It is important to emphasize that Atlas Direct’s insurance plan offers only limited health benefits and that, as a result, the plan is not a substitute for comprehensive major-medical health insurance.
One way to see this is to compare what Atlas Direct’s plan does cover with what it does not cover.
- Atlas Direct's coverage includes fixed payment amounts for:
- Hospital admissions
- Emergency Room visits
- Skilled nursing care
- Ambulance transportation
- Childbirth
- Cancer treatments
- Hospice care
- 439 surgical and diagnostic procedures
By contrast, Atlas Direct’s insurance plan excludes a wide variety of medical services and products, including:
- Medications
- Lab work
- Imaging
- Substance abuse
- Mental health
- Dental
- Vision
- Infertility
- Primary care
- Immunizations
- Specialists
- Speech therapy
- Home health
- Pain management
Thus, while it is true that Atlas Direct was designed to be a good complement for Direct Primary Care, neither the Atlas Direct DPC Program as whole nor its insurance component by itself is a substitute for comprehensive health insurance. Thus, we strongly recommend that anyone seeking comprehensive health insurance consult with a licensed insurance agent or visit their state’s health-insurance marketplace for comprehensive-coverage options.
Please note that some states place restrictions on the surgeries and medical procedures that Atlas Direct’s insurance plan is allowed to cover. Thus, in those states, fewer than 439 surgeries and medical procedures may be covered. Please refer to the Certificate of Coverage and Schedule of Benefits that apply to your state of residence for the applicable list.
