Direct Primary Care: WAITLISTED

What is Direct Primary Care?

Direct primary care offers a more personalized relationship with your doctor.

Direct primary care membership is offered for a monthly fee, similar to Netflix or the gym, which allows the following benefits:

  • Includes office or telehealth visits (includes well visits, sick visits, sports physicals, medication checks, minor office procedures, etc.)
  • Direct access to your doctor
  • No crowded waiting rooms (due to our keeping the practice size limited)
  • Simple problems stay simple with optional use of phone, text, portal or video
  • Free in-office procedures, such as EKGs, cryosurgery, lesion removal, laceration repair, abscess incision and drainage, ear flush, splinter removal, etc.
  • Free in-office tests, such as urine, strep or pregnancy testing
  • Steeply discounted fees for labs, pathology, and imaging (our negotiated prices for lab testing are often >90% off “insurance” prices)
  • Sick on vacation? Contact us! Direct access and use of technology enables us to take care of you. If we determine you need in person care, we can offer recommendations to keep your costs as low as possible.
  • Chronic conditions covered, such as diabetes, high cholesterol, hypertension, osteoarthritis, GERD/acid reflux/indigestion, smoking cessation counseling, asthma, depression, anxiety, insomnia, etc.
  • Acute condition covered, such as sore throat/laryngitis, pink eye/styes, headaches, cough, cold, congestion (URI, etc), flu-like symptoms, non-bloody diarrhea/nausea/vomiting, earache and ear infections, strains/sprains/musculoskeletal problems (including back pain, excludes fractures), acute urogenital complaints, abscess/skin infections, minor burns, rashes, hives/allergic reactions, ticks/insect bites and stings, splinter removal, simple laceration repair, etc.
  • Option for low cost wholesale generic medications dispensed in office
  • Frequent member education for health advice and maintenance
  • Added bonus: your private health information stays private. Because of not participating with insurances, direct care practices are not obligated to collect your health data and submit this to your insurance company in order to get paid.




If you are interested in more information or would like to schedule a future appointment with Dr. Koski, please contact our office. A waitlist is available at this time.

What does my membership fee cover?

The fee covers excellent primary care through office visits, annual wellness exams, well-child exams, sports physicals, school physicals, basic office procedures, and treatment of acute illness or minor injuries all with minimal wait times in the office. No copays, no extra charges–they’re covered. In office procedures like EKGs and minor skin procedures are also covered.

Most importantly, you have direct access to your doctor.

As a patient, you will also have access to discounted labs, medications, and radiology (cash based pricing). You also receive access to discounted member pricing for additional integrative care or specialty osteopathic or craniosacral manipulation services.

What costs are involved in becoming a direct primary care patient?

After paying a signup fee, patients pay a membership fee, paid monthly or annually. This will cover costs of providing care to you throughout the year. There are zero copays for visits. Because we do not participate in insurance, we can offer wholesale pricing on labs, pathology services, medications, imaging, etc. For example, a CBC (complete blood count) might cost $108 in the insurance-based setting, but will cost about $3.50 in the wholesale cash-based setting. That’s a big difference! If there are any additional charges for labs, pathology services, medications, you will receive clear and upfront information on cost.

What is the monthly fee?

An individual monthly membership is a flat $100 per month per adult age 20 and over and an additional $50 per month for children under 20 in the same household as an adult member. The maximum monthly family cost is $300. Each member receives free primary care office and telehealth visits, and membership wholesale pricing on labs/medications.

Direct primary care members are also invited to schedule integrative care or osteopathic services if they wish, at additional discounted cost.

What if I want more in-depth integrative care, beyond basic primary care?

Integrative care services offers more in-depth exploration of problems and more expansive testing options. It is the recommended model for patients struggling with symptoms that may have slipped through the cracks of traditional medicine, such as chronic fatigue, brain fog, emotional or sleep disturbances, hormonal problems, and bloating or gastrointestinal disturbances. You can schedule integrative care outside the membership or, if you are already a direct primary care member, your integrative services will be discounted as a perk of your membership.

Do you see patients of all ages?

Yes, I provide care for patients of all ages.

Do you share my medical records?

No. Patient privacy is a benefit of direct, cash-based care. We do not send records or private patient information to insurance or pharmaceutical companies.

In insurance-based care, your information is easily “portable” to thousands of entities without your express consent or knowledge, legally, in accordance with the Health Insurance Portability and Accountability Act. 

We do not provide third parties with your records without your consent, unless Triple T Health is subject to subpoena or search warrant. 

Your records are YOURS, with no outside reporting without your consent.

How do I join if the practice is full?

In order to provide you the highest level of personalized, quality care, membership is limited to a smaller number of patients. As a result, once our practice membership is full, a waiting list will be established. As openings become available, you will be contacted regarding membership.

Is my membership fee at Triple T Health tax-deductible?

Generally, your membership fee is not yet defined as a “medical expense” in most states and therefore is typically not tax deductible. We advise that you discuss this further with your tax preparer or accountant.  Often, anything we order such as labs, radiology, and medications can be applied to HSA, HRA, FSA, or out of network deductible.

What if I decide to cancel?

My goal is direct care that is truthful, transparent, and engenders trust. If our relationship is not meeting these qualities, you are welcome to cancel your membership and terms of cancellation will be applied as outlined in the Patient Agreement.

So is this like MDVIP or similar concierge practices?

This is not like MDVIP. MDVIP doctors and other concierge practices still contract with insurance companies, and as a result are required to collect a copayment, coinsurance, deductibles, and any non-covered service amounts as required by the health insurance contract, plus the retainer fee.

MDVIP doctors also have a higher annual retainer fee, between $1800 – $2200 per individual, which does not include the office visits or procedures, which are offered at the typical charges in addition to annual retainers.

Our payment model is straight-forward and simple: no copayments, no mysterious “non covered” services, no surprise bills, no insurance hassle.

Lastly, because MDVIP offices contract with insurance, they are unable to sell wholesale medications and services. We can–because we don’t take insurance!

Why is a Direct Patient Care practice a better option than other models?

With our membership model, patients can maximize the amount of healthcare they get and minimize their cost.  This is especially attractive for patients who are uninsured or who have high deductible insurance plans.  In addition, each patient receives a more personalized form of care, with direct access to your doctor.

In addition, we have arranged for low cost prescriptions and we can also get labs at wholesale pricing as well, which will be a substantial savings for the patient. So in the long run, we actually end up saving our patients more than the membership costs.

I don’t go to the doctor much, so how does Direct Primary Care help me?

Direct primary care allows physicians to really get to know their patients as people. With a deeper understanding of your personal health needs, care can be tailored for you. Every visit will help us to get to know you better and to find more ways to improve your health. Traditional insurance-based medical practices are not able to build relationships as effectively, due to time constraints in the office.

How will I know if the doctor is right for me?

We invite you to simply schedule a free meet and greet by contacting us today! 

Can you cut the costs of my meds? What about labs?

Because we are an insurance free practice, we have a unique situation where we can directly purchase generic medications at wholesale cost from the manufacturer. We can then pass these savings on to you. In addition, we have a contract with a lab to purchase lab testing at wholesale prices (often 90-95% less than “insurance” prices”).

Membership in our practice gets you these cost-saving discounts on medications and laboratory tests (much like Costco).

What happens if I need to go to the hospital or see a specialist?

Our patients, if hospitalized, are seen by the hospitalist. Our commitment is to help you avoid being hospitalized by early detection of disease and/or subtle signs that an existing disease state is worsening. Having an attentive doctor who is directly available to assist in your health care is key to helping to reduce hospital stays.

We will still refer patients to specialists as indicated, and this will be determined on an individual basis. If you have already been seeing a specialist for a medical condition, we generally request that you to continue this important relationship.

What if I need medical attention while I’m away from home?

Please contact us so we can determine the most effective means of communication to best handle your specific situation. We’ll help you find the nearest pharmacy or any resources and prescribe any medications you need.

When do I pay my fees for non-covered labs and procedures?

All fees are charged up front and applied to your preferred method of payment.

Do you take my health insurance?

We are an insurance-free practice and this means we do not accept health insurance.

Because we are not contracted with third parties, patients come first.  Being insurance-free allows us the freedom to care for patients without being tied to the various restrictions and rules of insurance companies.

You can still use your insurance for imaging, labs, medications, and specialist visits if needed.

As a direct primary care patient, will I still need insurance?

Yes, your membership is not a substitute for insurance.  Although health insurance is not required for membership, we recommend that you have insurance or another type of cost sharing health coverage to help cover the costs of medical care that you receive outside of our practice.

Insurance may help cover costs such as prescriptions, labs, imaging (X-ray, CT, MRI, etc.), specialist visits, hospitalizations, and surgeries.

Ideally we encourage our patients to carry a high deductible plan, a plan with a health savings account, or a health sharing membership. You should consult with your insurance provider to help you find a plan that works best with our medical model and that will meet your specific needs.

Can I use my insurance for my membership fees?

No. We are an insurance-free medical practice which means that we do not accept insurance. This means we accept ALL patients regardless of their insurance plans.

Because we do not contract with insurance companies, we do advise you to review your insurance contract regarding “Out-of-Network” benefits for any possible reimbursement of services you receive from us.

If I have Medicare, can I join as a patient?

Yes. You will need to sign a waiver every two years declaring that care received in our practice will not be submitted to Medicare for reimbursement. Your Medicare benefits outside this practice will remain unchanged and can continue to be used for all other medical care outside of our practice. Medicare will still cover any laboratory testing, imaging, medications, or hospitalizations prescribed by us.

How can I save on insurance costs?

Because with Triple T Health the membership covers all office visits and most procedures, plus low negotiated labs/imaging/medication costs, our patients may find it worthwhile to change from an expensive health insurance plan to a lower cost high deductible health insurance or health sharing plan to save money.

Are monthly membership fees eligible for HSA or FSA reimbursement?

You will want to check with your human resources department regarding the use of Health Savings Accounts (HSA’s) and Flexible Spending Accounts (FSA’s) as possible payment options for your annual membership. If you are unable to use these funds to pay for the annual membership fee directly, there is a good chance that you can still use your HSA/FSA as reimbursement for certain services provided through our office.