top of page

Big News: Medicare Patients Can Enroll Starting in July 2025!

Writer's picture: Selena Raines, DOSelena Raines, DO


I’m thrilled to share an exciting update for Body Mind Spirit-Direct Primary Care! Starting in July 2025, I will be able to enroll Medicare patients as members. This marks an important step in growing the practice and expanding access to personalized, patient-focused care for individuals over 65.


Why the Wait?

If you’re wondering why it has taken time to offer this option, it’s because of federal rules regarding how physicians can work with Medicare beneficiaries. While my clinic does not bill insurance, the government requires doctors to go through a process called opting out of Medicare to contract directly with Medicare patients.


Here’s what opting out involves:

Filing a form with the Centers for Medicare and Medicaid Services (CMS) to officially declare that I will no longer bill Medicare for any services.

Once opted out, I’m removed from Medicare’s list of billing physicians nationwide. This step allows me to legally offer membership agreements to Medicare patients under the Direct Primary Care (DPC) model.



However, many DPC physicians, myself included, don’t initially opt out of Medicare. Here’s why: building a DPC practice takes time, and most physicians work additional jobs in the insurance system to support themselves during the early stages. In my case, I’ve been working night shifts at a local hospital and teaching family medicine residents one day a week, where their services are billed under my name as their supervising physician. These roles have made it impossible for me to opt out of Medicare until now.



What’s Changing?

This July, things are finally aligning. I’ve found someone to take over my teaching role, and my practice has grown to the point where I can leave my side jobs. This means I’ll be able to complete the opt-out process and begin welcoming Medicare patients into the clinic.

I couldn’t be more excited. When I worked in corporate medicine, the majority of my patients were over 65, and I deeply miss caring for this population.



What This Means for the Clinic

This next chapter represents growth and potential. With the ability to enroll Medicare patients, I’ll also have opportunities to expand the services I offer at the clinic. But don’t worry—staying true to the DPC model means keeping a small panel of patients to ensure I can focus on each person’s unique needs and provide truly individualized care.

Even though I won’t bill Medicare or any other insurance for membership fees, patients with Medicare or commercial insurance can still use their coverage for:


  • Diagnostic testing

  • Specialist evaluations

  • Expensive medications

  • Surgical procedures

  • Hospitalizations


This hybrid approach allows patients to enjoy the best of both worlds—the personalized care of DPC and the coverage of their insurance for external costs.


Get on the Waiting List

Pre-enrollment for Medicare patients will begin in June 2025. If you or someone you know has Medicare and is interested in joining my practice, I encourage you to click below to join the waiting list. I’m so excited for this next chapter and the chance to care for more people in this incredible community.


Click Here to Join the Waiting List! Scroll to the bottom of the screen to find the waiting list.


Thank you for your continued support as Body Mind Spirit-Direct Primary Care grows. I can’t wait to see what the future holds!




Elevate your healthcare experience!



23 views0 comments

Commenti


Body Mind Spirit Direct Primary Care Lexington Logo
bottom of page