Direct Primary Care Frequently Asked Questions

Direct primary care (DPC), also referred to as direct pay care or direct patient care, is a new spin on the way medical care used to be delivered. Once you enroll, you can access high-quality healthcare for one low monthly fee—free from the hassle and high costs of insurance claims, co-pays, and deductibles. In addition, because your family care physician is no longer constrained by insurance requirements, they can spend more time developing a personal relationship with you.

Direct primary care practices, including Sparrow, focus on keeping costs lower so that high quality care is available to more patients, including those who are uninsured.  We also do not bill your health insurance.  In Concierge Medicine, the yearly or monthly fee is typically higher and they bill your insurance.  We like to think of DPC or direct primary care as “affordable concierge medicine” – same great quality with an additional focus on value, because we think all people deserve this quality of medicine regardless of their insurance.

At Sparrow Family Medicine in Lancaster, Pennsylvania, your membership includes unlimited visits with primary care physician Dr. Candice Cavicchia Miller, direct access to her by phone, email, or text, convenient appointments within one to two days of your call, and discounts on labs, testing, and imaging. Compared to the average 15-minute primary care appointment, Dr. Cavicchia Miller dedicates the time needed with each patient at every visit to fully understand your health history and concerns, accurately diagnose your condition, and create a custom care plan tailored to you.

We desire to care for all and love to work with both individuals and families. Whether you are single, married, parenting, or assisting with care for your parents, we are here to help. Signing up as a family, either with your significant other, children, or parents just allows you to rest easy that when you or your loved one is in need of medical care, that care will be convenient, high-quality, and with someone who knows and cares for all of you!

No, Sparrow Family Medicine is not insurance. The cost of your membership covers your primary care needs as well as many of your urgent care needs. We can also assist with providing discounted lab, imaging and medication costs, but they are not included in the membership fee. Sparrow does not cover visits to specialists or hospitalizations.

We encourage everyone to have insurance to cover things such as hospitalization, needed specialist care, and surgery. If you have insurance or don’t have insurance ,you can still be a member at Sparrow!

You can still be a member at Sparrow and receive all of the same benefits! DPC care is a great-add on to Medicare coverage. As we age, it’s more important than ever to prioritize our health, focus on preventive medicine, and get great high-quality medical care. And that is exactly what being a member at Sparrow Family Medicine allows you to do! If and when you need extra medical care, knowing that you can instantly access treatment and have someone who is looking out for your health is valuable for patients at any age and with any insurance.

As with all other insurances, we do not bill Medicare for our services. You will need to sign a one-time waiver stating that neither you nor Sparrow Family Medicine will directly bill Medicare for services from our practice. You will still be able to use your Medicare benefits for all care outside of Sparrow including specialist visits, medication, imaging and hospitalizations.

Enrolling in a direct primary care program can significantly reduce your primary care costs. While Sparrow Family Medicine does not accept insurance because all of your care costs are part of the monthly fee, we recommend that every patient consider enrolling in an insurance plan that covers extensive specialty care, surgeries, and emergency care.

Preventing, diagnosing, or treating a health condition starts by listening to the patient. But if you notice your doctor is spending less and less time with you, and you leave your appointment with more questions than answers, you’re not alone. To maximize insurance reimbursements, today’s physicians see up to four patients an hour, limiting care to a prescription pad.

At Sparrow Family Medicine, we make accessing high-quality primary care affordable by keeping our enrollment and monthly membership fees cost-effective for families. Your membership covers unlimited visits, direct access to Dr. Cavicchia Miller, and minor in-office procedures. For patients with high deductibles and co-pays, those with chronic medical conditions, and families with children who require regular visits, the direct pay model especially offers considerable cost savings when compared to fee-for-service insurance billing.

Having members pay a monthly membership allows us to keep our enrollment limited, which is what allows us to offer high-quality care. In traditional medicine, a primary care physician can have a panel of up to 3,000 patients. It’s impossible to offer the type of quality care that we believe in at that level. Limiting our patient panel and using a membership model is what allows us to be available to you when you need us and provide longer appointments so that we can truly meet your medical needs.

We are so happy when our patients are healthy! That is what we desire for you! But we strongly believe in the value of preventive care, including the opportunity to work with you on lifestyle, nutrition, and other health opportunities. We also want to be there for you when the unexpected arises. If you get sick or have a medical problem, you want to be able to talk immediately to a physician who knows you well. That’s what we offer at Sparrow! Finally, with a monthly membership, you can budget for all of your primary care needs and most of your urgent care needs which is especially helpful for patients with a high deductible plan or health care sharing plan.

Yes, but Sparrow Family Medicine is a membership-based practice with limited enrollment. This is how we can provide the high-quality care that we think is so valuable. You deserve great care now, and we don’t want you to miss out on the chance to place your health first. Once we are at capacity, we will establish a wait list.