Diagnosed in 2 Months After Searching Since 2022. Her Doctor Still Says Keep Insurance for the Big Stuff.
Dominique Spagnola had just had a baby. Then her body started acting wrong, and she couldn't get in to see her primary care doctor or the specialists she needed.
She'd been chasing answers since 2022. So she reached out to Dr. Meghan Montie, who runs Heirloom Family Medicine, a direct primary care practice in Albany. "She immediately got me right into these specialists that I needed to see," Spagnola told CBS6.
Within 2 months she had an official diagnosis, primary aldosteronism, a condition where one adrenal gland malfunctions, and a pathway to a cure.
Years of searching. Then 2 months.
That's what happens when a doctor has time. Heirloom patients pay a monthly membership of $250 to $600 and get 24/7 access by phone, text, or email, same- or next-day appointments, and longer visits. Montie even sees some patients at home if they're postpartum or have trouble getting around. "It really just allows me to go much deeper with my patients," she said.
Spagnola's verdict on the fee: "The monthly membership is something I don't even notice." She figures that if she'd started with Heirloom sooner, she'd have saved about $2,000.
Here's the line I want every direct care patient to hear, and it came from the direct care doctor herself:
"Health insurance is still very important for catastrophic events."
She's right. Spagnola kept her insurance through work alongside the membership, and Montie says that's common. Some of her patients pick a higher-deductible plan with lower premiums and pair it with direct care.
So direct primary care handles the everyday. It fixed a diagnosis that the old system dragged out for years. But it was never meant to pay for the night you end up in the hospital.
The catch is what those higher-deductible plans actually do when something big happens. You hit the deductible first. You find out what's in network and what isn't. Then you get the bill.
That gap is why we built Atlas Direct. It pairs with your direct care membership and pays cash benefits for hospital stays, ER visits, surgery, and childbirth. No deductibles to burn through first. No networks to check. The money goes to you, and you decide how to use it.
Your doctor handles your health. Atlas Direct handles the catastrophe. Neither has to pretend to be the other.
Montie says direct care fits people with nontraditional jobs who don't have insurance, and people who change jobs often and don't want a new doctor every time their coverage changes. That second group should think hardest about the big stuff, because coverage tied to a job leaves when the job does.
Spagnola got her answers in 2 months. The next step is making sure the bill for the worst day of your life doesn't take years to pay off.
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Source:
- CBS6 Albany, "As insurance costs rise, more doctors offer direct primary care as a cheaper option" (Oct 19, 2026): cbs6albany.com/news/wellness-watch/as-insurance-costs-rise-more-doctors-offer-direct-primary-care-as-a-cheaper-option