Frequently Asked Questions

Direct Primary Care (DPC) — a healthcare model where patients (or households) pay a flat, recurring membership fee (usually monthly or annually) directly to a physician or practice in exchange for comprehensive primary care services.

Key features include:

• No insurance billing: Services are paid for directly, eliminating most third-party payer involvement.

• Membership model: Fees typically cover all routine primary care—office visits, preventive care, chronic disease management, and telemedicine.

• Smaller patient panels: Allows for longer visits, more direct physician access, and personalized care.

• Transparent pricing: Additional services (e.g., labs, imaging, specialist referrals) are often offered at wholesale or discounted rates.

The goal of DPC is to restore a more personalized, accessible, and proactive doctor–patient relationship by removing the time, cost, and complexity burdens of traditional insurance-based primary care.

Everything you need for comprehensive, concierge-level primary care and proactive health optimization:

• Annual 60–90 minute longevity-focused physical

• Unlimited in-person or virtual visits

• Same-day or next-day sick visits

• HIPAA-secure messaging directly with Dr. DeMarco

• Advanced care coordination across specialists and systems

• Vitality Blueprint Lab Analysis and Performance Plan — once (1) annually (labs billed separately)

• DexaFit Testing — up to two (2) DEXA scans per year included; additional VO₂ Max, RMR, or repeat testing available at reduced member rates

• HealthBook+ access with PaiGE, your personal AI health assistant

• Exclusive member discounts on testing, supplements, and partner diagnostics

This is a true partnership — not just care when you’re sick, but a thoughtful plan for staying healthy, aging well, and optimizing long-term performance.

Our $350/month fee reflects far more than unlimited office visits — it represents a different model of care designed around you. We built this price point through careful market analysis to remain competitive with other high-touch concierge and DPC practices, while also offering a level of service that goes beyond what most patients experience in primary care.

Your membership funds a small, intentionally limited panel of patients, which means longer visits, unhurried conversations, and same- or next-day availability when you need it. It also allows us to integrate advanced services — like DEXA body composition, VO₂ max testing, and metabolic health assessments — right into your routine care, so we can track what really matters for longevity and prevention.

But the greatest value often comes in the moments you don’t anticipate. Care coordination is where this model shines. When you face a new diagnosis, need a specialist, get abnormal labs, or leave the ER or hospital asking “what next?” — you have a physician who knows your history, has the time to investigate options, and can act as your advocate and guide through a complex medical system. That support saves you time, worry, and often unnecessary interventions, while giving you clarity about the best next step.

In short: the membership price reflects experience, access, time efficiency, coordination of care, prevention, and peace of mind. It ensures that when you need care the most, you’re not left to navigate it alone.

Yes — but with a modern, preventive focus. Our practice follows a Direct Primary Care (DPC) model, which shares many features with concierge medicine: smaller patient panel, direct physician access, and same- or next-day appointments. What sets us apart is our emphasis on data-driven prevention and optimization — including integrated DEXA scans, VO₂ max testing, advanced lab panels, and lifestyle medicine informed health coaching — alongside traditional primary care.

Unlike many concierge practices, your membership fee covers unlimited visits, care coordination, and direct messaging, not just a retainer for access. The result is a model that combines the best of concierge medicine with a proactive, precision-health approach designed to keep you well, not just treat you when you’re sick.

No. OptimizeMD is a Direct Primary Care (DPC) practice, which means we do not bill insurance for office visits or services.

Instead, your membership fee covers everything listed above, with no co-pays, deductibles, or surprise bills.

You can still use your insurance for:

• Medications

• Lab work

• Imaging

• Specialist referrals

• Therapy visits (Physical Therapy, Occupational Therapy, Speech Therapy)

• Mental Health visits (Counseling, Psychology visits, etc)

• Emergency Room Visits

• Hospital visits

You’ll also receive itemized invoices (upon request) if you’d like to submit for HSA/FSA reimbursement.

Yes. OptimizeMD welcomes Medicare beneficiaries — but it’s important to understand how it works.

OptimizeMD does not bill or contract with Medicare, Medicaid, or any government insurance program. Instead, your membership fee is paid directly to the practice. If you are a Medicare beneficiary, you’ll be required to sign a private contract acknowledging that you are opting out of Medicare for primary care services with Dr. DeMarco.

That said, you may still use Medicare as usual for everything outside of OptimizeMD: labs, imaging, prescriptions, hospitalizations, and specialists.

⚠️ A note about Medicare Advantage (MA) plans:

• MA plans do not recognize Direct Primary Care physicians as “in network.” This means they may not honor Dr. DeMarco’s orders for labs, imaging, or referrals.

• To get the most from your OptimizeMD membership, we recommend maintaining traditional Medicare Parts A & B along with the supplemental Medigap plan of your choice. This ensures coverage and flexibility outside of your OptimizeMD care.

Key highlights if you currently have Medicare Advantage:

• You can switch from MA to Original Medicare during Annual Open Enrollment (Oct. 15 – Dec. 7).

• When leaving an MA plan, you can add a Part D prescription drug plan and purchase a Medigap policy for extra coverage.

• Medigap enrollment rules vary by state, so switching outside your initial eligibility period may involve underwriting. Planning ahead is wise.

• Original Medicare + a supplement is typically more flexible — allowing you to see any provider nationwide who accepts Medicare. This flexibility is important for travel, specialty care, and fully benefiting from Direct Primary Care.

Absolutely. Your membership includes referrals, coordination, and communication with specialists whenever you need them. You’ll still have full access to cardiologists, dermatologists, orthopedists, or any other specialty care — either within your insurance network or out-of-network if you prefer.

What makes this different from traditional primary care is the level of support and follow-through you receive. We help you choose the right specialist, prepare for your visit, review your results, and integrate their recommendations into your care plan. When something unexpected comes up — a new diagnosis, a hospital stay, or complex testing — we serve as your advocate to make sure nothing falls through the cracks and you always know “what’s next.”

Most importantly, you’re not limited to one hospital system or referral network. We help you access the very best specialty care available, wherever that might be — so you get expert opinions and treatment plans tailored to your needs.

In many cases, yes—especially for services like lab testing, consultations, and diagnostic assessments.

Health Savings Account (HSA):

• Starting January 1, 2026, HSA funds can be used to pay for DPC membership fees (up to $150/month for individuals, $300/month for families) thanks to recent federal legislation. Until then, fees must be paid out of pocket or with other funds.

Flexible Spending Account (FSA):

• FSA eligibility for membership fees varies by employer plan. Some may allow it under “doctor’s fees,” but you should check with your FSA administrator.

That said, both HSA and FSA dollars can always be used for qualified services provided through your DPC membership—like lab work (if paying wholesale-prices through Dr. DeMarco), DexaFit testing, supplements, many wearables, and other diagnostics.

We’ll provide itemized receipts and documentation upon request to maximize your reimbursement opportunities.

Your OptimizeMD membership covers all your visits with Dr. DeMarco, including office and virtual visits, secure messaging, and coordination of care — none of this is billed to your insurance. You’ll continue to use your commercial insurance for things outside of OptimizeMD: hospitalizations, imaging, prescriptions, labs, or specialists.

Example: If you see Dr. DeMarco for knee pain, your membership covers that visit with no copay or deductible. If he orders an MRI, your insurance covers the imaging center bill. If he prescribes medication, you pick it up at your pharmacy using your insurance. If you need an orthopedist, that visit runs through your insurance as usual.

So you get unlimited access to your doctor through OptimizeMD, while your insurance continues to cover everything else in the broader system.

Your OptimizeMD membership is not billed to Medicare, which means your membership fee is paid directly to the practice. Medicare still covers everything outside of OptimizeMD: hospitalizations, imaging, labs, prescriptions, and specialists.

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’ll still have access to MyChart, but most patients find they rarely use it once they join OptimizeMD. MyChart will remain available if you need to communicate with a specialist or a hospital-system based PCP, but your main health hub will be HealthBook+ (HB+).

Think of HB+ as a “universal MyChart” — it pulls in your complete medical record from every hospital system, along with daily wearable data, and then uses AI to create personalized insights, track trends, and prepare you for each visit. No more digging through old test results or scrolling through endless messages — just ask PaiGE, your AI health assistant. Similar to ChatGPT, PaiGE can instantly summarize what matters most, whether your record is small or extensive, so you always have exactly what you need at your fingertips.

All communication happens securely through Spruce Health, a HIPAA-compliant communications platform for:

    •    Text messaging

    •    Phone calls

    •    Virtual visits

    •    Image sharing

    •    Direct care coordination

Enrollment is managed through Hint Health, our HIPPA-secure membership platform.

You’ll receive a personalized invitation with a secure link to complete registration, select your payment plan, and we will reach out to you to schedule your onboarding visit.

If enrollment is full, you may choose to join the waitlist.

OptimizeMD is a membership-based practice. Instead of billing insurance for each visit, you pay a flat monthly or annual fee that covers unlimited visits, direct access to Dr. DeMarco, and the core benefits of your care.

• Direct Primary Care (DPC): $350/month

• Year One Prepaid Discount: If you prepay for your first year of membership by September 30, 2025, you’ll receive 10% off (e.g., $3,780 instead of $4,200 - a $420 savings). After the first year, membership renews at the standard monthly rate.

This model eliminates surprise bills and copays, giving you predictable, all-inclusive access to your physician and proactive, longevity-based primary care.

OptimizeMD offers concierge-level care coordination, including:

• Direct referrals to trusted local or on occasion, national specialists

• Communication with outside providers (before and after visits)

• Interpretation of outside labs and imaging

• Ongoing integration of specialist care into your larger plan

Dr. DeMarco believes in staying involved — not just making referrals.

OptimizeMD provides continuity of care wherever life takes you. While you’re away from home, you’ll still have access to:

• Virtual visits with Dr. DeMarco via Spruce (subject to state licensure laws where you are located at the time of the visit)

• Secure messaging for quick questions, updates, and lab/test review

• Care navigation support—helping you decide whether urgent care, the ER, or telehealth prescription support is most appropriate, and when needed, speaking directly with the medical provider where you are to coordinate your care

• Coordination with local pharmacies, specialists, and facilities when needed

If you’re traveling to a state where Dr. DeMarco is registered or licensed for telehealth, full virtual care—including prescribing—can be provided. In other locations, care may be limited to guidance, coordination, and recommendations until you return home or connect with a licensed local provider. Either way, Dr. DeMarco will support your care coordination and can assist in prescribing to an Ohio-based pharmacy, who typically can transfer your scripts to you out of state (This works best with Walgreens and CVS).

If you’re hospitalized or need surgery, Dr. DeMarco will provide:

• Pre-hospital planning to ensure your care team has full background and records

• Post-hospital guidance to review discharge plans, medication changes, and next steps

• Ongoing recovery oversight to help you avoid complications and optimize healing

You’ll never be left to figure it out alone.

This practice is ideal for people who:

• Want a trusted, long-term health partner

• Value longevity, prevention, and performance optimization

• Are active participants in their healthcare

• Have chronic conditions and want better, more attentive support

• Are frustrated by rushed, transactional visits in traditional care

• Appreciate quick, efficient visits when appropriate—and unhurried, detailed longer visits when diagnosing concerns or during annual wellness exams

• Prefer shared decision-making and being informed on the “what, so what, and what next” in their healthcare

• Are ready to invest in their health and want care that is focused, modern, and personalized

This practice is not for those who want a physician to act as a “prescription vending machine” without meaningful dialogue, who have minimal interest in active participation, or who expect full insurance reimbursement for all services.

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 at any time with 30 days’ written notice (email will suffice). If you’ve prepaid for the year (First-Year Prepaid Special Offer), you will be refunded the unused portion on a prorated basis, less any completed services (e.g., DexaFit Testing, Vitality Blueprint, etc).

If you’re paying monthly, there’s no additional penalty — you’ll simply stop being billed after your final month of service, and will no longer have access to Primary Care with Dr. DeMarco.

Yes — couples are welcome, but each adult requires their own full membership. This ensures that both individuals receive the same level of personalized attention, diagnostics, and access.

OptimizeMD does not dilute care by offering shared visits or reduced services for spouses or partners — everyone deserves high-quality, physician-led care.

Couples Discount:

Couples who enroll together receive a 10% discount off the total combined membership fee.

Example: Two adults = $350/mo each = $700/month regular price. Couples discount = $630/mo for the couple, or $315/mo each (10% off)

However, if taking advantage of the first year pre-pay discount the couples discount will not start until paying monthly, after the 12th month of membership.

No. OptimizeMD is for adults only.

Those 16 and up can get DexaFit services, and would be encouraged to sign up for fitness optimization, if desired, through the cincinnati.dexafit.com platform.

Young adults (18-26) within an existing member’s household may be considered for a basic membership on a case by case basis. Please contact Dr. DeMarco for more information.

Yes — that’s available through our Longevity Memberships (Core, Plus and Elite Plans) at DexaFit Cincinnati. These programs focus on advanced diagnostics, labs, and consultation without ongoing Primary Care.

They include:

• Precision diagnostics (DEXA, VO₂ Max, RMR)

• Advanced lab testing with the Vitality Blueprint

• 60–90 minute consults with Dr. DeMarco

• 45-60 minute consults with a Registered Dietician for Nutritional Assessment and Counseling

• 45-60 minute consults with a Doctor of Physical Therapy for Fitness Assessment and Counseling

• Optional à la carte follow-up consults for health optimization

This is a great fit if you want data, insight, and a proactive health plan without needing ongoing medical care or coordination.

OptimizeMD Primary Care membership provides all the benefits of a traditional doctor-patient relationship plus more time, access, and proactive care. This includes acute visits when you’re sick, care coordination, cancer screenings, and other preventative services.

Longevity Memberships, on the other hand, focus on advanced testing, data interpretation, and health optimization. They do not include primary care services like acute care, sick visits, or ongoing medical management.

If you’re unsure which option is the best fit, just ask — we’ll help guide you.

That’s great — you’re already familiar with the testing and technology we use as the foundation of our Longevity Pathways. As an OptimizeMD member, your DexaFit data (DEXA scans, VO₂ Max, RMR, and more) can be fully integrated into your personalized health plan.

If you already have an active DexaFit package or recent results, this data will be seamlessly integrated into your medical record moving forward.

You can choose to continue with individual testing, start a true doctor-patient relationship with a Longevity membership or step into OptimizeMD Direct Primary Care for full, ongoing medical support.

Yes., but this is not necessary. Your OptimizeMD Direct Primary Care membership is flexible — some patients choose to keep their existing PCP for insurance-related reasons, while others transition fully to Dr. DeMarco for their primary care. If you’d like Dr. DeMarco to deliver acute care or help coordinate your broader medical care, he is more than willing to play that role.

This model works best with clear communication about the role you’d like each physician to play. Once that’s defined, Dr. DeMarco will stay in the lane you prefer — whether that’s as your primary physician, your longevity and prevention expert, or a blend of both.