How it Works

What is Direct Primary Care?

Direct Primary Care (DPC) is not a new concept. It is the way primary care medicine was practiced in the old days before insurance companies stepped in and took control of health care at the primary care level. DPC doctors do not take any insurance. They charge a flat monthly fee as a membership to their patients. This fee covers all services provided by the primary care doctor to their patients. At Sweetbay, we use technology (text messaging, online scheduling, virtual visits, email) to augment the care and convenience of our members. No copays or coinsurance. Pricing is transparent.

Why would I pay "extra" for a membership to Sweetbay Pediatrics if I already have health insurance?

Health insurance is not health care. We believe that health insurance often stands in the way of quality, personalized care. Sweetbay Pediatrics was created to transform the traditional doctor’s visit to a more personalized, convenient health care experience for your family. The goal is to spend time with patients and to get to know them, providing excellent care throughout their growth and development. Pediatric care the way it should be.

Insurance and DPC

DPC doctors do not work for insurance companies, they work for you! DPC practices don’t bill through insurance and therefore they eliminate the constraints, confusion around billing, and price hikes that come with insurance. The DPC model has the benefit of comprehensive care with a full range of personalized services through a low membership fee.

Do I still need insurance?

We recommend that all patients have health insurance to provide coverage for catastrophic events, prescription medications, radiologic studies, labs, hospitalization, and other expensive unexpected health needs. Your health insurance mitigates the expense of hospitalizations and procedures but most patients pay substantial amounts out of pocket for the vast majority of their healthcare. In our practice, you just get a lot more value for your money.

Do you accept insurance?

We do not participate in any insurance plan or Medicaid. The membership model enables us to provide more personalized pediatric care to better serve our patients. We are considered an out-of-network provider on health plans. Your insurance company may reimburse you for out-of-network services, but this varies widely with each insurance plan. If you have any questions about out-of-network reimbursement, contact your individual insurance representative for additional information.

Does Sweetbay offer virtual visits?

Absolutely! We provide high quality care in the most convenient way possible. Many times, we can answer your question in an email, text or video chat or over the phone, which means you don’t have to make a trip to the office. All of this is included in your exclusive membership benefits. A lot of DPC parents come to realize how much they enjoy being able to contact us with relatively minor concerns about their healthy children simply because it's so easy!  At traditional practices, there are so many layers & barriers between the patient and the physician that it's difficult to get a simple or non-urgent question answered without going through phone trees, leaving messages and talking to a nurse first. Not at Sweetbay....ask away!

Do you take care of children with Medicaid?

Yes! Because the type (or lack) of insurance, doesn’t matter, we see every child regardless of their insurance status. We do not bill Medicaid, however, and a membership fee will still apply.

What if my child gets sick after hours?

We know that illness doesn't respect traditional office hours. If your child is ill, you can call or text our doctors. You will have a secure app that allows you to reach us 24/7.

What is your vaccine policy and how are vaccines paid for?

Check out Our Vaccine Policy for more information!

We just don't go to the doctor very often. Will a membership to Sweetbay Pediatrics still be worth it?

Bumps, scratches, bruises and rashes happen often, and childhood illnesses and injuries are unpredictable. Depending on the time of day and circumstance, a traditional practice may refer you to an urgent care or ER for care that can easily be provided by your pediatrician. A single visit to an ER or urgent care can carry a cost equal to months of personalized care at Sweetbay. We’ve designed our practice to help you when the unexpected happens. When your child needs stitches, has a late night fever, gets sick while out of town, or needs that last minute sports physical, we are available to provide peace of mind and compassionate care for your child. We have also received feedback from numerous Sweetbay parents that they never realized how many non-urgent inquiries they have about their children that they would never wait on hold to ask at a big practice, but that they love bouncing off of our doctors with a simple text. Just knowing that a physician’s advice is one text away 7 days/week, without phone trees, added fees or being filtered through an advice nurse, provides immense peace of mind.

Even the few times you visit the doctor for an annual physical or well child check will be a whole new experience! Same day or next day appointments, no waiting, longer appointments, and a relaxed, casual atmosphere with toys, books, snacks and popsicles. This is the type of pediatric care you have always wanted, but never received. As a member of a pediatric DPC practice, you will receive a higher level of personalized care than you could hope to find in today’s large, busy pediatric practices.

What happens if my child needs to go to the hospital or see a specialist?

In providing superb care with unprecedented direct access, we seek to prevent or reduce hospitalizations and specialty referrals. In instances where those types of care are required, we will certainly continue to work with the hospitalist during your hospital stay, as well as work closely with any specialist involved in your child's care. It goes a long way to have a doctor who truly knows your child and can speak physician to physician on his/her behalf. Our Doctors will always personally advocate for the best care possible for your child, wherever they are.