FAQ

Direct Primary Care (DPC) is a membership-based healthcare model that restores the direct relationship between you and your healthcare provider by removing insurance companies from routine, outpatient medicine.​In traditional fee-for-service practices, doctors are burdened by insurance billing codes, prior authorizations, and administrative red tape—forcing them to rush through 10-minute visits and take on thousands of patients. At Mainely Primary Care, we bypass the insurance billing middleman entirely. Instead, members pay a predictable, transparent monthly fee for comprehensive, unhurried primary care.​The Core Benefits of Direct Primary Care:Extended, Unhurried Visits: Routine appointments are 30 to 60 minutes, ensuring we have the time to listen, review your health holistically, and get to the root cause of symptoms.​Guaranteed Fast Access: Members receive guaranteed same-day or next-business-day appointments for acute illness or injury, starting on time with virtually zero waiting room time.​Direct Provider Communication: Reach your clinical team directly via call, text, or video through Spruce Health without jumping through call centers or phone trees.​Zero Copays or Visit Fees: Office visits, annual wellness evaluations, and routine in-office procedures are covered by your membership.​How DPC Works for Uninsured Patients​For individuals without insurance, freelancers, gig workers, and small business employees in York County, Direct Primary Care provides a complete, affordable medical home:Full Cost Transparency: You never receive a surprise bill, hidden facility charge, or unexpected claim denial.​Free Generic Medications: Members are automatically enrolled in our prescription program, making most routine generic medications 100% free. For brand-name drugs, we coordinate international pharmacy fulfillment to cut costs dramatically.​Direct Wholesale Lab Pricing: Routine preventive blood work (CBC, CMP, lipid panels, HbA1c) is billed at our wholesale pass-through lab costs—typically $5 to $10 per panel (up to 90% below hospital rates).Affordable Diagnostics & Procedures: Standard in-office procedures (EKGs, joint injections, laceration repairs, skin biopsies) are included at no extra cost. When you need outside imaging (X-rays, ultrasounds, CT scans, MRIs, mammograms) or home sleep apnea studies, we steer you to the most affordable, transparent cash-pay facilities across Southern Maine.​How DPC Works for Insured Patients (Commercial, Medicare, HDHPs)​If you already have private commercial insurance (such as Anthem BCBS, Harvard Pilgrim, Aetna, Cigna, UnitedHealthcare) or Medicare, enrolling in DPC gives you premium primary care access while keeping your coverage intact:​Your Insurance Works Just Like Normal Outside Our Clinic: Because Maine law requires insurance carriers to honor clinical orders from licensed providers, your health plan continues to pay for outside specialists, hospital care, physical therapy, and emergency medicine just as it always has.​Seamless In-Network Specialist Referrals: When you need specialized care, we refer you directly to participating in-network specialists across Southern Maine hospital systems (like MaineHealth or InterMed) and submit necessary prior authorizations on your behalf.​The Perfect Match for High-Deductible Health Plans (HDHPs) & HSAs: If you have a high deductible, paying out-of-pocket for traditional office visits and overpriced hospital labs can cost hundreds of dollars before insurance kicks in. DPC handles 80–90% of your everyday medical needs for a low monthly fee, while your HDHP protects against catastrophic emergencies. Plus, HSAs can be used tax-free for DPC membership fees and wholesale labs.

The current fee-for-service model is confusing, expensive and incredibly frustrating. DPC is everything the traditional model is not. Costs are affordable, transparent and communicated upfront, care is personal, not rushed, and most importantly no longer incentivized by insurance reimbursement. This is what really changes things, care just feels easier, more natural and accessible without insurance getting in the way. Try us out and you'll know why DPC is spreading so quickly.

It may not seem obvious at first glance, but a DPC membership saves you money. The overwhelming majority of patients never reach their deductibles, so they end up paying almost all of their health care costs out of their own pocket. For a monthly membership similar to the cost of your cell phone, which is likely a small fraction of your deductible, a DPC can handle the overwhelming majority of your medical care. For every emergency room visit we prevent, we save our patients the equivalent of 2-5 years of monthly payments. AND the care is far more accessible and personal than you are used to receiving.

Sure! Check it out.