaging done elsewhere that participates with Medicaid, or medications at an outside pharmacy that participates with Medicaid).

The short answer is Yes! We cannot participate with TRICARE in our practice, however, we are able to see TRICARE enrolled patients, as long as it is mutually agreed upon that any service delivered directly by our practice cannot be billed or submitted for TRICARE reimbursement/payment by you as the patient or by us as the service provider. Any service that is NOT personally delivered by the practice our patients can still take to TRICARE for reimbursement as they would normally cover (such as labs or imaging done elsewhere that participates with TRICARE, or medications at an outside pharmacy that participates with TRICARE). 

The Problems:

Traditional healthcare models are burdened by:

• High costs and hidden fees.

• Limited access to direct patient-physician interaction.

• Non-medical, administrative opinions that do not guarantee a priority of the interests of patient health and safety first.

• Overextended physicians that lead to long wait times and rushed appointments.

• Healthcare providers who may be under-qualified for the scope of care they are offering.

• Delayed care due to insurance and administrative hurdles, which also often compromises quality.

Our Solutions: 

The DPC and DSC models allow us to eliminate these obstacles by:

• A micro-practice direct care model that prioritizes quality over quantity.

• Offering affordable, transparent membership plans that directly mitigate exorbitant healthcare industry costs.

• Discounted rates on outside services such as outside labs, studies, and imaging.

• Maintaining small patient panels for more personalized, unhurried care.

• Providing direct access to physicians for timely care.

• Emphasizing holistic, preventive, and patient-specific care.

• Avoiding insurance-related complexities and barriers, allowing our direct care to be guided solely by medical expertise and patient needs.