Direct-Pay Primary Care Agreement

doctor and patient review a sheet of paper.

This page describes our agreement for Direct-Pay Primary Care.

1. Nature of services

Recharge Medical provides direct-pay medical services under a membership model. This Agreement is for non-insurance-based primary care services only. It is neither insurance nor a substitute for insurance.

This service is included… But…
1 Annual Wellness Visit (AWV) per year no diagnosis or treatment included
Up to 11 in-clinic single-issue visits per year a maximum of one per month; $150 for each additional
Up to 1 telehealth single-issue visit every 30 days a maximum of 11 per year; $100 each additional
1 in-clinic blood draw per month in conjunction with an in-clinic visit the lab will bill separately for processing
Writing prescription refills for existing medications writing new prescriptions must be handled during visits

All new prescriptions, lab or imaging orders, referrals, or documentation requests must be addressed during a scheduled in-clinic or telehealth appointment. If additional requests are needed outside of visits, a new in-clinic or telehealth appointment must be scheduled and may incur additional charges.

2. Fee, payment, and term

Biannual Plan Annual Plan
6-month minimum,
$1,200 due at first visit		 12-month minimum,
$2,100 due at first visit

3. Payment policies

  • All payments are non-refundable.
  • Only one in-clinic visit and one telehealth visit per month are included.
  • Additional in-clinic or telehealth visits are $150 / $100 each.
  • Additional charges may apply for complex documentation (e.g., disability forms, DMV, legal documents).
  • Services such as cosmetic procedures, immigration medical exams, IV therapy, standalone lab testing, and travel medicine are not included in this agreement.

4. Insurance policies and billing disclaimer

Recharge Medical is a direct-pay medical clinic and does not accept or bill any insurance plans of any kind, including Medicare, Medi-Cal, or private/employer-sponsored plans.

  • We will not bill your insurance.
  • We do not accept insurance payments.
  • We do not provide insurance billing documentation (superbills, CPT codes, diagnosis codes, or itemized statements for reimbursement purposes).
  • We do not communicate with or assist in any way with insurance companies.

Attention: Some insurance plans (including Medicare and many employer-based plans) do not allow patients to enter into direct-pay or concierge medical agreements. It is solely the patient’s responsibility to review their insurance policy and ensure they are allowed to participate in this agreement. Recharge Medical takes no responsibility for insurance-related conflicts, coverage issues, or claim denials.

5. Patient responsibilities

Patients are required to maintain active health insurance for services not provided by Recharge Medical, such as:

  • Emergency services.
  • Specialist visits.
  • Hospital care.
  • Laboratory processing fees.
  • Imaging services.
  • Prescription medications.

6. Termination

Recharge Medical reserves the right to terminate this agreement for the following reasons:

  • Non-payment.
  • Repeated policy violations.
  • Inappropriate behavior toward staff.
  • If the patient’s medical needs are too complex to be safely managed within the scope of services Recharge Medical provides.

7. Limitations

  • Only one issue may be addressed per visit.
  • Only one in-clinic and one telehealth visit per month are included.
  • No urgent care or emergency services are offered.
  • Appointments are required for all services.
  • All services must be requested and completed during scheduled visits.

8. Acknowledgment and agreement

I acknowledge and understand that:

  • This agreement is not health insurance.
  • Recharge Medical will not bill or accept payments from any insurance company.
  • I will not receive any insurance billing documentation.
  • I am responsible for all costs associated with this agreement.
  • I must maintain my own health insurance for services outside of this plan.
  • I have reviewed my own insurance policy and confirm I am permitted to enter into this direct-pay agreement.