Frequently Asked Questions

We work for YOU and NOT the insurance company!

We are not in network with any insurance companies. We do not take insurance or bill your insurance for our services. We charge our membership fee directly to you. Some insurance plans provide reimbursement for out-of-network providers. We are happy to provide you with a superbill/receipt for visits and services so that you may submit to your insurance. Contact your insurance representative to inquire about reimbursement rates for out-of-network providers.

DPC takes all of the worst parts about healthcare in America – insurance companies and their mountains of paperwork and red tape, corporate hospital systems, and all of the shadowy middlemen trying to eliminate price transparency –and throws them all out the window. By cutting out the expensive middleman of insurance, the doctor can provide longer visit times, same day or next day appointments, phone/video visits, and the patient has direct access to their doctor. We limit the number of members to ensure that we have sufficient availability.

We do not participate in Colorado’s Medicaid Program. Based on Colorado policy, Medicaid patients are not permitted to pay for any services covered by Medicaid, including primary pediatric care. Therefore, unfortunately we cannot have Medicaid patients be paying members of Milestone Pediatrics at this time.

We recommend that all patients have health insurance to provide coverage for catastrophic events, prescription medications, hospitalization, immunizations, labwork, imaging, specialist visits, and other expensive unexpected health needs.

Your car insurance covers collisions and major repairs but not car washes, oil changes, or new tires. Your health insurance covers expensive hospitalizations and procedures but most patients pay out of pocket for the vast majority of their healthcare. In our practice, you just get a lot more value for your money.

In Colorado, direct primary care membership should qualify for health savings account (HSA) and flexible spending account (FSA), but please confirm with your individual plan.

DPC membership is especially cost effective for patients/families with:

PPO (preferred provider organizations) plan, or other out-of-network coverage. Choose your doctor, and allow us to coordinate your care best! Two great benefits of PPO plans are: 1) You do not need referrals from an in-network primary provider to see a specialist. 2) Many patients on PPO plans receive reimbursement from their insurance for the services we provide (subject to the specific terms of each policy). We are happy to provide a receipt for you to submit after visits.

High deductible plans; enjoy concierge care instead of paying towards a deductible you'll never meet.

Health sharing plans (ie, Zion, Medishare) which often don’t cover well child care, but do have lower monthly premiums.

Inconsistent health benefits. DPC allows you to keep the same pediatrician, with amazing access and communication.

Yes, by appointment only. Milestone Pediatrics, Concierge Care for Kids is designed to be truly convenient for your family! Most of our care is in the comfort of your own home, without the disadvantages of early office check-in, waiting room germs, long waits in the office, pages of paperwork when you arrive, and rushed visits due to tight scheduling in corporate medicine.

By appointment only, our Office Membership & Pediatric Urgent Care office visits are in our new private office space: clean and comfortable, conveniently located at I25/Woodmen.

We serve a large region to include Colorado Springs, Monument, Palmer Lake, Larkspur, Castle Rock, Peyton, Falcon, Elbert, Fountain, Widefield, Pueblo, Woodland Park & Divide. Not all locations are eligible for in-home Premium Membership, but anyone is welcome to do Office Membership with the same reliable communication anytime. Schedule a free video Meet & Greet or call with questions. 

Membership provides you with all routine wellness visits (in-home), unlimited telemedicine video visits, unlimited home visits (as needed), and 24/7 communication with your pediatrician via secure messaging and phone calls. Any testing that would be done in the office is included (i.e., strep/flu/covid testing, urinalysis, etc.). Minor procedures (i.e., foreign body removal, wart treatment, simple laceration repair, ear wax removal, etc.) and certain treatments (i.e., oral medications, inhaled medications, etc.) are also included.

Labwork, imaging studies, and prescriptions are not covered under any of our membership plans. Your insurance may be used to cover these services. Alternatively, we will work to provide the most reasonable prices to our patients, and will have certain medications available to avoid the need for prescription.

Your pediatrician will administer immunizations during visits, as desired. We partner with VaxCare, who will bill your insurance directly to cover the cost of vaccines. Members who do not have insurance coverage for vaccinations have the option of being invoiced for vaccines or to receive them at the Health Department. 

Medical services from other providers (i.e., specialists, urgent care, emergency room, surgery, in-patient hospitalizations) are not covered under any of our membership plans. Within the scope of our medical license and expertise, we will always do our best to treat your child(ren) without the need for additional services, but will use our best clinical judgement to determine if it is in your child’s best interest to seek a higher level of care. Earlier access to care and communication with your pediatrician can sometimes prevent the need for further care.

As medical professionals, we feel that vaccinating children on the schedule endorsed by the American Academy of Pediatrics (AAP) is best. However, we understand that you may have concerns about vaccines or vaccine schedules, and love that our Milestone Pediatrics model fosters unrushed visits and reliable communication with your trusted pediatrician who knows and respects your family! We enjoy helping you navigate your options with confidence and good information. We do support alternative and selective vaccine schedules, if you are more comfortable with that. Our in-home care also eliminates the risk for exposures in an office. We feel strongly about honoring parent choice, and strive to never create pressure or judgement around vaccines.

We partner with VaxCare, who will bill your insurance directly to cover the cost of vaccines. Members who do not have insurance coverage for vaccinations have the option of being invoiced for vaccines we administer at home or to receive them at the Health Department. Current vaccine fees are available upon request.

Yes. Your membership can be canceled by either party at any time, with 30-days written notice. If you decide to leave Milestone Pediatrics, there is absolutely no fee or penalty. If you have prepaid your membership fee for the year, you will be reimbursed for the unused months.

Should you desire to re-enroll at a later date, there will be a $150 re-enrollment fee.

Yes. If at any point you decide to switch membership plans, you may do so by written notice, and that change will be effective immediately. Future payments will be adjusted accordingly. No more than one switch may be made in a 12-month period. All children in the household must be on the same plan.

We will do our best to notify families in advance of planned absences. Your pediatrician may still remain accessible via messaging, phone, and even telemedicine during their absence. However, in the event that your doctor is not available (including illness and emergencies), we will do our best to arrange coverage by another trusted, board-certified pediatrician.

Yes! We offer prenatal meet and greet visits so that you can have your pediatrician selected well before your baby is born. We recommend this for the best care and continuity, and because there will be wait lists at times.