Can you explain how a direct primary care practice works?
Direct primary care is a practice model in which each patient pays a Membership Fee to the physician to receive comprehensive primary care services, including annual physicals, preventive care, sick visits, and care coordination with other providers. The extensive care included with your Membership Fee goes beyond what is provided in a traditional primary care practice. Dr. Polgar is able to spend more time with her patients, reduce in-office wait times, provide same or next-day availability for sick visits, and give patients direct access via the online patient portal, e-mail, or telephone. Your insurance will not be billed and there are no other fees unless you exceed the number of covered visits and services (see Services and Pricing for details). Howard County Direct Primary Care’s philosophy is the physician-patient relationship to be based on trust and compassion, unencumbered by insurance company policies and provider-network restrictions.
What does the Membership Fee include and what payment options are available?
Under Services and Pricing you’ll find a detailed description of all services covered by the Membership Fee and the various payment options for individuals and families, either annually or monthly, and by cash, check, credit card, or automatic withdrawal.
Is this a type of medical insurance plan? Do I still need my medical insurance if I join?
This membership model is NOT an insurance plan, and you will need to keep your existing health insurance to pay for prescription drugs, hospitalizations, visits with specialists, laboratory tests, x-rays and other diagnostic services not covered under the Membership Fee. However, if you do not currently have health insurance, in addition to the services included in the Membership, we can carry out your laboratory testing at a very low cost and can also help you negotiate lower prices with imaging centers.
I’m covered by Medicare. Can I see Dr. Polgar?
Yes; however, because Dr. Polgar has opted out of Medicare, Medicare will not cover any portion of the Membership Fee or any services provided by Dr. Polgar that are charged separately outside the Membership Fee (e.g., office visits exceeding 10 per year). Dr. Polgar will not submit any claims to Medicare and you may not submit claims to Medicare for payment for any services provided by Dr. Polgar. Dr. Polgar may continue to write prescriptions and orders for labs, x-rays, and other services needed outside of her practice and your Medicare coverage will continue to cover all other physicians, hospitals, imaging, and labs. Participation in Howard County Direct Primary Care will not affect your Medicare coverage for these other services in any way.
I am covered by an HMO. Can I see Dr. Polgar?
Yes; however, it is important to know that Dr. Polgar does not participate in any HMOs. If your HMO requires prior authorization from your primary care physician for referrals and labs, Dr. Polgar will not be able to perform that role. Dr. Polgar will not submit any claims to your HMO and you may not submit claims to your HMO for payment for any services provided by Dr. Polgar.
Can I submit invoices to my insurance provider for possible reimbursement?
At the time of your appointment, Dr. Polgar can provide you with an itemized invoice for all services rendered representing the reasonable value of the services provided. Depending on your insurer (but not Medicare), you may be able to submit this to your private insurer to seek out-of-network reimbursement. Because each insurer may approach this differently, you should contact your insurance company representative before submitting an invoice for reimbursement or seeking to apply your Membership Fee to your deductible.
I have a Health Savings Account, Health Reimbursement Account, or Flexible Spending Account. Can I access that for any reimbursement?
In many cases you may be able to use such funds to pay for all or a portion of the Membership Fee, but because policies differ you should check with your plan administrator. By using pre-tax dollars designated for medical expenditures, you may be able to reduce your out-of-pocket costs. You should consult with your accountant regarding any decisions that may affect your taxes.
Will Dr. Polgar assist if I am in the hospital?
You may be admitted to the hospital of your choice. Although the hospitalist service will be the attending physician of record, Dr. Polgar will coordinate your care with the hospitalist as your personal physician. If you are in the hospital, please ask the attending physician to call Dr. Polgar’s cell phone so she can provide your medical history and coordinate your care.
What if I need to see a specialist?
Dr. Polgar will coordinate your care with the appropriate specialist(s) to best address your particular medical needs and she will closely monitor your progress while you are under the specialist’s care.
Will Dr. Polgar make house calls?
Yes. House calls will be made when medically necessary: if it is not possible for the patient to be seen in the office and hospital evaluation and tests are likely not necessary. House calls (as determined to be appropriate by Dr. Polgar) are included in the annual professional fee as office visits. House calls that exceed the number of office visits in the Annual Fee will be billed as additional visits.
How can I reach Dr. Polgar?
Dr. Polgar is available to her patients 24 hours/day, 7 days/week, with the exception of vacations and unexpected emergencies. For routine or non-urgent matters, you have the option of using the secure online patient portal, calling the office, or sending an e-mail or a fax. For urgent matters during regular office hours, you may contact Dr. Polgar at the main office number, or for urgent matters after hours, you may contact Dr. Polgar on her cell phone. If she is not able to take your call immediately, she will return your call as quickly as possible, usually within 30 minutes. In case of an emergency, please dial 911 or go to the nearest Emergency Room.
Does Dr. Polgar see patients in the evening or on weekends?
Howard County Direct Primary Care does not have regular scheduled evening or weekend hours; however, Dr. Polgar will make every effort to accommodate individual patient needs for appointments outside of normal business hours.
Can my family members join the practice?
Yes, family members ages 18 and over may join the practice, so long it is still open to new patients. In order to provide members with the care and attention that they deserve, Howard County Direct Primary Care’s membership is capped at 500 patients. Details on family member discounts are located in the Services and Pricing section of the website.
What happens when Dr. Polgar is away on vacation or unavailable?
Dr. Polgar will make arrangements with an experienced colleague to provide coverage during medical conferences, vacations, or emergencies.
What happens if I move away or if I decide to leave the practice? Will I be reimbursed some portion of the Annual Fee?
Yes. If you leave the practice for any reason, you will be reimbursed on a pro-rated basis based on whole months remaining in the contract year. If you have already received your annual physical examination for the year, then $300.00 will be deducted from any pro-rated refund owed to you.
Why is this type of practice right for me?
This type of practice developed in response to physicians’ desire to devote more time and attention to patients’ preventive, routine, and urgent care needs. By having a smaller patient panel, Dr. Polgar is able to spend more time with each patient and provide more personalized care. She is available to her patients when they need her outside of regular business hours and is able to be a partner in your health, when you are well and when you are sick.
How can I obtain further information?
If you have any further questions, please send an e-mail to drpolgar@outlook.com. You may also call (443) 864-5503 and leave a message with best times to call you back to discuss any questions.