One monthly fee, no copays

Yes, and most of my patients do. The membership covers your primary care with me: visits, messages, medication management, and ongoing care for chronic conditions. It doesn't cover hospital stays, ER or urgent care visits, specialists, imaging, surgery, pathology, or the cost of the lab tests themselves (though I pass lab prices through at wholesale where I can).

Most people pair the membership with a high-deductible or catastrophic plan. The membership handles everyday care, and insurance handles what happens somewhere else.

Insurance billing is a big part of why primary care moved to short visits and high volume. Without it, I can spend the time a visit actually needs and keep your price the same every month.

No. Medicare and Medicaid rules don't allow me to take patients enrolled in either program, so I can't accept you as a member. I wish it worked differently.

If you become eligible for Medicare while you're a member, let me know. I'll refund any fees you've paid ahead and help move your records to your next provider.

Anything that happens at a facility, with a specialist, or in an emergency: hospital stays, ER and urgent care visits, specialist consults, surgery, imaging, and the lab fees themselves. Labs, wholesale medicines, and supplies I arrange are billed at my actual cost, and only when you use them.

Care outside primary care altogether isn't included either. That means maternity, dental, vision, hearing, cosmetic care, allergy testing and shots, medical equipment, long-term care, home health, and hospice. The membership agreement has the full list.

The IRS treats direct primary care fees in different ways depending on the plan. Many people use HSA or FSA money for the membership and lab fees, but please check with your tax professional about your own situation.

I'm a board-certified Adult Nurse Practitioner (ANP-C) with more than twenty years of caring for adults. Nurse practitioners are licensed to diagnose, prescribe, order labs and imaging, and manage chronic conditions. In North Carolina, nurse practitioners work with a collaborating physician, and I do. For anything outside primary care, I coordinate with specialists the same way any practice would.

I prescribe as part of your care, and prescriptions go to the pharmacy you prefer. The membership doesn't cover the medicine itself, but I'll help you find the lowest price through generics, GoodRx, Mark Cuban Cost Plus, or your insurance formulary.

As a general rule, I don't manage long-term controlled substances like ongoing opioids, stimulants, or benzodiazepines. A specialist is usually a better fit for those. If you're already taking one, we can talk it through case by case.

Send me a message in the patient portal, and I'll usually answer the same day or the next business day. If something needs a conversation, we'll book a video visit. For anything urgent, call 911 or go to the nearest emergency room.

For an emergency like chest pain, a serious injury, a sudden change in thinking, or signs of a stroke, call 911 or go to the nearest emergency room. Afterward, I'll coordinate your follow-up care so nothing falls through the cracks.

I'm licensed in Virginia, North Carolina, South Carolina, and Florida. If you move within those states, nothing changes. If you move somewhere else, I'll help send your records to a new provider and close out your membership.

Membership is month to month. To cancel, give me thirty days' written notice, and your last month is prorated so you only pay for the days you were a member. I'd suggest giving it a few months, since the care gets better as I get to know you.

If you cancel and later want to come back, I may ask for a re-enrollment fee covering the months you were away, up to twelve. Short gaps usually aren't a problem.

Book a free fifteen-minute call. We'll talk through what you're looking for and whether my practice fits. If it does, you can sign up on the call or take some time to decide. I don't need a card until you join.