What is Direct Primary Care (DPC)?

DPC describes the model of general medicine/primary care that involves the doctor and patient only. DPC does not involve insurance companies or any other third parties in the clinical, administrative, or financial management of the physician-patient relationship.

What do we get for the monthly retainer?

In general, patients become a member of a DPC practice by paying a monthly fee and, in return, receive primary care per a list of services offered by the doctor. At a minimum, patients typically receive all care generally offered by a primary care physician (PCP), including acute care (sick visits) and chronic disease management.

What do you treat?

Nearly all acute and chronic primary care, with the exception of obstetrics/gynecology.

Primary Care services include: Obesity/Insulin resistance counseling, Weight loss recommendations, thyroid care, GI health, HRT, Hypertension, Heart health / high cholesterol, Back pain, Arthritis, Diabetes (type 2), Autoimmune workups, Gout, Acne, Rashes, Migraine, Neuropathy, Urinary symptoms, Fever, Flu/Cold symptoms, Allergies, Physicals for Insurance or Sports, medications for travel, EKGs

We also offer treatment of minor Urgent Care needs including: Infectious workups (In-office Strep, Flu, RSV, Covid), hypertensive urgency, migraine attack, suture removal, IM steroids, abscesses, EKG.

Do you prescribe HRT?

Yes, HRT is encouraged for peri- and postmenopausal women. Testosterone therapy is considered for patients with very low levels of Testosterone confirmed on lab testing, not for preferential or recreational use. Holistic/natural efforts are always preferred for increasing Testosterone levels organically before employing pharmaceuticals. Dr Marino does not insert Testosterone pellets.

Do you practice Functional Medicine?

Yes, functional medicine practices and philosophies are incorporated into diagnosis and management of any issue when applicable. She is not certified by the IFM, but she addresses topics of food, exercise/movement, sleep and mental health with all patients. She is consistently engaged in Continued Medical Education from the Institute of Functional Medicine. She views evidenced based medicine as valuable and functional medicine as a key component to preventive medicine. These two forms of medicine should not be viewed in opposition to the other but as partners for wellness optimization. She utilizes Genova Diagnostics for in-depth investigation into gut health and/or possible triggers of chronic disease, and DUTCH testing is used for in-depth hormone health investigation.

What do I get for my monthly membership fee?

Please see the Services List in the “Services” section. In brief, patients receive all care generally offered by a primary care physician (PCP), including acute care (sick visits), chronic disease management, ongoing prescription needs, and wellness optimization recommendations.

Are labs free?

No, but the yearly basic labs are included in the yearly physical exam for Members. Other bloodwork done throughout the year (ie, thyroid follow-up, autoimmune disease panel, etc) is billed directly to the physician’s office at a discounted price. MarinoMedica is responsible to pay the lab bill, and patients reimburse the practice via credit card on file for any labs they received. 

Example: You see Dr. Marino for persistent urinary symptoms after an initial round of antibiotics for a Urinary Tract Infection (UTI). Dr. Marino orders a Urinalysis (UA) and Urine culture to further investigate the UTI. You go to the lab to give a urine sample. You pay the lab nothing and do not receive a bill from the lab. Dr. Marino pays the lab bill of $15, and you reimburse the practice $25 (to include the $10 convenience fee). You saved $40-$200 on these labs and saved time by not handling a lab bill and/or insurance company. (The hypothetical charge between Lab and Insurance company for a UA in this scenario is impossible to pinpoint for comparison, as each Insurance company has different charge/payment agreements with each lab. Based on a review of sample lab bills from actual patients over the past 3 years, the charge for a basic UA ranged from $40 - $200).

Do you accept Insurance?

No, DPC excludes third parties (Insurance companies, Medicare) from the doctor-patient relationship. We do not submit bills to insurance companies for any services or time spent with patients/members. MarinoMedica endorses the non-profit medical cost sharing communities (CHM, MediShare, Sedera, etc) over traditional for-profit health insurance to maximize cost effectiveness in your medical care. Alternatively, MarinoMedica membership could be paired with a high-deductible health insurance plan. Superbills can be provided upon request for Members that would like to submit request for reimbursement from their HealthShare company.

I have traditional insurance. Can I still be a member of MarinoMedica?

Yes! All patients are welcome. Those with insurance simply will not have their insurance plan involved in the clinical or financial relationship with Dr. Marino. MarinoMedica will never ask to see your insurance card.

What if I need to see a specialist?

Dr. Marino makes referrals to any and all specialists regularly. Referrals are made directly via doctor-to-doctor communication (typically electronically) if/when deemed necessary by Dr. Marino. Patients are responsible for all communication with the specialist’s office regarding scheduling, insurance questions, and other administrative logistics once Dr. Marino has made the referral. Of course, patients who have insurance can choose to involve their insurance plan to pay for services from that outside specialist..

What if I need medical attention on the weekend?

Dr. Marino no longer works on weekends. She also does not manage Spruce communications on weekends. For urgent medical needs on a weekend, you should visit a local Urgent Care or ER.

Can I sign up my children, as well? Is there a family discount?

Internal Medicine doctors specialize in the diagnosis and management of acute and chronic medical issues for adults. Pediatricians and Family Medicine doctors receive training on medical care for children. Dr. Marino does not take on patient members under the age of 18. Once a patient is 18 yrs old, he/she can reach out directly to the office to establish care, as the office does not communicate to any patient via their parent(s).

Spouses of existing members do receive a $30 discount on their monthly retainer. When a married couple joins the practice at the same time, one adult will be charged the $130/month fee and the second adult will be $99/month.

Do I have to be a patient member just to get a yearly physical exam?

No! At this time, nonmembers can still schedule an annual physical exam (APE). APE’s are $350, which includes a basic lab panel, 1-hr office visit, lab review and EKG. The fee also includes one (1) 30-min follow-up visit to discuss any issue(s) that were discovered/discussed in the original appointment. After the APE, if it’s decided that medications are in order (ie blood pressure medication) then a prescription would be written for 90 days’ worth of therapy. Beyond that, the patient would need to decide whether to establish membership with Dr. Marino for ongoing care/refills or to establish care with another office. Ongoing prescriptions are not written for non-members.

Non-member visits are limited to TWO (2) visits per year, as a key goal of DPC is to establish a long-term doctor/patient relationship via membership.

Do I have to be a member to schedule a sick visit?

Yes. Due to increasing patient volume, sick visits are reserved for established patient members only. Walk-ins are not accepted.

I’ve been on 1-2 medication(s) for years and don’t expect any changes. Do I have to be a member to get medications?

Yes, ongoing prescriptions are not written/refilled for non-members.

I don’t think I need a membership. Do I have to be a member to consult Dr. Marino on 1 or 2 focused issues?

Outside of membership, Dr. Marino now only offers regular focused consults on these topics: HRT, Gut Health, and Peptide therapy. Please see the Services page for a breakdown of costs. On occasion, Dr Marino will consult on other issues on a case-by-case basis — feel free to contact the office to discuss your needs and Dr. Marino will review the request for a nonmember consult.

**Coming Spring 2026, the office will also offer Ionized/Hydrogen water share for a competitive price!

Do you prescribe controlled drugs?

No, Dr. Marino does not prescribe schedule II - IV drugs, as these drugs have great potential for misuse or abuse. Specific examples of these include opiates (ie Norco, Percocet, or Vicodin), benzodiazepines (ie Xanax or Valium), stimulants (ie Adderall, Vyvanse) or sedative-hypnotics (ie Lunesta or Ambien). Patients that use these medications are still welcome as members, but Dr. Marino will not be the prescriber of these medications.

How do I get started?

Simply visit the Calendar feature at the bottom of the Contact section of this site to choose a time slot for a FREE informational meeting with Dr. Marino. If patients choose to join, they will pay a one-time onboarding fee of $99 and their membership will start whenever they would like Dr. Marino to be available as their PCP/GP.