Direct Primary Care
The Direct Primary Care (DPC) plan has no copays, deductibles or coinsurance for DPC services, as long as you use your CHI Health DPC provider. If you see a non DPC, you receive no coverage for these services and will pay the full billed charges. The average DPC panel size is approximately 900 patients (2300 for primary care). With the smaller panel of patients, this provides same-day or next-day appointments and the ability to spend more time with your provider at each appointment.
Don’t forget to use your health care portal on the CHI MyChart to communicate with your provider - you may not need to come in for an office visit. Many requests can be handled through the CHI MyChart portal.
Be sure you understand the plan and how it works prior to enrolling as you will not be able to select another CommonSpirit Health plan until Annual Benefit Enrollment for 2025, unless you have a qualifying event.
You can only see the DPC providers for primary care if you select the DPC/BCBSNE medical plan. If you select the DPC plan - please establish care/schedule a visit with your provider within the first couple of months of the New Year. Your provider can explain, in detail, the benefits of the DPC plan you have selected. Virtual Visits and MyChart messaging are great alternatives to an in person visit once you have established care with your DPC provider.
If you choose, you can still see your OB/GYN and dependents can see their pediatrician for an annual well check.
You can receive two free Priority Care visits per covered patient, after hours only (during the following times: nights-after 5 pm, weekends, the following holidays-New Year’s Day, Memorial Day, July 4th, Labor Day, Thanksgiving, Christmas and snow days). If you choose to use Priority Care on the weekdays, between 8am-5pm, you will be billed at the time of service. After office hours (nights- after 5pm, weekends, the above listed holidays and snow days) once you have used your two free visits, you will be billed in full for any additional Priority Care visits.
For additional questions, please contact the CommonSpirit Health Benefit Contact Center at 855-475-4747 and select Option 1—available Monday–Friday, 8 a.m.–7 p.m. CT. or our DPC Administrative Assistant at 402-742-8404.
Frequently Asked Questions
Omaha Providers:
William Lowndes, MD, Cristella Torres, MD, Leah Ridder, APRN, Clint Gregory, PA-C, Cara Henderson, PA-C
402-717-9490
13315 West Center Rd.
Omaha, NE 68144
Council Bluffs:
Michael Keane, DO and Josalynn Swan, PA-C
712-328-8800
1288 Valley View Dr.
Council Bluffs, IA 51503
Lincoln Providers:
Adam Linck, MD
402-327-7510
1601 N 86th St, Ste. 100
Lincoln, NE 68505
Grand Island Providers:
Mandy Carlson, APRN
308-398-5522
908 N Howard Ave, Ste 109
Grand Island, NE 68803
Kearney Providers:
Amber Rogers, APRN
308-865.2141
211 West 33rd St.
Kearney, NE 68845
Note: The provider list and availability are subject to change. Certain services provided by a non-DPC provider will not be covered.
William Lowndes, MD, Cristella Torres, MD, Leah Ridder, APRN, Clint Gregory, PA-C, Cara Henderson, PA-C
402-717-9490
13315 West Center Rd.
Omaha, NE 68144
Council Bluffs:
Michael Keane, DO and Josalynn Swan, PA-C
712-328-8800
1288 Valley View Dr.
Council Bluffs, IA 51503
Lincoln Providers:
Adam Linck, MD
402-327-7510
1601 N 86th St, Ste. 100
Lincoln, NE 68505
Grand Island Providers:
Mandy Carlson, APRN
308-398-5522
908 N Howard Ave, Ste 109
Grand Island, NE 68803
Kearney Providers:
Amber Rogers, APRN
308-865.2141
211 West 33rd St.
Kearney, NE 68845
Note: The provider list and availability are subject to change. Certain services provided by a non-DPC provider will not be covered.
The DPC Plan combines a Direct Primary Care (DPC) membership for all your primary care services with the coverage for your non-primary care needs (hospital, specialty providers and emergency room services) by using one of BCBSNE’s Blueprint Network providers. Please review the Benefits at a Glance in the above section or by visiting the MyBenefits link found on EmployeeCentral.
As long as you visit your CHI Health DPC provider, all of your encounters are covered, whether they are for preventive services, illness, injury or management of ongoing medical conditions. This includes:
- All in-office X-rays
- In-office procedures such as stitches for cuts or mole/lesion removal done by your direct primary provider
- In-office labs such as urinalysis, blood count, strep, mono and influenza testing
- The common/usual labs direct primary care providers request and manage are also covered
- No-cost or low-cost generic medications filled at a CHI Health pharmacy
- Other labs will billed to your insurance and you are responsible for any copays/coinsurance
- Vital signs, including blood pressure, pulse, respiratory, temperature, height and weight
- Age-appropriate lifestyle review and screening tests done at the DPC office
- Review of any concerns that you may have
- Physical examination
- Lab work (age appropriate)
- Pap smear according to current guidelines
- Completion of your Preventive and Biometric Screening forms
- Recommendations on ways to improve your health and to keep you healthy
- Review the benefits of the program
- DPC on-call provider – always call your DPC provider FIRST for after-office hours care
- CHI Virtual Quick Care – unlimited virtual visits are offered 24/7 at no cost
- CHI Priority Care – Two in-person visits per year for each member and their covered dependents when the DPC office is closed (nights - after 5 pm, weekends, above listed holidays and snow days)
- During Clinic hours, 8 a.m. - 5 p.m., you will need to contact your DPC provider’s clinic
- Urgent Care Clinic – visits at a BCBSNE in-network facility, a copay will apply
- Non-emergent questions – you may use your healthcare portal on “MyChart” to communicate with your provider (which will be addressed next business day)
- Emergency Department – for true medical emergencies you may be seen at a BCBSNE in-network facility, a copay will apply
No, if you see a primary care provider outside of the DPC program, for Primary Care Services (family/internal medicine), the visit will not be covered. See the Benefits at a Glance or the Benefit Summary and Coverage (SBC) sections on this page or visit MyBenefits found on EmployeeCentral for listings of all other covered services.
No. Work related injuries are covered 100% by workers compensation insurance and since the Direct Primary Care Program does not send claims to insurance you would not see your DPC provider for a work comp injury. Please contact the CHI Work Comp Coordinator or Employee Health as they can help guide your care. You can also be seen the same day at one of our CHI Company Care locations which specialize in the case management of work-related injuries.
Though 80-90% of most health care needs can be covered though your DPC provider, you can see a specialist. Your DPC provider can help make appropriate specialty referrals. Specialty services are covered at a minimal copay, as long as you use a BCBSNE provider within the Blue Print network. If your specialist orders labs that can be performed at your DPC clinic, they are NOT covered under the DPC plan, they will be billed to insurance and you are responsible for the fees that are not covered by the insurance plan.
Our DPC Providers can provide Well Child Checks, as well as manage acute and chronic health care needs. However, if you choose to see a pediatrician for your Well Child Checks, your CommonSpirit medical insurance will cover the visit. All other pediatrician visits will not be covered.
Yes, exams are covered at an OB/GYN office as long as they are a Blueprint Health network provider.
The Direct Primary Care Program does not send claims to insurance so if you want to submit an insurance claim, you would not be able to see your DPC Provider.
If you choose the Common Spirit Health DPC plan, then Medicare will become the secondary insurance.
DPC Providers are not credentialed with Medicaid and therefore cannot order medications or tests that would be filed with Medicaid.