Legal

Membership Agreement

Draft for clinic and legal review before publishing.

Notice: Not Health Insurance

The organization facilitating the direct primary care agreement is not an insurance company and the direct primary care company guidelines and agreement are not an insurance policy. Participation in the direct primary care agreement or a subscription to any of its documents should not be considered to be a health insurance policy. Regardless of whether you receive treatment for health care issues through the direct primary care agreement, you are always personally responsible for paying any additional health care expenses you may incur.

Direct Primary Care Agreement Requirements (ARS § 44-1799.92)

A direct primary care agreement shall meet all of the following requirements:

  1. Be in writing.
  2. Be signed by the primary care provider or an agent of the primary care provider and the individual patient or the patient’s legal representative. A copy of the agreement shall be provided to the individual patient or the patient’s legal representative.
  3. Allow either party to terminate the agreement on a thirty-day written notice to the other party. The agreement shall include terms for relocation and military duty.
  4. Describe the scope of primary care services that are covered by the periodic fee.
  5. Specify the periodic fee for the agreement and any additional fees outside of the periodic fee for ongoing care under the agreement.
  6. Specify the duration of the agreement and any automatic renewal periods.
  7. Provide a prominent written disclaimer that the agreement is not health insurance, in substantially the form of the notice above.

Fees (ARS § 44-1799.94)

  1. A direct primary care agreement may not require more than twelve months of the periodic fee to be paid in advance. On discontinuing the agreement all payments prepaid for months following termination of the agreement shall be returned to the patient.
  2. A direct primary care agreement shall prohibit the direct primary care provider from submitting a claim for reimbursement to the patient’s health care insurer for primary care services that are provided to the patient and that are covered under the direct primary care agreement.
  3. A direct primary care agreement may allow the periodic fee and any additional fees for ongoing care under the agreement to be paid by a health care insurer or other third party.

Important Notices

Celeste Clinica also sees patients with insurance, Medicare, and Medicaid. Direct Primary Care memberships do not involve insurance billing for covered services. Concierge memberships include a fee for enhanced services; the practice may still bill insurance for other medical services.

  • Membership is not health insurance.
  • The practice does not bill insurance for services covered under the membership.
  • Telehealth has limitations and is not for emergencies. If you believe you are having a medical emergency, call 911.
  • Detailed medical information is not collected on our public website. Please do not include it in website forms.
  • Medicare: if you are a Medicare beneficiary, special rules may apply to services covered by a membership. Please ask us before enrolling.

The signed membership agreement, including scope of services, fees, term, renewal, relocation and military-duty terms, is completed at your physician consult. See also our Direct Primary Care and Concierge Care pages, medical disclaimer, telehealth consent and privacy policy.