“So what do I actually get for the monthly fee?” It is the first question almost everyone asks, and it deserves a straight answer rather than a brochure.
Here is the honest version: a direct primary care membership covers your primary care at the practice, generously, and at Ridgeview Direct Care it also includes sports medicine appointments. It does not cover the rest of the healthcare system. Knowing exactly where that line falls is what stops people from being surprised later.
What the monthly fee generally covers
At Ridgeview, the membership is built around the things a primary care physician does, without per-visit charges layered on top.
- Office visits, without counting them. You are not rationing appointments against a copay. If something needs three visits to sort out, it gets three visits.
- Unhurried appointment times. Visits are scheduled around the problem rather than a billing slot. We wrote about why that changes the medicine and not just the experience.
- Same-day and next-day availability for most needs, rather than a wait measured in months.
- Multimodal access. Follow-up can happen in person, by video, by phone, or through secure portal messaging. The membership fee does not change based on which one you use and none of them carry fees outside the membership.
- Preventive care and physicals, including screening discussions appropriate to your age and history. The preventive care page covers what that can involve.
- Acute illness and injury, the sore throats, rashes, sprains, and infections that make up much of ordinary life.
- Chronic condition management, including high blood pressure, high cholesterol, diabetes, and others listed on the primary care page.
- Medication management and care coordination, including help making sense of what specialists have recommended.
- Sports medicine consultations, which is less common in a primary care membership and worth knowing about.
What sits outside the membership
This is the part worth reading twice. A membership does not cover:
- Hospital care of any kind, including admissions and hospital-based testing.
- Emergency department visits.
- Surgery and the anesthesia, facility and follow-up costs attached to it.
- Specialist visits, whether or not the referral came from us.
- Most imaging, such as MRI, CT, and x-rays done at outside facilities.
- Prescription medications themselves, which you still obtain through a pharmacy or through our office at wholesale prices.
- Urgent care visits elsewhere, though a DPC membership often makes them less necessary.
In other words, the membership handles the front door of your healthcare. You still need insurance coverage for everything behind it.
The grey areas: labs, imaging, and procedures
These are the questions that come up most, and the answers depend on the specific test and how you want it handled.
Labs are generally ordered by the practice and billed by the lab. You can usually choose to run them through your insurance or to pay cash, and which one costs less is genuinely situation-dependent rather than always one or the other. Ask at the time of ordering rather than assuming. Ridgeview is part of a national network of DPC practices that gets steep discounts on cash prices for labs.
Some things done in the office are part of a normal visit. Others, particularly procedures that use specific more expensive supplies, are priced separately. At Ridgeview, PRP injections are an example: they are currently listed at $700, or $500 for members, rather than bundled into the membership. Sports medicine procedure pricing is published on the sports medicine pricing page.
The useful habit is simply to ask “is this included, and if not, what will it cost?” before anything is ordered. A practice that publishes its prices should be able to answer that in a sentence.
What a membership is never
To say it as plainly as possible: a direct primary care membership is not health insurance. It is not a health plan, not a health sharing ministry, and not a substitute for coverage. It does not satisfy any requirement that you carry insurance, and it will not pay a hospital bill.
Most members pair a membership with a high-deductible plan or another form of coverage. Our post on how the two work together walks through the pairing. For questions about your own plan, your plan administrator is the right source, and for tax questions about HSA or FSA use, please speak with a tax professional.
What membership costs at Ridgeview
Founding membership rates are $99 per month for an individual and $179 per month for two adults. Standard rates are $129 and $199. Children up to age 26 in a family membership are $39 per month each. Current details, including family and small business options, are on the join page.
A quick way to work out whether it fits
Rather than comparing the fee to nothing, compare it to what your household actually spends and experiences in a year:
- How many primary care and urgent care visits did you have, and what did each cost you out of pocket?
- How many times did you not go because getting an appointment was too hard?
- How many hours on work or school days was spent in waiting rooms?
- Are you managing something ongoing that would benefit from regular, unhurried review?
Our honest look at who DPC suits goes through this in more depth, including who it does not suit.
When to be seen regardless of membership
No membership changes what counts as an emergency. Chest pain, trouble breathing, sudden weakness or numbness on one side, confusion, a severe headache unlike any you have had before, or heavy bleeding call 911 or go to the nearest emergency department. For anything new, worsening or worrying that is not an emergency, please get evaluated by a physician rather than waiting to see whether it settles.
Ask us anything you are unsure about
Dr. Christopher Kroner, MD MPH, has practiced family and sports medicine since 2013, including twelve years of full-time academic practice training medical students, residents, and fellows. If you want the specifics for your own situation, a meet and greet is the place to ask, and you can see what one involves first.
Ridgeview Direct Care is at 4045 Wadsworth Blvd #300 in Wheat Ridge, open Monday through Friday, and serves patients from Arvada, Lakewood, Golden, Edgewater, and west Denver.
Book a free 30-minute meet and greet with Dr. Kroner or call 720-807-9961.
This article is for general educational purposes only and is not medical advice. Please see our medical disclaimer.