It's that time of year again.
Open enrollment notices are hitting inboxes, HR departments are sending reminders, and most people are doing exactly what they did last year: skimming the options, feeling mildly overwhelmed, and clicking "re-enroll in current plan" before the deadline passes.
We're not here to tell you which insurance plan to pick. That's a conversation for your HR department, your insurance broker, or a licensed benefits advisor who knows your specific situation. What we do want to talk about is the part of your healthcare that open enrollment doesn't actually determine and that most people never stop to reconsider.
Your Insurance Card and Your Care Are Two Different Things
Open enrollment is about coverage. It determines how your healthcare costs are paid, what's included in your network, and what your financial exposure looks like in a given year.
What it doesn't determine is the quality of care you actually receive.
That depends on your doctor, specifically, whether you have a primary care physician who knows your health history, has time to actually address your concerns, and is thinking about your whole picture rather than managing each issue in isolation or automatically sending you off to a specialist.
For a lot of patients, the answer to those questions is: not really. Conventional primary care in the United States has been squeezed into a model of brief appointments, high patient volumes, and reactive care. You get seen when something is wrong. The visit is 15 minutes. The physician may or may not be the same one you saw last time. Complex questions get a referral.
That experience has nothing to do with your insurance plan. You can switch plans every year and the primary care experience stays the same…because it's a structural problem, not a coverage problem.
What Direct Primary Care Does Differently
Direct Primary Care is a membership model for primary care that operates entirely outside of insurance billing. Instead of your physician billing your insurer for each visit, you pay a flat monthly membership fee directly to the practice. In return, you get something that has become genuinely rare in medicine: a physician who has time for you.
At Madsen Medical, that means:
Same-day or next-day appointments with Dr. Madsen
Appointments long enough to address complex questions without feeling rushed
Direct phone and messaging access to your physician 24/7
Physician-led management of BHRT, GLP-1 therapy, and chronic conditions
A doctor who knows your full health history because you're seeing the same person, consistently, over time
Note: Hormone therapies and weight loss medications are prescribed and managed through your membership, but the medications themselves are billed separately. We're happy to discuss costs and what to expect during your consultation.
DPC is not insurance, and it is not a substitute for insurance. You still need coverage for hospitalizations, emergency care, specialist visits, and major medical events. DPC works alongside your insurance, it simply changes how primary care is delivered and experienced.
Why This Matters for Patients Managing Ongoing Health
For patients managing chronic conditions, hormonal health, weight, or anything that requires consistent attention over time, the DPC model makes a meaningful difference.
In a conventional practice, managing something like perimenopause, thyroid dysfunction, metabolic syndrome, or early cardiovascular risk means repeated brief appointments with a physician who may not have your full health context, with punctuated by specialist referrals whenever something falls outside a narrow scope. The result is fragmented care, delayed answers, and a patient who often ends up coordinating their own records between providers.
In a DPC practice, those conditions are managed longitudinally by a physician who knows you. Dr. Madsen is a Doctor of Osteopathic Medicine with 38 years of medical practice and 36 years serving Chillicothe and Southern Ohio. His training in integrative, whole-body medicine means he can manage conditions that conventional primary care routinely refers out. And his DPC model means he has the time to do it properly.
The difference isn't the insurance plan. It's the physician relationship.
Open Enrollment – A Moment to Consider Your Options
We're not suggesting you ignore your insurance decisions. Coverage matters, and reviewing your options carefully with your HR team, benefits advisor, or a licensed insurance broker is worth your time.
But while you're taking stock of your healthcare situation this fall, ask yourself a second question alongside "which plan should I choose?" That question is: does my current primary care actually serve me well?
If you're having trouble getting timely appointments, if you feel like your doctor doesn't know your history, if you're managing hormonal health or chronic conditions and want more attentive oversight, those are problems that no insurance plan change will solve.
Open enrollment closes January 15, but DPC membership at Madsen Medical has no enrollment window. You can join any time of year — January, March, August, whenever the timing is right for you.
Frequently Asked Questions
Is Direct Primary Care the same as insurance? No. DPC is a direct membership agreement between you and your physician. It is not insurance and does not function like insurance. Ohio law explicitly defines DPC agreements as distinct from insurance products. You need both: insurance for major medical coverage, and a DPC membership for primary care.
Can DPC work alongside my existing insurance plan? Yes. Your insurance covers hospitalizations, emergencies, specialist visits, and other major medical needs. Your Madsen Medical membership covers primary care. The two work side by side.
Can I use my HSA to pay for a DPC membership? HSA eligibility rules for DPC memberships are nuanced and have evolved in recent years. We recommend consulting with a tax advisor or your HSA administrator for your specific situation.
Is DPC only for healthy people who don't need much care? Actually, the opposite is often true. Patients managing complex or chronic conditions, hormonal imbalance, metabolic issues, thyroid disorders, or cardiovascular risk factors, tend to get the most value from DPC, because they benefit most from a physician who knows them well and has the time to manage their care thoughtfully.
Does DPC membership cover my medications? Physician management of your prescriptions is included in your membership. The medications themselves — including hormone therapies and GLP-1 medications — are a separate cost. We are able to offer most medications at a lower cost with our in-house pharmacy. We encourage you to ask about specifics during your consultation.
When can I join? Any time. Unlike insurance open enrollment, DPC membership at Madsen Medical is available year-round. There is no enrollment window and no deadline.
What is a consultation and what should I expect? Our consultation is technically your first appointment, but it is a no-commitment conversation with Dr. Madsen. It's an opportunity for you to ask questions about the practice, explain what you're looking for in primary care, and determine whether Madsen Medical is a good fit with no pressure and no obligation.
I already made my insurance selection. Is it too late? Not at all. Your insurance decision and your DPC membership are completely separate. You can enroll in Madsen Medical regardless of when or what you chose for insurance coverage.
The Part of Your Healthcare To Reconsider
Insurance open enrollment happens every year. It's a built-in prompt to evaluate your coverage and a good time to ask a broader question about whether your healthcare setup is actually working for you.
If the answer is that primary care has felt rushed, fragmented, or difficult to access, we'd be glad to have a different kind of conversation.
Madsen Medical is a Direct Primary Care practice in Chillicothe, Ohio, serving patients throughout Ross County and Southern Ohio. Dr. Madsen, DO, has practiced medicine for 38 years, 35 of them in this community. This post is for general informational purposes only and does not constitute insurance, tax, or medical advice. Consult a licensed professional for guidance specific to your situation.
Call us at (740) 200-3860 | 192 S. Paint Street, Chillicothe, Ohio 45601
