Medicare & Insurance Questions Ask Us

Do I need insurance?
You do not need insurance to be a patient of Dr. Shelby’s - your “coverage” is part of your membership plan with the clinic. To comply with federal law, however, we do recommend patients carry some type of insurance, such as a health savings account or high-deductible medical plan. This would ensure financial help and coverage should you require a specialist or hospitalization. Check with your insurance provider to see what plan would best fit alongside our primary direct care model to meet all of your needs.

What if I have Medicare - can I still join?
Yes, you can. Please be aware that your monthly membership fee cannot be submitted for reimbursement through Medicare. Every two years, you must sign a waiver to show that you nor your doctor will bill Medicare for your membership fee.

For medical costs outside of Dr. Shelby’s clinic, Medicare and Medicare supplemental insurance will still cover those costs. This includes prescriptions at an outside pharmacy, labs run at outside labs, imagining, physical therapy, or hospital charges. As a patient of Dr. Shelby, you can still maintain your Medicare coverage.

How can I save on insurance costs as Dr. Shelby’s patient?
As a patient of Dr. Shelby’s, you will pay zero co-pays; plus labs and generic prescriptions are available at wholesale prices to you. Patients often have traditional health insurance plans that have minimal co-pays (or none at all) for labs and prescriptions. Patients may find it beneficial to switch from a high-option plan to a more basic plan.