Frequently Asked Questions
Things You Want to Know
What is the membership model at Shores Health?
At Shores Health, you join by paying a recurring membership fee (monthly, quarterly or annually), which gives you access to a defined package of primary‐care services without the typical insurance‑based billing. This model allows us to focus on you, spend more time per visit, and offer same‑day/next‑day access when needed. This model is referred to as Direct Primary Care (DPC).
How is this different from traditional insurance‑based primary care?
In a traditional model, the practice bills insurance for each visit, labs are reimbursed individually, office visits may be crowded and short, and appointment access can be limited. At Shores Health:
- We do not bill your insurance for routine primary care visits included in your membership.
- You benefit from enhanced access (telehealth, house calls, messaging, same‑day/next‑day visits) and longer visit times.
- Because of the direct arrangement, we aim to reduce your overall healthcare cost for everyday needs and give you more personalized care.
Do I still need health insurance if I join Shores Health?
Yes. Our membership gives you excellent access to primary care services, but it is not a substitute for comprehensive insurance coverage. Insurance (or a health‑share plan, high‑deductible plan, or catastrophic plan) is still important to cover hospitalizations, surgeries, imaging, labs, specialist care, and emergency events. Think of your membership as your ‘everyday health’ partner, and insurance as your safeguard for major events.
What does the membership include?
Your membership coverage depends on which tier you choose. See our DPC membership overview for full details and contact us if you have further questions at info@shores-health.com or call us at 904-495-1610.
How do lab work, imaging, medications and specialist referrals work?
- Laboratory tests, imaging studies, pathology or referrals are billed separately (often at reduced negotiated fees through our partners).
- Specialist care, hospital procedures or inpatient care are not included in the membership.
- You may still use your insurance for labs, imaging and specialists if desired—but our negotiated cash‑pay options are often lower than typical copays or deductibles.
When can I schedule an appointment, and how do I reach my provider?
As a member you’ll have flexible access: same‑day or next‑day appointments are prioritized (within our service area). You also get secure messaging, telehealth visits, and direct communication with your care team. For urgent issues outside the office hours, we provide guidance and, if appropriate, coordinate care or direct you to local resources.
What if I have an emergency or need urgent specialist/hospital care?
In the case of a true emergency (chest pain, difficulty breathing, major trauma, etc.), you should call 911 or go to the nearest emergency department. While your membership covers your primary care, it does not include inpatient or hospital care. If you are hospitalized or require specialty referral, we will assist in coordinating your care and communicating with the hospital or specialist team on your behalf.
What’s the cancellation or transfer policy for membership?
We strive to keep things straightforward and transparent: you may cancel your membership at any time with 30 days’ written notice. Membership fees already paid are non‑refundable once services are available. If you move outside our service area or pause membership, please contact us so we can help with your transition.
Can I join if I already have Medicare, Medicaid, or other insurance?
Yes — you may participate in our membership model regardless of your insurance status (commercial, Medicare, etc.). Please be aware that we will not bill your insurance for the services included in the membership. Insurance may still cover labs, imaging, medications, or specialists depending on your plan. Medicare or Medicaid may or may not recognize membership fees as reimbursable — you may want to check with your plan or tax advisor about deductibility or HSA eligibility.
What payment methods do you accept, and how is billing handled?
We accept payment via bank draft (ACH), credit/debit card, or other recurring payment methods set up when you join. Your membership fee is auto‑drafted based on your chosen billing cycle (monthly, quarterly or annually). Any external services (labs, imaging, specialist referrals) will be billed separately, and you’ll receive clear statements for those.
Can I receive care while traveling or outside the service area?
Yes — for many primary care needs, telehealth or messaging is available when you’re away. Our goal is to continue to serve you wherever you are, within reason. For urgent or in‑person services outside our area, we’ll help coordinate care and guide you appropriately. Keep in mind, membership does not replace local urgent care or emergency facilities in remote or out‑of‑area settings. Some prescriptions may not be prescribed outside of Florida.
What happens if my condition becomes complex or I need long‑term specialty care?
Our membership model is designed to address most primary care, preventive and chronic condition needs. If a condition evolves that requires specialist intervention or hospital care, we will partner with you and your insurance network (or provide cash‑pay options) for those services. We’ll still remain your medical home — coordinating communications, reviewing specialist findings and helping you navigate your health journey.
Who is eligible to join and are family memberships available?
Shores Health has four tiers of membership to choose from. See available membership details.
Family/employee memberships or an employer plan may be available — let us know if you’re interested in exploring that for your household or business. (Note: children under 18 may be served through a separate arrangement; please contact us for details.)
Are there any insurance or contract obligations?
Joining Shores Health does not require you to drop your insurance. You are free to carry any plan you choose. There is no long‑term contract binding you beyond the monthly (or quarterly/annual) billing cycle — you may cancel with notice as stated. However, payment of the membership fee is required for access to included services.
How do I get started or schedule a 'meet & greet'?
We offer a complimentary consultation (via phone, video or in‐person) for prospective members to learn more about our practice, ask questions, and determine if the membership model fits your health care needs. Once you decide to join, we’ll guide you through enrollment paperwork, payment setup, and choosing your membership tier. After enrollment, you may schedule your first wellness visit and begin messaging/telehealth access right away.
Can I still be seen at Shores Health if I am not a member?
Yes, a non-member can still be seen and treated by Shores Health. Pricing is a bit higher for services for non-members but still affordable. See non-member details and costs. For questions, please contact us at info@shores-health.com or call us at 904-495-1610.
Still Have Questions?
Didn’t find the answer you were looking for?
We’re happy to help! Send us a message through our contact form or email us directly — we’ll respond promptly with the information you need.
Schedule Your First Visit
Your first visit is the perfect way to meet your provider, review your health goals, and learn how Shores Health’s Direct Primary Care membership works.