Patient-Centered Direct Primary Care

It's a fair question and a reasonable one to ask. You've paid for your healthcare; you should be getting more for it than you are, and being asked to pay again for something you were promised is a reasonable thing to feel funny about. Nobody here is going to argue you out of that.

Here's how we'd explain it. The membership isn't replacing your insurance. It takes the party deciding appointment length and what counts as a billable reason out of the room. Your car insurance doesn't pay for oil changes or maintenance, and that arrangement doesn't strike anyone as unfair.

So please keep your insurance. You need it for specialists, imaging, hospitals and emergencies; it's genuinely good at those, and we'll help you use it. The membership pays for your doctor.

While concierge practices share some similarities with direct primary care, they are not quite the same. Concierge practices generally charge a high annual membership fee and remain in varying insurance networks, still billing insurance, so copays and additional bills are still part of it. Direct primary care is designed to be more affordable and completely independent of insurance. SAGE does not bill insurance for the services that are part of the membership.

$99 to enroll, once. Then $150 a month for ages 19 to 44, or $200 a month for 45 and over. FSA and HSA accepted. That's the whole price list, and it's on the membership page rather than available on request.

There are no copays for anything the membership covers, and no bill arrives afterward for a visit.

No, and please don't drop your coverage. Membership covers primary care at SAGE. It does not cover specialists, hospital care, surgery, emergencies, imaging or most prescription medication, and you need insurance for all of that. Direct primary care works best alongside a plan, and it pairs particularly well with a high-deductible one.

Some testing happens here in the office while you wait, and that's included. For any other labs, imaging, and medications, both insurance and discounted cash-pay options may be available. Cash-pay rates are often competitive and, in some cases, may be lower than insurance-based pricing.

Medicare patients are welcome to join as members. SAGE has opted out of Medicare, so we do not bill Medicare for our services, and members sign a waiver acknowledging that neither they nor SAGE will bill Medicare for care received here. You can still use Medicare for prescriptions, hospital care, emergencies, labs and imaging. It simply cannot be applied to the monthly membership fee.

Yes, you can become a member at SAGE with an HMO plan. One thing worth knowing: HMO plans require you to have a primary care provider inside their network in order to get referrals for specialists, imaging and other covered services, and SAGE cannot serve as your official PCP for that purpose. Many members keep their in-network PCP for referrals and come to SAGE for their actual care.

In most cases, yes. We accept HSA and FSA funds for membership. Plans vary, so it is worth checking with yours to confirm.