Health Care Research – Direct Medical Care

Just a quick follow up to my last post regarding health care planning. I had mentioned a coworker uses his health savings account (HSA) to pay for medical care with his family of four. His doctor charges a set fee which is believed to be about what an insurance company would have paid the doctor or less.  I met with him briefly for more details.

The doctor’s web page is  There are two levels of payment depending if your family is a “member” or not. An annual fee is $800 for a couple or $1,200 for a family. Basic doctor’s visits, annual physicals and more are free for members. For non-members a doctor’s visit is $70 for example. And the doctor offers on-line medical care they call “virtual care” at $50 during office hours or $60 after hours. Also, the doctor will met him at the office after hours for care such as if he need stiches at a cost generally lower than an urgent care facility.

I asked my co-worker when he might use his insurance coverage and he said only for major medical issues such as for hospitalizations or referral to a specialist. Under the direct medical care service the doctor’s office does not file insurance claims. You must do that on your own, however the doctor’s office will provide you with the appropriate codes to submit to the insurance company.  I also asked how this affects meeting his annual insurance deductible. He has a high deductible plan and does not worry about it because he does not ever meet the deductible unless his family has a major-medical issue. I’d want to check with the insurance company to see if I could maintain records to show how much I had spent out of pocket or how they are handling services from doctors who except cash payment. Luckily, Karen knows how to file accurate insurance claims.

I could see doing more research in finding a doctor who does not take insurance but charges a lower fee such as this. Perhaps we might find a service in whatever state we decide to domicile in or spend our winters. Then have all the records sent to the new doctor. Or another option might be to switch to a doctor who is near our current home where we intend to later visit family for longer periods. I really am interested in the “virtual visit” portion of the plan. Not only would we not have to subscribe to another service while on the road but our established doctor would have a better idea of our issues before we hit the road, such as the need for prescription medications and more.

I wonder if having an established doctor in the state we select as a domicile will make a difference in establishing a “legal” domicile or not?

This is the first I have ever heard of such as service.  Once I started surfing the internet I found it to be more common than expected. Click on the link for direct medical care and have a look.

6 thoughts on “Health Care Research – Direct Medical Care

  1. Wow…that is very interesting, Mark. I could see where this would be helpful to a lot of folks. On the domicile: as long as you have your doctor established before you switch domiciles, you shouldn’t have an issue with legality. We are now Florida residents, but still have our old doctor and dentist up north. Same with our bank, although it does have branches in Florida. Our residence has never been questioned.

    Liked by 1 person

  2. This is interesting, and I will have to check into it. I have insurance through my employer (Mayo) that I recently retired from. If I turn it down and shop around, I will lose it forever–but as we get older and health conditions could develop/worsen, I am confident in their care. We still have 3 girls that are not yet 26, so it covers them as well. However, it is very expensive and only covers fully when we are at a Mayo facility (which we are not at the moment, but our girls are). I had a throat infection recently and had to do the Urgent Care Center visit, and insurance only covered 60% because I was out of network. I do have a condition that requires regular blood work and a visit at least every six months, so we just plan to be back to Florida to accomplish all of those visits and I can find a blood lab locally wherever I am. It’s so complicated and expensive–not matter what options we go with. Of course, we’ll bite the bullet if anything urgent happens, but it’s our fervent prayer that it does not. Thank you for providing this link. Best wishes, Dawn


    • After all the research about the full time RV life I have to say obtaining medical care has to be the largest unknown for Karen and me. Maybe followed by will we like the lifestyle or not. Really good to see programs like what Dr. Riggs offers popping up around the country. Suppose we Americans are going to have to take the affordable health care issue on for ourselves.

      I mentioned to Karen how a co-worker just pays the doctor’s office direct and does not use his insurance unless there are major medical issues. Karen says good – it’s time to stop paying insurance companies. By that I assumed she meant how insurance companies are profiting off the doctor and us. She says the insurance companies are owned by large financial companies. To many people profiting off the vulnerable in my opinion.

      Now that some of the cost is coming out of my HSA account I’m more focused on the cost of services. Before I just worried about getting a bill from the doctor based on what the insurance company would not pay. I’ll bet more and more people are going to be asking the hospital, doctor or other service providers what things cost rather than handing out blank checks. My mom and dad went through a lot before their deaths. The medical staff were superb. I wish they would not have had to worry about what the insurance company would pay rather than just treating what was needed.

      I’ve often wondered what % of the doctor’s billing is based on insurance costs such as malpractice. That’s another target as far as I’m concerned. Although there are those who have been done wrong, I’m sure a few of the lawyers in the high rise office in downtown Kansas City are nothing more than ambulance chasers. Tort reform has to be part of all of this. I plan to talk to my congressman. I’m also going to talk to Senator Roy Blunt out of Springfield Missouri about this. He is not my state senator but I think he will listen anyway.

      Thanks for sharing your own situation with us. I enjoyed watching Mike and your videos Your class A is beautiful.

      Liked by 1 person

  3. Great blog post–we do care for a lot of snowbirds, college kids, and some who have just moved out of the area with ties back to here. We can do so much virtually these days that it has made sense. We have at least one in person visit per year. States we have patients living in: FL, NY, WI, KS, OK, TX, AZ, ID, WA, WY. Thanks for sharing!


    • Thanks for stopping by the blog Dr. Riggs. D. Foster is my co-worker and he said he stopped by your office just this morning for a visit. Nice to see you have patients in Florida and Texas. South Dakota is the third popular state for full time RV travelers. Your web site is a amazing source of information, especially if one follows the links in the Frequently Asked Questions section.


  4. Pingback: Additional Health Care Planning | Our Future in an RV

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