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Frequently Asked Questions

Do I still need health insurance?

Yes. Concierge medical practices do not take the place of Health insurance coverage. Epical HealthMed is working as a supplemental service to your primary insurance, therefore, you should continue your PPO, Medicare, Medicaid or other Health insurance coverage. However, if you do not have health insurance Epical HealthMed will provide care of your primary health.

Are you a provider for Medicare?

No. Epical HealthMed is not a participating provider for Medicare and Medicaid.

What are the fees?

The annual membership fee varies according to plan selected; the average is less than $1,000 per primary member and less than $800 per family member. Family plans are available.

The best way to determine what your fits your needs and the associated fee is to visit our Epical HealthMed office to meet with our staff.

Does my fee depend on my current health conditions?

No. The fee depends on the plan you chose, and because Epical HealthMed does not required a medical exam to be accepted as an affiliate, the level of care does not affect your annual fees.

What exactly does the membership fee cover? What services are billed to insurance?

The annual membership fee covers those services listed under the plan service contract. Epical HealthMed does not bill anything to your health insurance because we work as your independent contractor, the membership fee covers the services provided and visits schedule of co-pays, if applicable.

Is my concierge fee tax deductible?

We advised you to consult with your tax consultant or CPA, because your fee might be reimbursable from a Healthcare Reimbursement Account or Health Savings Account as such may be tax deductible.

What about lab fees?

Your membership fee covers your comprehensive wellness exam, but does not cover the rest of laboratory costs; the patient has the right to choose any lab of their preference. However, Epical HealthMed has partnerships with local labs for cost saving rates for our patients.

What about X-ray fees?

These costs are neither covered by your membership fee, nor billed by Epical HealthMed. All other services will be billed by the Healthcare entity performing the services. Epical HealthMed has partnerships with some Healthcare entities for cost saving ratesfor our patients; however, the patient has the right to choose any lab and/or x-ray of her/his preference.

What if I need hospitalization?

Epical HealthMed is not Healthcare insurance, this is the reason we work as supplemental health insurance; hospital fees need to be paid by your insurance provider and/or per your arrangement made directly with the hospital.

What about prescription medicines?

Prescription medications are the patients’ responsibility and are usually covered by their insurance plans. Epical HealthMed works with you to get the optimum coverage of prescriptions possible under your Healthcare plan coverage. Moreover, Epical HealthMed offers a pharmacy program with cost saving rates for its members.

Can I cancel my contract at any time?

Yes, you can cancel Epical HealthMed contract any time, without penalty; nevertheless, we request written notification by letter within 30-days in advance for cancelation and there is a one-year calendar restriction if you decide to return to our Epical HealthMed practice.

Who provides medical coverage?

We have a strong commitment to recruit the most valued physicians, board certified by American Board of Medical Specialties and Advanced Practitioners with a solid experience in Healthcare. The credentialing process is rigorous and thorough to ensure the Healthcare that our patients deserve.

Why Would I Need IV Medicines at Home?

You may need high doses of antibiotics or special types of antibiotics that you cannot take by mouth, even for dehydration.

What is considered an Urgent Medical Condition?

Urgent medical conditions are ones that are not considered emergencies but still require care within 24 hours. Some examples of such conditions include:

  • Accidents and falls.
  • Sprains and strains.
  • Moderate back problems.
  • Breathing difficulties (i.e. mild to moderate asthma).
  • Bleeding/Cuts. Not excessive bleeding but requiring surgical stitches.
  • Diagnostic services, including X-ray and laboratory tests.
  • Eye irritation and redness.
  • Fever or flu.
  • Vomiting, diarrhea or dehydration.
  • Severe sore throat or cough.
  • Minor broken bones and fractures (i.e. fingers, toes).
  • Skin rashes and infections.
  • Urinary tract infections.

Dial 911 immediately for any medical problem that appears to be life threatening

What is considered an Emergency?

Emergency condition is one that can permanently impair or endanger the life of an individual.

Some examples of conditions that require emergency medical care include:

  • Severe chest pain or difficulty breathing.
  • Compound fracture (bone protrudes through skin).
  • Convulsions, seizures or loss of consciousness.
  • Fever in newborn (less than 3 months old).
  • Heavy, uncontrollable bleeding.
  • Deep knife wounds or gunshot wounds.
  • Moderate to severe burns.
  • Poisoning.
  • Serious head, neck or back injury.
  • Pregnancyrelated problems.
  • Severe abdominal pain.
  • Signs of Heart attack (i.e.. chest pain lasting longer than two minutes).
  • Signs of Stroke (e.g. loss of vision, sudden numbness, weakness, slurred speech, confusion).
  • Suicidal or homicidal feelings.

What happens if I have an Emergency?

For a life-threatening emergency, call 911 immediately or go to your nearest ER, but call Epical HealthMed (or have a family member call) as soon as possible so we can quickly step-in to provide and coordinate the appropriate medical care and referrals. For non-life-threatening emergencies (i.e., urgent care), do call Epical HealthMed office first.

DO NOT USE EMAIL TO INFORM OR CONTACT EPICAL HEALTHMED ABOUT AN EMERGENCY OR URGENT MEDICAL PROBLEM.

Can Epical HealthMed cancel my contract?

Yes, The American Medical Association (AMA) has established guidelines regarding when a doctor may terminate a patient relationship, based on its code of ethics.
Among the reasons Epical HealthMed may cancel your contract are:

  • Patient non-compliance. When the patient fails to follow the treatment recommendations established by the Healthcare professionals. In addition, this is why it is so important that you and Healthcare professional make treatment decisions together.
  • A patient’s rude or obnoxious behavior, which is considereda form of abuse.
  • Non-payment of bills.

Epical HealthMed reserves the right to refuse service to anyone or terminate the agreement.

Will Epical HealthMedsee me in the hospital if I require admission?

No, Epical HealthMed will arrange for direct admission to any hospital in our coverage service area. In addition, you will be seen by one of the hospitalist to manage your in-patient care. However, as much as possible we will be involved in your care during this period. You are not alone!

Will my insurance cover the yearly membership fee?

No. Any health insurance companies, Medicare or Medicaid cover the yearly membership fee.

Does my yearly fee cover all my home visits for the year?

No. The fee visit depends on the plan you select.

Does Epical HealthMedtake my insurance?

No. The insurance company and government payers have many regulations for seeing patients at home, and Epical HealthMed does not have contracts with any insurance company or government payers.