Your Partner in Health.

Direct Primary Care, or DPC, is a monthly membership clinic that provides unlimited access to a doctor without copays, deductibles and without billing or using insurance.

OVALLE, M.D. members get to call, text, email or visit their provider anytime to get primary care services like physicals, preventive care, urgent care, managing chronic diseases, and mental healthcare, without worry of hidden fees.

Traditional insurance often leads to long waits and higher out-of-pocket costs, resulting in quick, rushed appointments. This can force people to rely on urgent care or the ER or even not seeing your own provider or any provider for routine issues.

Direct Primary Care (DPC) was created to fix that, without using insurance.

OVALLE, M.D. has 75% fewer patients than insurance-based doctors. This means more immediate access via text, phone, email, video call or in-person visits, whenever you need it.

You can sign up by clicking here. In order to provide excellent service to patients, Dr. Ovalle will be capping his patient panels at about one fourth the size of physicians in a traditional practice.

HOURS:
Monday  9:00 AM to 6:00 PM

Tuesday  9:00 AM to 6:00 PM
Wednesday  9:00 AM to 12:00 PM
Thursday  9:00 AM to 6:00 PM

Friday  9:00 AM to 12:00 PM

Saturday, Sunday and Holidays available upon request and with prior phone appointment for members.

We cannot accommodate walk-in appointments, but we strive to provide same-day or next-day appointments for established OVALLE, M.D. primary care members. Members may reach us via email for non-urgent matters or via phone for urgent medical issues.

OVALLE, M.D. may be closed on major holidays, but phone and email messages will always be reviewed for any emergencies.

No, fortunately for both you and us. Perhaps the most critical distinction in our model of care clinic is a direct, personal relationship between you and your doctor. That directness carries over to our business model as well.

We forgo insurance payments to save our patients from the arbitrary, intrusive decisions that come with using insurance. Charging a direct monthly fee frees us (you and us) from the typical contractual agreements that prevent non-DPC physicians from offering wholesale prices on laboratory tests, imaging, and medications.

Item descriptionYes, we take care of any patient regardless of your insurance situation. Since we work completely outside of the insurance system, none of the billing for care here is eligible for insurance reimbursement. However, we recommend that everyone have insurance coverage, which is still important in the event of a major health issue.

Yes. We recommend our patients continue a major medical plan with a high-deductible and a health savings account. If you experience a major health issue, you will still need insurance to help cover it. We’re happy to refer you to insurance representatives who can help customize an insurance plan to your specific needs.

By law ACA / Primary Care Enhancement Act you need to have insurance for emergency care (HMO, PPO, Catastrophic) - Not needed for DPC provider.

Although we do not accept insurance, we still believe insurance is important to help cover hospitalizations and severe illnesses. Many patients in DPC practices have high-deductible, catastrophic insurance plans. We think our model is best compared to car insurance. We use our car insurance for major accidents and large expenses, not for routine oil changes and maintenance services. It is important to note, though, that the direct primary care model is not insurance and does not meet the criteria for insurance as set forth in the Affordable Care Act.

Yes. You need only sign a one-time waiver declaring that neither you nor your doctor will directly bill Medicare for our services (opt-out form). Even though Medicare will not pay us for any services you receive in our practice, your Medicare benefits will otherwise remain unchanged and can continue to be used for all other medical care received outside of our practice. Medicare will still cover any laboratory testing, imaging, medications, or hospitalizations prescribed by our office.

As the Affordable Care Act (ACA) was being drawn up, several doctors worked very diligently to insert into the health reform bill a clause that allows for Direct Primary Care practices like ours to be a legal option under the health reform bill.

In short, the best option for many patients will be an “exchange qualified” major medical type plan combined with a Direct Primary Care provider like OVALLE, MD. This combination will save the maximum amount of money, while also allowing for a maximum amount of health care for patients.

The ACA allows insurance companies to create "wrap-around" plans that combine DPC with traditional insurance. The ACA allows DPC to compete with traditional insurance in health exchanges when combined with a high deductible plan. The physician is not incentivized to limit care.

You may want to check with your human resources department regarding the use of Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) as possible payment options for your membership.

You can deduct your monthly membership fee as a medical expense on your taxes, according to the IRS. But your cost for DPC cannot be counted toward your insurance deductible if you also have a high-deductible health plan or other insurance. Please confer with your tax consultant to clarify tax consequences in your particular circumstances.

Health insurance is still important for everything outside of OVALLE, M.D.. 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 air filter. 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 OVALLE, M.D., 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 Ovalle does not participate in Medicaid. Patients with Medicaid are welcome to join the practice, but OVALLE, MD does not accept Medicaid payments. Medicaid will generally cover ordered tests and referrals.

Dr Ovalle hopes that patients without health insurance will find OVALLE, M.D. to be a refreshing change. The fee schedules are designed to make primary care affordable and accessible to everyone, insured or not.

EMPLOYEER BASED HEALTHCARE: If you have the opportunity to choose a High Deductible Health Plan (HDHP), this is preferable. If you work for a small or medium-sized business, you might consider asking your employer to offer direct primary care (DPC) as an option to yourself and other employees. Ask us how.

HIGH DEDUCTIBLE HEALTH PLANS: OVALLE, M.D. works well in conjunction with a High Deductible Health Plan (HDHP), commonly referred to as catastrophic insurance.  Combining a clinic membership with an HDHP addresses the main drivers of increasing cost in healthcare. It allows individuals and families to have extra money on hand every month, often saving thousands of dollars per year, while still allowing families to be proactive about their health and ancillary medical costs such as medications, labs and imaging.

HEALTHSHARES: A health sharing program is a non-insurance option that functions as a type of healthcare cooperative where members make monthly contributions to a pool managed by a company. These organizations started out as faith-based operations and have been around for decades. Now, there are many options for both religious and secular health shares. Health shares are not insurance, so please call the organizations to learn more about their options.

You won't have to pay a co-pay for office visits or routine physicals. Also you'll be able to avoid many visits altogether by sending your questions directly to us via email and text – something you won't get from a traditional practice. Feeling sick? We also provide medications (such as antibiotics, steroids, topicals, etc.) for common acute ailments, so you can save a trip to the pharmacy.

More importantly, since you are getting all this amazing care from us, you can cut back on your insurance premiums. Many DPC patients find a high-deductible, low-premium insurance plan so they're covered in the case of a major health issue. But leave the rest of your healthcare to us.

Of course. Everyone benefits from a service tailored directly to them. That’s why we offer truly custom healthcare. We’re here for you if you're sick or hurt, but we also help you proactively maintain good overall health. Every visit with us will be thorough and relaxed, so we can adequately address your health concerns. The longer you're our patient, the more we learn about your health and lifestyle, and the better we can help you maintain that health.

No. The terms are sometimes mistakenly used interchangeably, but they are not the same. Both DPC and concierge practices charge a periodic fee, however, under the concierge model, this fee only gets you access. A concierge practice still bills insurance for your visits. Under DPC, your visits, communication, consults and other care with your doctor are included in your fee.

We offer discounted labs and imaging, but you are also able to bill your insurance for these services, if desired. We will work with your insurance to obtain necessary imaging (x-ray, ultrasound, CT scan, or MRI) and to refer you to the specialists needed to assist in your care.