Retainer Patient Services

What is the Direct Primary Care model (Retainer Practice)?

Direct Primary Care is primary care offered to the consumer without the billing of insurance. It is intended to remove financial barriers of healthcare by reducing the cost to the patients. A provision of the Patient Protection and Affordable Care Act, found on page 77, allows for direct primary care to compete with traditional health insurance options in the mandated health insurance exchange when combined with a low cost high deductible plan. Please see the Direct Primary Care Coalition website for more information:

Member Services Overview

Service Services included in annual membership Cost after membership option used for the year
Initial visit to build chart and health plan Free N/A
Physical exam Unlimited N/A
Office visit Unlimited N/A
Phone consults Unlimited N/A
Complete coordination of care with specialists Unlimited N/A
House calls by request; travel time is included in the appointment time Available for patients within city limits for who travel is difficult N/A
Skin lesion excision 1 per year $50 per lesion
Joint injection 1 per year $50 per injection
Abscess I&D 1 per year $50 per treatment
Cryotherapy 6 lesions per year $10 per lesion
Minor uncomplicated wound closure 1 per year $50 per closure
Ingrown toenail 2 per year $10 per treatment
Ear lavage 4 per year $15 per treatment
EKG 1 per year $20 per study
Vaccinations At cost N/A
Rapid strep 2 per year $5 per study
Fecal occult blood 1 per year $10 per study
Microalbumin 4 per year $10 per study
Mono spot 1 per year $10 per study
HGB A1C 4 per year $15 per study
INR 4 per year $15 per study
Urinalysis 3 per year $5 per study
Pregnancy test 2 per year $5 per study
Glucose finger stick Unlimited No charge
Phlebotomy Unlimited Unlimited
Tuberculosis test (PPD) 1 per year $15 per study
Annual PAP 1 per year $86 per study
CBC 1 per year $8
Comprehensive metabolic panel 1 per year $15
Lipid panel 1 per year $18
PSA 1 per year $25
All other lab studies At cost N/A

What if I need medical care away from home?

Because we are so familiar with each of our patients, we are happy to discuss any health problems that arise while you are away over the phone. In the age of telemedicine, many illnesses can be evaluated and treated over the phone. For such illness, we are happy to call in a prescription, or help to coordinate the care that you need.

Services not included in the monthly fee:

Cascade Direct Care is not health insurance. Your membership covers the services listed above only. You, or your insurance is responsible for payment of all additional medical costs such as X-rays, outside labs, vaccines, medications, pathology (pap smears, biopsies), emergency room visits, prenatal care, hospital care, surgery, or specialist care. Not all conditions can be treated by Cascade Direct Care providers, and at times, additional medical care is required. Please note: Cascade Direct Care is not a chronic pain clinic, and does not provide medical marijuana cards, dental care, or obstetrics.

Participation and Enrollment Fees

Your first month is pro-rated based on days in the enrollment month and subsequently renews on the 25th of the month automatically for the following month. An enrollment fee is required for first time applicants and any individual re-enrolling after ceasing Membership. Under no circumstances is the enrollment fee refundable.

Participation Levels and Fee Schedule

Each Adult: $60 per month; each additional Adult $50 per month
Each Dependent Child up to 18 years of age: $25 per month

Enrollment Fee

Initial enrollment for Adult, Couple or Family: $100 nonrefundable fee per adult or family Re-enrollment for prior Member $100 nonrefundable fee per adult or family

Termination of Participation

Cascade Direct Care may cancel participation at any time for non-payment for services, abusive or fraudulent behavior. Participation will not be canceled for health reasons.

The state of Oregon requires the following disclosures:

This practice does not constitute insurance. This practice provides only the limited scope of primary care as specified in the retainer medical agreement. Specialty and/or hospital care, pharmaceuticals, and testing (labs that are not included, X-ray, Ultrasound, etc.) are not covered by your fee and are your financial responsibility. The Department of Consumer and Business Services issued a certificate to this practice. You can contact consumer advocates at the Department of Consumer and Business Services at (888) 977-4894,, or Oregon Insurance Division.

How to Cancel Your Participation

There is no long-term obligation to remain in the Practice. We want every Member in the practice to be happy and satisfied with the service that we provide. If you choose to cancel your Participation, you must notify us in writing 30 days in advance. If you fail to pay the Participation Fee when required under this Agreement and the appropriate amount is not paid within ten business days, we will assume that you have chosen to cancel your Participation, and your Membership will cease. Re-enrollment will require payment of the $100 enrollment fee. No fees will be refunded retroactively. Monthly fees will be pro-rated to the day cancellation becomes effective. Any Participation Fees we may be holding for future periods will be refunded to you.

Changes to the Practice or Discontinuation; Refund Policy

If it becomes necessary or desirable to discontinue or change the Practice substantially or make material reductions in its services, (for example, the addition of another provider or offering additional lab services) we will notify you in writing. If you cancel your Participation within thirty days of our notice of such a change or reduction, we will cancel your Participation at the end of that month, and you will have no further obligation to pay the Participation Fee. Any Participation Fees we may be holding for future periods will be refunded to you.