Frequently Asked Questions

  • Longevity⁺ is a physician-guided health optimization program designed to align healthspan with lifespan through structured testing, advanced analytics, and ongoing strategic support. Built on the foundation of an Annual Optimization Bundle (AOB), it delivers a year-long longitudinal pathway that integrates advanced functional blood work, DexaFit body composition and metabolic testing, nutrition and fitness assessments, and dedicated physician time to interpret data, refine strategy, and guide meaningful progress toward your longevity and performance goals.

  • Annual Optimization Bundle (AOB) — Foundational Testing & Strategy

    • DexaFit 3-Test Bundle (DEXA body composition, VO₂ Max, and Resting Metabolic Rate)

    • Vitality Blueprint advanced functional blood work

    • 90-minute baseline strategy session with Dr. DeMarco to review results and establish your personalized longevity plan

    Longitudinal Health Optimization — Ongoing Support

    • 120 minutes of additional physician time to use throughout the year — typically a 60-minute 6-month follow-up plus flexible time for ongoing consultation and plan adjustments

    • Initial Registered Dietitian assessment for nutrition assessment and strategy

    • Initial Doctor of Physical Therapy assessment for fitness assessment and strategy

    • Follow-up DEXA + VO₂ Max testing (at 6 months) to track progress objectively

    • Second Vitality Blueprint lab panel (at 6 months) for reassessment and refinement

    • HealthBook⁺, your universal health record with AI-supported insights and longitudinal tracking (exclusive access)

    • Secure messaging access

    • Discounted member pricing on additional testing, consults, supplements and advanced tools

  • Longevity⁺ is a consultative health optimization pathway and is not a primary care program.

    Participation in Longevity⁺ does not establish a comprehensive primary care relationship and does not replace the role of your existing primary care physician or specialist providers. Members are expected to maintain an active relationship with a primary care provider for routine medical care, preventive screenings, vaccinations, acute illness evaluation, and urgent or emergent medical needs.

    Longevity⁺ focuses on prevention, performance, metabolic health, and longevity strategy through structured testing, data interpretation, and physician-guided planning. Services provided through Longevity⁺ do not include acute care visits, emergency care, routine cancer screening programs, or immunizations.

    When clinically appropriate and within scope, Dr. DeMarco may prescribe select therapies related to health optimization — which may include hormone therapy (e.g., TRT/HRT), weight management medications, mood-support medications, or other treatments on an individualized, as-needed basis. All prescribing decisions are made at the sole clinical discretion of the physician and may require coordination with your existing medical providers.

    Longevity⁺ is designed to collaborate with your current care team, helping interpret data, align strategies, and reduce duplication or gaps in care. Communication and recommendations may be shared with your primary care physician or specialists, with your consent, to support continuity and safety.

    For those who prefer an ongoing physician relationship that includes comprehensive primary care services and unlimited visits integrated with longevity strategy, our Concierge Direct Primary Care (DPC) membership may be a better fit.

  • Longevity⁺ is designed for proactive individuals who want more than reactive healthcare.

    Rather than one-size-fits-all medicine, the program delivers personalized, physiology-driven care built around your unique data, goals, and metabolic profile. Longevity⁺ focuses on:

    • Preserving lean mass and optimizing metabolic health

    • Slowing or preventing chronic disease progression

    • Using objective testing and biomarkers to guide long-term decisions

    Members often join because they want structured strategy, accountability, and ongoing refinement — elements that are rarely available within traditional healthcare models, which tend to focus primarily on acute issues rather than proactive optimization.

  • Longevity⁺ is not traditional concierge medicine.

    It is a consultative health optimization pathway built around advanced testing, physiology-driven data interpretation, and personalized lifestyle strategy rather than unlimited primary care access. While it does not function as a primary care program, Longevity⁺ provides concierge-level consultative support, offering structured physician guidance, accountability, and ongoing strategy refinement designed to help you optimize performance, metabolic health, and longevity.

    For those who prefer an ongoing physician relationship that includes comprehensive primary care services and unlimited visits integrated with longevity strategy, our Concierge Direct Primary Care (DPC) membership may be a better fit.

  • Longevity⁺ is a direct-pay program and operates outside of traditional insurance.

    The membership itself is not billed to or reimbursed by insurance. In some cases, individual labs or imaging ordered separately may be submitted to insurance or paid through discounted cash pricing when appropriate. Certain services may be eligible for HSA or FSA use, depending on your plan — we recommend confirming eligibility with your benefits administrator.

  • Yes. Longevity⁺ is a consultative health optimization program and does not replace primary care, so Medicare beneficiaries are welcome to participate while maintaining an active relationship with their primary care physician. Because Longevity⁺ operates outside of insurance and we do not bill Medicare, Medicare patients will be asked to sign a Medicare private contract / opt-out acknowledgment at enrollment confirming that services provided through the program are not submitted to Medicare for reimbursement.

  • Absolutely. Longevity⁺ is designed to complement — not replace — your existing medical care. We strongly recommend that members continue receiving guidance from their primary care physician and appropriate specialty providers. Dr. DeMarco can help interpret results, provide strategic input, and coordinate recommendations, and referrals may be made when appropriate — always with the goal of maintaining clear communication and alignment with your primary care team to avoid duplication or gaps in care.

  • Some Longevity⁺ services may be eligible for payment using HSA or FSA funds, depending on your individual plan and applicable IRS guidelines. Longevity⁺ operates as a direct-pay program outside of insurance, and eligibility for HSA/FSA use is determined solely by your plan administrator. Patients are responsible for confirming allowable expenses and proper use of funds prior to payment.

  • Longevity⁺ is a direct-pay program and operates outside of traditional insurance. The membership itself is not billed to, submitted to, or reimbursed by commercial insurance plans. When clinically appropriate, certain labs, imaging, or prescriptions ordered separately may be billed through your insurance or offered at discounted cash pricing; however, coverage decisions are determined solely by your insurance carrier.

    We strongly encourage members to maintain an active relationship with their primary care physician and continue using their insurance for routine medical care, preventive services, and specialist visits. Longevity⁺ is designed to complement — not replace — your existing healthcare coverage by providing consultative, physiology-driven strategy and longitudinal guidance.

  • Longevity⁺ is a direct-pay, consultative health optimization program and is not billed to Medicare. Participation requires signing a Medicare private contract / opt-out acknowledgment, confirming that services provided through Longevity⁺ will not be submitted to Medicare for reimbursement. Members are expected to maintain an active relationship with their primary care physician and continue using Medicare for routine medical care, preventive services, hospital care, and specialist visits. When clinically appropriate, certain labs, imaging, or prescriptions ordered outside of the membership may still be processed through Medicare, subject to standard coverage rules.

    Example: If you see Dr. DeMarco for shoulder pain, your membership covers the visit itself. If he orders an X-ray, Medicare covers it through the hospital or imaging center. If he orders labs, they run through LabCorp/Quest and are billed to Medicare. If he prescribes a medication, Medicare Part D (or your supplemental plan) covers it at the pharmacy. If you need a cardiologist, that specialist visit is billed to Medicare.

    The difference is that your OptimizeMD membership gives you unlimited, direct access to Dr. DeMarco for primary and longevity-focused care, while Medicare continues to pay for everything else in the healthcare system.

  • All medical records and visit notes will be managed through Elation Health — a secure, clinician-focused EHR platform. You’ll have access to your personal record as needed, through an Elation-based portal, and through HealthBook+.

  • Yes — you will continue to have access to MyChart or other patient portals used by your existing healthcare providers. Longevity⁺ does not replace those systems. We encourage members to use HealthBook⁺ as a universal health record to help organize information from multiple healthcare systems, wearable devices, and testing platforms in one place. HealthBook⁺ allows for more comprehensive data review and AI-supported insights to enhance longitudinal tracking and medical decision-making.

  • Longevity⁺ members have access to secure messaging through Spruce, our HIPAA-compliant communication platform, for non-urgent questions, updates, and consultative guidance throughout the year. Messaging is intended for health optimization support and care coordination and is not a substitute for urgent or emergency medical care. Response times may vary based on clinical schedule, and members should contact their primary care provider, urgent care, or emergency services (call 911) for time-sensitive concerns.

  • Enrollment in Longevity⁺ may begin either as a standalone program or after completing an Annual Optimization Bundle (AOB), once it is confirmed that the pathway aligns with your goals and expectations. Registration and membership management are completed through Hint Health, our secure membership platform. Participation requires review and electronic signature of the Longevity⁺ Membership Agreement, informed consent documents, and applicable financial and policy acknowledgments prior to activation. Membership becomes active once all required forms are completed and initial payment is received. Availability may be limited to maintain appropriate physician access and program quality.

  • Longevity⁺ includes a $500 annual onboarding fee and a $199 monthly membership. If you have already completed an Annual Optimization Bundle (AOB), a portion of that investment may be applied toward enrollment when applicable.

    Longevity⁺ is a direct-pay program and is not billed to insurance. Pricing, program structure, and availability are subject to change and are confirmed at the time of enrollment through Hint Health.

  • Longevity⁺ is a consultative program, so secure messaging may remain available when you are traveling or out of state, subject to applicable licensure and telehealth regulations. Longevity⁺ does not provide urgent or acute medical care. For time-sensitive concerns, members should contact their primary care physician first or seek care through local urgent care or emergency services (call 911).

  • Longevity⁺ is a consultative program and does not provide hospital-based or emergency medical care. If you experience a medical emergency or require hospitalization, call 911 or seek immediate care through your local emergency department. Members should also notify their primary care physician and hospital care team, as Longevity⁺ is not a substitute for acute medical management.

  • Longevity⁺ is designed for proactive individuals who want a personalized, physiology-driven approach to optimizing healthspan — not just reactive or one-size-fits-all care. It is often a strong fit for:

    • Adults focused on prevention, performance, and aging well

    • Individuals with metabolic concerns such as pre-diabetes, visceral adiposity, or cardiometabolic risk

    • Aging athletes or active professionals looking to preserve lean mass, fitness, and resilience

    • Patients who value data-driven strategy, accountability, and longitudinal follow-up

    • Those who want coordinated guidance alongside — not instead of — their primary care and specialty providers

    Longevity⁺ is best suited for individuals seeking structured health optimization and consultative support rather than acute or urgent medical care. 

    For those who prefer an ongoing physician relationship that includes comprehensive primary care services and unlimited visits integrated with longevity strategy, our Concierge Direct Primary Care (DPC) membership may be a better fit.

  • As a board-certified family physician with 23+ years of experience, Dr. DeMarco offers support for:

    • High blood pressure, cholesterol, prediabetes, and metabolic syndrome

    • Men’s health, sleep optimization, and gut health

    • Fatigue, inflammation, and vague or hard-to-pinpoint symptoms 

    • Lifestyle coaching for diet, exercise, and weight loss

    • Lab review, diagnostic strategy, and decision-making for testing/treatment

    • Mental wellness, stress, and burnout

    • Guidance on reducing unnecessary meds and improving quality of life

    • Second opinions and diagnostic clarity

    You get a physician who listens, investigates, and walks your health journey with you.

  • You may cancel your Longevity⁺ membership at any time with 30 days’ written notice (email is acceptable). If you have prepaid annually, any unused portion may be refunded on a prorated basis, less the value of services already completed or scheduled — including physician consult time, DexaFit testing, Vitality Blueprint labs, assessments, or other program components provided prior to cancellation. Specific terms are outlined in the Longevity⁺ Membership Agreement.

    If you’re paying monthly, there’s no additional penalty — billing will stop after your final month of service, and access to Longevity⁺ benefits will end at that time. Patients may continue working with OptimizeMD and DexaFit Cincinnati through a-la-carte services, including Annual Optimization Bundles (AOB), individual testing, or physician-guided consults as needed, based on availability.

  • At this time, Longevity⁺ memberships are individualized and priced per person to ensure dedicated physician time, personalized planning, and program quality. While couples are welcome to participate together, each member enrolls separately under their own membership agreement.

  • At this time, Longevity⁺ is designed primarily for adults and is not structured as a pediatric or primary care program. Participation for individuals under 18 may be considered on a limited, case-by-case basis and requires parental consent, appropriate clinical review, and alignment with the program’s consultative scope. Routine pediatric care, acute illness management, and preventive services should continue through the child’s primary care provider.

  • You are always welcome to access DexaFit Cincinnati testing and selected lab services on an a-la-carte basis without enrolling in Longevity⁺. Many patients choose individual DEXA scans, VO₂ Max testing, metabolic testing, or advanced lab panels independently — with or without physician-guided reviews, depending on their preferences and goals.

    We also offer the Annual Optimization Bundle (AOB) as a once-yearly, comprehensive option that provides significant depth through advanced testing, labs, and physician strategy without requiring an ongoing membership. While the AOB delivers a detailed snapshot and personalized recommendations, it does not include the longitudinal follow-up, accountability, or ongoing consultative support that are signature elements of the Longevity⁺ pathway.

  • Primary Care focuses on comprehensive medical management — including preventive screenings, chronic disease treatment, acute illness evaluation, vaccines, and coordination of routine healthcare needs. Longevity⁺, by contrast, is a consultative health optimization pathway designed to complement — not replace — primary care. It emphasizes advanced testing, physiology-driven strategy, metabolic health, performance, and long-term healthspan planning rather than urgent or routine medical services.

    Members are encouraged to maintain an active relationship with their primary care physician for ongoing medical care, while Longevity⁺ provides structured data interpretation, personalized strategy, and accountability — signature elements of the pathway. For individuals who prefer an integrated model that includes both comprehensive primary care services and longevity-focused strategy, our Concierge Direct Primary Care (DPC) membership may be a better fit.

  • Many Longevity⁺ members begin as DexaFit Cincinnati clients. If you’ve already completed testing or participated in an Annual Optimization Bundle (AOB), Longevity⁺ builds on that foundation by adding structured physician strategy, longitudinal follow-up, and coordinated nutrition and fitness assessments.

  • Yes — and in fact, Longevity⁺ requires that members maintain an active relationship with a primary care physician. Longevity⁺ is a consultative health optimization pathway and does not replace comprehensive primary care. Members should continue working with their PCP for routine medical care, preventive screenings, vaccines, acute concerns, and specialist referrals and ongoing management through their primary care team. When appropriate and with your consent, we may collaborate with your existing providers to support continuity, reduce duplication, and help minimize gaps in care.

    If you prefer to receive primary care services directly from Dr. DeMarco, you may consider enrolling in our Concierge Direct Primary Care (DPC) membership, which integrates comprehensive primary care with longevity-focused strategy.