FAQs

Health insurance is still important for everything outside of Beyond Primary Care. Insurance plays its originally intended role by covering emergencies, severe illness, surgeries, and catastrophic matters. For example, you use your auto insurance for accidents. You don’t use your auto insurance for oil changes, windshield wiper replacements, tune-ups, or brake pad changes. Your homeowner’s insurance kicks in if a tree falls on your roof, but not if it needs new shingles. We expect to pay out-of-pocket for these routine things. The vast majority of primary care services are actually more affordable than if we left out insurance claims all together. Patients with any insurance can enroll in Beyond Primary Care, but your insurance plan is between you and the insurance company. Usually, insurance will cover tests ordered and referrals by an “out of network” physician, but that is not always the case. Patients should check with their insurer for the specifics of their policy. Be wary of HMO and Medicare Advantage policies that require you to have orders approved by an insurance oriented provider.

No. That's the main feature of this practice. We forego insurance payments in order to save our patients from the arbitrary, intrusive decisions that inevitably come with third-party payers.

Dr. O’Boyle does not participate in Medicare. Patients with Medicare are welcome to see either doctor, but they are not contracted with Medicare. Normal primary care services provided by Dr. O’Boyle are not covered or reimbursable by Medicare due to federal regulations. Medicare will generally cover ordered imaging tests, outside labs, and referrals.

Dr. O'Boyle does not participate in Medicaid. Patients with Medicaid are welcome to join the practice, but they do not accept Medicaid payments. Medicaid will generally cover ordered tests and referrals

Dr. O'Boyle hopes that patients without health insurance will find Coldwater Direct Primary Care to be a refreshing change. The fee schedules are designed to make primary care affordable and accessible to everyone, insured or not.

We believe that vaccines are a very important part of preventative healthcare for our patients. We understand that many families have questions about vaccines, and we have the time to answer your questions! Coldwater Direct Primary Care is open to individuals and families who wish to pursue alternative vaccine schedules, but outright refusal of any age-appropriate or seasonal vaccines is not compatible with our clinic.

There is a $150 enrollment fee per household.

Yes. If you were previously a member with Coldwater Direct Primary Care and would like to re-enroll, there is a fee of $300 per household.

No. There is no minimum enrollment period. All agreements are month to month.