Q: Does this single annual fee cover ALL of Dr. St. Louisí
primary care services?
A: Yes, there will be no other routine charges from my office
beyond the comprehensive annual fee. Refer to the "Scope of
Services" outline for more details.
Q: Does this luxury primary care arrangement take the place of my
A: No, one of the assumptions of luxury primary care is that
patients will retain their health insurance coverage. Your health
insurance will continue to reimburse you for the cost of medical
services that I cannot provide, such as lab and x-ray studies,
hospital costs, subspecialty consultation and care, etc.
Q: Will your annual fee be covered by Medicare?
A: Medicare forbids physicians from collecting fees which exceed
its mandatory charge limits. Therefore, Medicare cannot be billed
and you will not be reimbursed by Medicare for this annual fee. In
order to offer luxury primary care (LPC) services I must resign from
the Medicare program. While some LPC practices may continue to bill
Medicare in addition to their annual fees, there is concern that
this practice will be held in violation of Medicare rules.
Q: Will enrollment in Dr. St. Louisí luxury primary care practice
jeopardize my Medicare benefits?
A: No, your Medicare benefits will not be affected by your
participation. Medically-necessary services that I cannot provide
(such as lab, x-ray, hospital costs, other doctorsí care, etc.) will
continue to be covered by Medicare and any secondary policy that you
Q: Can you bill private insurance carriers or secondary insurance
for your services? Is this fee tax-deductible?
A: Yes, I will be happy to file claims for you with private
insurance carriers for this annual fee or on a fee-for-service
basis, upon your instructions. Naturally, any reimbursement from
your carrier will be determined by the provisions of your health
care policy. Consult with your tax adviser to determine if this fee
qualifies as a deductible medical expense in your case.
Q: Do you offer a discount for "snow birds?"
A: The annual fee is the same for all patients, as is my
year-round duty and commitment. I realize that many patients live in
their desert homes for only part of the year, and that these
patients are likely to benefit most from my care while in residence
in the desert. However, having a personal primary care physician who
is always available has year-round advantages. I will continue to be
actively involved in each patientís medical care from any distance,
and will regularly communicate with patients and collaborate with
any hometown physicians to assure optimum quality and continuity of
Q: I am healthy and only need to go to the doctor once a year for
my physical. Is this a necessary luxury for me?
A: The "annual physical," although beneficial, may not be
sufficient to provide for a patientís unpredictable medical care
needs. If you should become ill, the availability of personal
physicians in our community is limited. Rather than just a
once-a-year snapshot of your health status, my practice offers
immediate access to superior year-round care whenever you need it.
Because I will be the private physician for only a small number of
patients, I can offer a level of personal attention unavailable in a
conventional primary care practice. Patients joining my practice
will receive something of value in return: confidence in me as their
physician; peace of mind that they will receive an immediate
response if they have medical trouble or questions; assurance that
the hassles, headaches and delays that they now encounter while
negotiating the medical system will be taken care of for
Q: What is your refund policy?
A: Because the majority of practice expenses are incurred on an
annual basis, one half of each patientís annual fee is nonrefundable.
The remainder of the fee will be refunded on a prorated basis (by
month) in the event of a patientís withdrawal from the practice, or
should it become necessary to close the practice. If a patient is
asked to leave the practice, a prorated refund of the entire annual
fee will be provided. Because medical care is typically most
intensive near the end of life, no refund will be provided in the
event of a patientís death.
Q: How will you provide access 24/7/365?
A: I will be available to my patients 365 days a year, an
unprecedented professional commitment made possible only by the
restricted number of patients under my care. Outside of office
hours, your calls will always come directly to me, either via pager
or cellular telephone, and my response will be immediate. For minor
or routine problems, triage or treatment can be performed over the
phone. If you need to be seen, I will see you at any time. Only when
I am out of town or on vacation and not physically able to attend
you, will I arrange for another excellent internist to
provide for your hands-on care needs. Other luxury primary
care (LPC) practices have succeeded as partnerships of two or more
physicians. At present I have no such plan. I intend to always
preserve one major benefit of the LPC model: the consistency and
security of a dedicated personal physician.