What’s this no insurance thing? How does that work?

States Dr. Fraser is Licensed in:

Alabama, Arizona, California, Kentucky, Tennessee, and Washington State

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So, we run a practice that is trying to provide a premium service, the type you cannot get at corporate managed practices, or practices that rely on insurance.  Part of this is to not have the massive overhead of staff who spend hours trying to get your insurance to agree to pay for X, Y, or Z.  We don’t do medication refills (see the rationale below), we don’t chase down appeals for medications your insurance doesn’t want to pay for, or labs they don’t want to pay for, etc.  Incidentally, usually we have better options and approaches!  We also don’t spend 7-8 minutes on average with you, with you taking 2-3 hours of your day out to come see us.  There is a value proposition here, but insurance isn’t really part of it.  If you aren’t on Medicare, we do give you a superbill, which you can submit to your insurance.

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What does it cost:

We have opted for a flat hourly rate.  This will be adjusted by inflation every year in January, but it is $400/hr.  However, for your first 2 months, while you get established and get to a stable 3 monthly follow-up, we discount this by 40%.  A minimal intake visit is 60 minutes, complicated patients require 90 minutes.  The booked time is spent one on one with Dr. Fraser, via telemedicine. During intake, Dr. Fraser takes substantial time, which is not billed, to review prior medical history, and order any needed labs and medications.

Our average patient, after initial intake and subsequent visits, sees us for a 30-minute quarterly visit, to address medication refills, labs, and any ongoing concerns.  This at full price presently is $200 per quarter.

Prescriptions are generated to take you to your next physician visit.  If there are refills needed, this means you’re beyond the expected follow-up date, and we need to meet.  The good news is that we have appointments available every week within no more than a few days waiting.

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How do labs/imaging work:

We order labs through LabCorp, Quest, or your laboratory of choice.  We can order radiology testing through any local facility and provide a requisition for use anywhere.   Our functional medicine labs for all the “interesting stuff” is through Rupa.  It is important for healthcare consumers to understand that medical tests are paid for by your insurance at negotiated rates.  However, IF your insurance doesn’t cover the test, you are billed a rate typically 10-15 times what your insurance would usually pay for this test.

If you have a high deductible health plan .. Just pay cash and have Dr. Fraser set it up cost effectively.  If not, or you are likely to exceed your deductible, then when you go to the lab or radiography center, have them confirm what will and won’t be covered.  DO NOT get any test done that your insurance won’t cover (you can cross it off the requisition, and just get the tests done that are covered).  Let Dr. Fraser know the things that you cancelled, and he will arrange for that to be done cost effectively.

For the functional medicine “interesting stuff” – this will be cash pay – but Dr. Fraser has you pay direct, and doesn’t add any costs to this.

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How do Rx Medications work:

Most of what we recommend will be standard Rx medications covered by insurance, and if you are on a high deductible plan, available cost effectively.

For compounded medications and drugs which might not be covered by insurance we have ways to make these cost effective.  For example, patients who need compounded hormones, costs are usually $35-40/month, and for Semaglutide (Ozempic) or Tirzepatide (Mounjaro) it is typically $100-150/month.

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How do Supplements work:

Most functional, anti-aging or longevity medicine practices will have proprietary supplements they sell you at a premium, or unbeknownst to you, are making profit on your purchase.  We avoid this situation, and if we end up getting a referral for a purchase, it is minimal, and doesn’t affect your cost.  Most supplements are simply available on Amazon, but we take care to only recommend items that have third party testing. Additionally, we provide expert advice on what to take and why. Supplements can be harmful, and certain combinations are not sensible - we can advise.

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Can we replace your Primary Care Physician?

This is complicated.  For ongoing preventive care, we do want this managed outside of our practice, as managing this through telemedicine is difficult.  However, managing your chronic health conditions, and importantly, your aging and longevity is what we do, generally at a level of detail that is different from typical care.  The fragmentation of care isn’t good, and it is common for us to replace multiple specialists.  The areas we have high level competence in include:

Hypertension

Hyperlipidemia

Neurocognitive decline prevention, especially Alzheimer's and Parkinson Disease

Hyper/Hypothyroidism

Disorders involving Cortisol/Melatonin dysregulation.

Male and Female HRT

Polycystic Ovarian Syndrome

Obesity/Overweight/Metabolic syndrome

Type 1 or 2 Diabetes/Pre-diabetes

Longevity therapies such as Rapamycin, SGLT2-I, PDE5-I, Dasatinib, and others

Long Covid

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If I need a lifestyle coach consult how does this work?

Yvette bills at $100/hr, but also extends the first 2 months at a 40% discount.  She is an expert in providing advice on how to modify lifestyle to promote longevity.  This is often a more powerful factor than pharmaceutical management.  It requires effort; but having an expert walk you through the mechanics of small changes sequentially making big differences is powerful, and empowering.  Individuals have so much ability to affect their outcomes with the correct information, a plan, and some motivation.

Summary:

You’ll get 100% of the time you book with the doctor!

Yvette is an incredible resource – and inexpensive for what she can offer.

A 60-minute appointment moves things forward in a meaningful way – this is never going to happen in current corporate medicine practice.

The drive to and from our practice will be perfect, takes 0 minutes.

Your time is valuable – spend it effectively.  In order to enact change, good luck if heading through the usual workflow of current medical practice!  Come see us, we can help with meaningful change.