Wise Patient Direct for Medicare Enrollees

 

Because Medicare is a federal program, the rules surrounding direct primary care are different than those supported by Washington State. Specifically, our Medicare contract has a clause that says it is against the contract for our practice to NOT bill Medicare for services that are covered by Medicare. The spirit of that clause, we suppose, is that practices don’t unfairly provide discounted care to some Medicare enrollees and not to others. At any rate, if you are covered by Medicare and want to joint Wise Patient Direct, we have no choice but to structure it like ‘concierge’ medicine as follows: 1) We still bill Medicare for your visits. 2) In addition, you pay to Wise Patient a concierge fee of $50/month, which is one-half of the DPC subscription rate for other-than-Medicare patients. 3) Therefore, you will still pay typical out-of-pocket costs associated with Medicare, such as co-pays and co-insurance,in addition to your monthly concierge fee paid to Wise Patient. 4) The Wise Patient Direct agreement you sign will simply state your agreement to pay the monthly concierge fee in exchange for guaranteed same-or-next business day appointments (since that guarantee falls clearly outside of Medicare’s covered services).

 

Please feel free to contact either of us with any additional questions.

 

Sincerely,

 

Sam Warren, MD, MSc and Rachel Beda, MD

Co-owners, Wise Patient Internal Medicine, PLLC
To sign up for the Wise Patient Direct – Medicare Enrollee Option, or if you have any questions, please contact our office at (206) 466-5937 or via your patient portal.

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