People are frustrated with their healthcare.  Really, what they’re most frustrated with is their insurance coverage.  Bream Medical aims to provide a direct primary care option for our patients via our subscription service.

                The days of having a good job where your employer provides excellent coverage, and the insurance company approves whatever you need are gone.  Insurance companies are charging higher premiums, reimbursing offices and hospitals less, and denying more claims than ever before – and making billions of dollars in profit.

                I came to this realization after the birth of my first child.  My wife and I were relatively young (37 and 33) and healthy (Jen has had two kidney stones).  We had a Blue Cross silver plan for her and a bronze plan for me.  We were paying about $1100 per month out-of-pocket with an $11,000 deductible.  When Lincoln was born, our insurance paid ZERO, and we ended up owing about $9000 out-of-pocket because we were nowhere close to meeting our deductible as we had only had our wellness visit.  So, basically, we paid more than $20,000 in healthcare costs (premiums plus healthcare costs) for our insurance to pay nothing. 

                This is one of main reasons I founded Bream Medical was to provide an alternative to the insurance-based healthcare model.   Had we been in a direct primary care model such as Bream Medical’s subscription service, we would have saved $10,000 per year on healthcare because of premium and deductible was so high and could have applied that savings to our child’s birth.  Instead, we paid heavily for both.

Why Direct primary care?

                Most offices have appointments stacked up, often double booked, which places incredible stress on the providers to herd patients in and out of the office like cattle.  This model is dissatisfying to the patients and to the providers.  Overhead costs are so high and reimbursement from insurance so low that offices that depend on insurance must schedule this way to make ends meet.

                With direct primary care, the set up is quite different.  The notable differences one would expect to see with Bream Medical’s direct primary care/subscription service versus traditional primary care include:

  • Longer appointment times: Traditional primary care offices often carry thousands of patients per provider.  Direct primary care offices carry only a few hundred patients.  As such, direct primary care appointments are usually 30-60 minutes – and can be longer if needed for extremely complex cases. 

Because direct primary care is free from the constraints of insurance, your doctor is able to spend more time with you because the provider is free from the cumbersome and useless data entry requirements mandated by insurance companies.

  • Increased access to care: With direct primary care, appointments are accommodated either the same day or the next business day. Further, you will have access to a direct line to a Bream Medical provider whenever you need to address your concerns. 
  • Less cost: With direct primary care, you pay a monthly fee to the office for your medical care. The monthly fee is MUCH LESS than a monthly insurance premium. At Bream Medical, our monthly fee is $50-$125 per individual depending on the type of plan.  According to a study by n 2020, the average national cost for health insurance is $456 for an individual and $1,152 for a family per month.  As such, Bream Medical’s plans would save people on average of over $300 per month.  That’s a savings almost $4000 per year. 


Additionally, because direct primary care doesn’t deal with insurance, Bream Medical has been able to negotiate extremely low lab costs with Mako.  Let’s look at a CBC, one of the most basic labs ordered.  With insurance, the cost to the patient is between $10-$20 depending on the type of insurance.  At Bream Medical, the cost of a CBC is about $4 – a 60-80% savings over using your insurance!

Bream Medical has X-ray in office which significantly decreases cost to the patient.

Procedures, such as stitches, abscess drainage, injections, among others, are performed at a discounted rate for direct primary care subscribers.

Because of the increase access to your provider, some visits will be avoidable due to an ability to directly email or contact your provider.  Also, because of the structure of direct primary care, patients who are vulnerable can be frequently reassessed which decreases the risk of hospitalization.

Lastly, with direct primary care, there are no co-pays, which saves patients even more money.

Care is more comprehensive:  Because the doctor can spend more time with the patient, care is more comprehensive. The doctor can take more time to assess your condition, as above, run labs for cheaper, and can see you back in the office quickly for reassessment.  In a traditional primary care office because care is rushed, more complex issues are often not assessed completely leading to overreliance on specialist referrals. 

Transparency: Because direct primary care does not deal with insurance as a middleman, the cost of care is transparent.  You know exactly how much your care costs at the time of service without any potential for surprise bills later

What if catastrophe strikes?

Direct primary care is not insurance.  However, direct primary care does provide significant cost savings that can be applied should a disaster occur.  However, many patients opt to keep a high-deductible plan, health share plan, or HSA plan for needs than cannot be accommodated through the office. 

For whom is direct primary care ideal?

Direct primary care is ideal for younger, healthier populations, independent contractors, or anyone who wants an alternative to a high-cost insurance plan.


Why Bream Medical for direct primary care?


                At Bream Medical, we are proud of our five-star Google rating and excellent customer service.  In addition to direct primary care, our providers all have significant Emergency Department experience, so we are trained in, and perform, procedures that many primary care providers are not comfortable performing.  Additionally, because we are accustomed to seeing truly sick patients, we can minimize the need for utilization of the Emergency Department by having significant supplies in the office to decrease the need for Emergency care and our comfort level in treating acutely ill patients. 

                We have an in-office X-ray machine in Stokesdale that decreases the need for expensive imaging at an imaging center or hospital.

                Bream Medical is adept at telemedicine appointments for patients

Bream Medical has significantly more experience than other practices with treatment of acute and long COVID

                Not being aligned with a corporation allows Bream Medical and its patients increased medical freedom

Join now!

                In November and December, we will offer an open enrollment special discount of $100 per month for our direct primary care service.

                Don’t wait!  Give us a call today to start getting better healthcare and save money!

 – John Bream, MD – Founder, Bream Medical

Bream Medical is an all-inclusive, non-corporate practice that provides urgent care, primary care, and direct primary care services in Salisbury, Stokesdale, and Edenton, NC, and provides telemedicine consultation anywhere in North Carolina.  We provide excellent healthcare by prioritizing patients care – not profits.  To learn more about Bream Medical, visit or call 704.216.1263.

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