Frequently Asked Questions
What is Direct Primary Care (DPC)?
DPC describes the model of general medicine/primary care that involves the doctor and patient only. DPC does not involve insurance companies or any other third parties in the clinical, administrative, or financial management of the physician-patient relationship.
What do we get for the monthly retainer?
In general, patients become a member of a DPC practice by paying a monthly (or discounted yearly) fee and, in return, receive primary care from a physician per a unique list of services offered by that physician. At a minimum, patients typically receive all care generally offered by a primary care physician (PCP), including acute care (sick visits) and chronic disease management.
What do you treat?
Nearly all acute and chronic primary care, with the exception of obstetrics/gynecology.
Primary Care services include: Obesity/insulin resistance counseling, Weight loss recommendations, Thyroid, GI health, HRT, Hypertension, Heart health / high cholesterol, Back pain, Arthritis, Diabetes type 2, Autoimmune workups, Gout, Acne, Rashes, Migraine, Neuropathy, Urinary symptoms, Fever, Flu/Cold symptoms, Allergies, Physicals for Insurance or Sports
We also offer treatment of minor Urgent Care needs including: Infectious workups (In-office Strep, Flu, RSV, Covid), simple sutures for minor lacerations, suture removal, IM steroids, abscesses, migraine attack
Do you do HRT?
Yes, HRT is offered as an option for peri- and postmenopausal women. Testosterone therapy is considered for patients with very low levels of Testosterone confirmed on lab testing, not for preferential or recreational use. Holistic/natural efforts are always preferred for increasing Testosterone levels organically before employing pharmaceuticals. We do not insert Testosterone pellets.
Do you practice Functional Medicine?
Yes, functional medicine practices and philosophies are incorporated into diagnosis and management of any issue when applicable. She is not certified by the IFM, but she addresses the topics of food, exercise/movement, sleep and mental health with all patients and consistently engages in Continued Medical Education from the Institute of Functional Medicine. She views evidenced based medicine as valuable and functional medicine as a key component to preventive medicine. She believes that these two forms of medicine should not be viewed as being in opposition but as partners for wellness optimization. We partner with Genova Diagnostics for in-depth investigation into possible triggers and underlying causes of chronic disease.
What do I get for my monthly membership fee?
Please see the Services List in the “Services” section. All members get the services listed according to their Membership Tier. In brief, patients receive all care generally offered by a primary care physician (PCP), including acute care (sick visits) and chronic disease management.
Do you accept Insurance?
No, DPC excludes third parties (Insurance companies, Medicare) from the doctor-patient relationship. We do not submit bills to insurance companies for any services or time spent with patients/members. MarinoMedica endorses the non-profit medical cost sharing communities (CHM, MediShare, Sedera, etc) over traditional for-profit health insurance to maximize cost effectiveness in your medical care. Alternatively, MarinoMedica membership could be paired with a high-deductible health insurance plan.
I have traditional insurance. Can I still be a member of MarinoMedica?
Yes! All patients are welcome. Those with insurance simply will not have their insurance plan involved in the clinical or financial relationship with Dr. Marino. MarinoMedica will never ask to see your insurance card.
Are labs free?
No, but the yearly/biannual basic labs are included in the yearly physical exam for Members. Other labs needed for additional investigations (work-up for fatigue, fever, Flu swab, Strep test, etc.) are billed directly to the physician’s office at a discounted price. Therefore, patients pay the doctor’s office at time of service for any labs ordered during that particular visit, and MarinoMedica is responsible to pay the lab for all labs ordered.
Example: You see Dr. Marino for abnormal urinary symptoms. Dr. Marino orders a Urinalysis (UA) to confirm presence of a Urinary Tract Infection (UTI). You pay Marino Medica $8.00 and go to the lab station to give a urine sample. You pay the lab nothing and do not receive a bill from the lab. You saved $30-$200 on the UA and saved time by not having to deal with a lab bill and/or insurance company. (The hypothetical charge between Lab and Insurance company for a UA in this scenario is impossible to pinpoint for comparison, as each Insurance company (and each patient’s plan) has different charge/payment agreements with different labs. Based on a review of one’s own personal lab bills over the past 18 months, the charge for a UA ranged from $40 - $200).
What if I need to see a specialist?
Dr. Marino collaborates with a group of DPC physicians in the Austin area that networks with a range of specialists (from cardiology to surgery) who are open to seeing direct-pay patients at discounted cash-pay prices. Referrals are made directly via doctor-to-doctor communication if/when deemed necessary by Dr. Marino. Patients who have insurance can choose to involve their insurance plans for the healthcare provided by a specialist outside of Dr. Marino’s office. Patients are responsible for all communication with the specialist’s office regarding scheduling, insurance questions, and other administrative logistics once Dr. Marino has made the referral.
What if I need medical attention on the weekend?
As her family grows, Dr. Marino is no longer working on weekends. For urgent medical needs on a weekend, you should visit a local Urgent Care or ER.
Can I sign up my whole family, including children, for a membership?
Internal Medicine doctors specialize in the diagnosis and management of acute and chronic medical issues for adults. Pediatricians and Family Medicine doctors receive training on medical care for children. Dr. Marino does see women who are at least 16 years old but recommends that girls under age 16 and boys under age 18 continue to see their Pediatrician or a Family Medicine physician. Family discounts are offered when couples and/or age-eligible kids begin a membership together.
Do I have to be a MarinoMedica member to consult Dr. Marino on a chronic/non-urgent issue or just get a physical exam?
No! At this time, nonmembers can schedule a yearly physical/lab appointment or a focused consult. Comprehensive Physical Exams are $350 and includes a basic lab panel. Consults (1-2 issues maximum) are billed at $200/hr and are scheduled for a minimum 1-hour for new patients. Follow-up visits related to the issue(s) originally discussed can be 30-minutes. Non-member visits are limited to 4 visits per year, as a main goal of the DPC is to establish a long-term doctor/patient relationship via patient membership.
Do I have to be a member to schedule a sick visit?
Yes. Due to increasing clinic volume, sick visits are reserved for established patient members only.
Do you prescribe narcotics?
No, Dr. Marino does NOT prescribe chronic schedule II narcotics, including opiates (like Percocet or Vicodin) or benzodiazepines (like Xanax or Valium). And she is no longer taking new patients on stimulants (ie Adderall, Vyvanse).
How do I get started?
Simply visit the Calendar feature at the bottom of the Contact section of this site to choose a time slot for a FREE informational meeting with Dr. Marino. If patients choose to join, they will pay a one-time onboarding fee of $99 and their membership will start whenever they would like Dr. Marino to be available as their PCP/GP.