Why We Don’t Take Insurance

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Why Do Some Medical Practices Not Accept Insurance?

Some medical practices choose not to accept insurance so they can provide longer visits, deeper diagnostic evaluation, personalized care, and preventive medicine that insurance plans often do not cover. Insurance-based care prioritizes volume and billing codes, while cash-based care allows physicians to focus on root causes, early detection, and long-term health outcomes. Patients who choose non-insurance practices often value time, expertise, and proactive care over brief visits and reactive treatment.

At Patients Medical in NYC, this model allows physicians to practice comprehensive, preventive, and integrative medicine—without the time and testing limitations imposed by insurance contracts.

Why don’t you take insurance?”

It’s an important question—and a fair one.

Insurance is deeply embedded in modern healthcare, and many patients assume that insurance-based care automatically means better or more complete care. In reality, insurance often limits what physicians are allowed to do, especially for patients with complex, chronic, or preventive health needs.

This page explains:

How insurance-based medicine actually works behind the scenes
Why many patients feel rushed, unheard, or dismissed
What physician-led, non-insurance care allows instead
Who benefits most from this model
Why Patients Medical chose this approach intentionally

How Insurance-Based Medicine Really Works

Insurance companies are not healthcare providers. Their primary role is to control costs and manage utilization.

To do this, insurance systems require doctors to:

Bill using rigid diagnostic and procedure codes
Limit visit length
Justify or deny testing
Follow standardized treatment pathways
Prioritize disease management over prevention

Doctors are paid per visit, not per outcome—and the system rewards speed, not depth.

Why Insurance Visits Are Often So Short

In most insurance-based practices:

Doctors see 20–30 patients per day
Appointments may last 7–12 minutes
Complex symptoms are split across multiple visits
Preventive care is deprioritized
Lifestyle, nutrition, stress, and sleep are rarely addressed

This model works reasonably well for:

Acute infections
Simple medication refills
Emergency or urgent care

It does not work well for:

Chronic fatigue
Brain fog
Hormonal imbalance
Autoimmune or inflammatory disease
Metabolic or weight issues
Longevity and cognitive health

What Insurance Typically Does Not Cover Well

Insurance often excludes or restricts:

Advanced preventive testing
Functional and integrative diagnostics
Root-cause analysis
Environmental toxin and mold testing
Detailed hormone and metabolic evaluation
Extended physician time

These services are frequently labeled “not medically necessary”, even when they help prevent disease progression.

The Problem With Disease-Only Medicine

By the time insurance intervenes, damage has often already occurred.

What Physician-Led, Non-Insurance Care Allows

Longer Appointments

60–90-minute new patient visits
Time to understand your full health history
No rushing, no assembly-line care

Deeper Diagnostic Evaluation

Advanced labs beyond basic panels
Functional, metabolic, inflammatory testing
Early risk identification

Personalized Treatment Plans

Based on your biology—not protocols
Adjusted over time as your health changes

Preventive & Longevity-Focused Care

Brain health preservation
Hormonal optimization
Metabolic health and inflammation control

Continuity of Care

Ongoing physician relationship
Trend tracking year over year
Prevention before disease

Why This Matters for Complex Symptoms

Many patients come to Patients Medical after being told:

“Your labs are normal”
“It’s just stress”
“That’s part of aging”
“There’s nothing more we can do”

Complex symptoms require:

Time
Pattern recognition
Systems-based thinking
Clinical judgment

Insurance models rarely allow for this depth.

A Physician’s Perspective: Why Some Doctors Leave Insurance

Many physicians leave insurance networks because they want to:

Practice medicine ethically

Spend time with patients

Prevent disease rather than react to it

Retain clinical autonomy

Treat root causes, not just symptoms

This decision is not about charging more—it’s about being able to practice medicine properly.

Is This Concierge Medicine?

Not exactly.

Unlike traditional concierge medicine:

There is no annual membership just for access
Care focuses on diagnostics and outcomes, not perks
You pay for time, expertise, and medical judgment

This is physician-led integrative and preventive care, not luxury medicine.

Is Cash-Based Care More Expensive?

At first glance, it may seem that way. But many patients find that it leads to:

Fewer unnecessary visits
Less trial-and-error medication
Earlier prevention
Better long-term outcomes

Investing earlier often reduces long-term healthcare costs.

Who Is the Right Fit for This Model?

Patients Medical is often the right fit for patients who:

Want answers, not quick fixes
Have complex or chronic symptoms
Value prevention and longevity
Prefer depth over speed
Want a true physician partnership

It may not be the best fit if you only need:

Urgent care
Quick refills
Basic physicals

What to Expect as a Patient

Extended intake and history review

Comprehensive diagnostic evaluation

Physician-led interpretation

Clear, personalized care plan

Ongoing follow-up and prevention

If you are looking for unrushed, physician-led, preventive care in NYC, Patients Medical offers a different model—one focused on time, expertise, and long-term health, not insurance limitations.

to schedule an appointment with
Dr. Rashmi Gulati, MD or Dr. Stuart Weg, MD

Why We Don’t Take Insurance — And What That Means for Your Care

This is one of the most common—and important—questions patients ask:

“Why don’t you take insurance?”

It’s a fair question.

Insurance is deeply ingrained in modern healthcare, and many patients assume that insurance-based care equals better care.

In reality, insurance often limits what doctors can do for patients—especially when it comes to:

Preventive medicine
Root-cause diagnosis
Chronic disease reversal
Longevity and brain health
Time, attention, and continuity of care

This page explains:

How insurance actually works behind the scenes
Why insurance-based medicine is often rushed and reactive
What cash-based, physician-led care allows instead
Who benefits most from non-insurance care
How Patients Medical structures care differently

How Insurance Really Works (Behind the Scenes)

Insurance companies do not exist to optimize your health.

They exist to:

Control costs
Limit utilization
Standardize care
Reduce time per patient

To do this, insurance requires doctors to:

Use billing codes
Follow rigid protocols
Justify every test
Limit visit time
Focus on diagnosis codes—not prevention

Doctors are paid per visit, not per outcome.

Why Insurance Visits Are So Short

In insurance-based practices:

Doctors often see 20–30 patients per day
Visits may last 7–12 minutes
Complex symptoms are split across multiple appointments
Prevention is rarely addressed
Lifestyle, nutrition, sleep, and stress are often ignored

This model works well for:

Acute infections
Simple medication refills
Emergency issues

It does not work well for:

Fatigue
Brain fog
Hormonal imbalance
Autoimmune disease
Chronic inflammation
Longevity and prevention

This is why patients cycle through medications without resolution.

What Insurance Does NOT Cover Well

Insurance typically does not cover:

Advanced preventive testing
Functional and integrative diagnostics
Longevity and aging assessments
Detailed nutritional evaluation
Root-cause analysis
Environmental toxin testing
Extended physician time

These services are labeled “not medically necessary” — even when they prevent disease.

The Problem With “Disease-Only” Medicine

Insurance medicine is designed to:

Treat disease after it appears
Manage symptoms
Prescribe medications
Monitor progression

It is not designed to:

Identify early dysfunction
Reverse chronic illness
Optimize healthspan
Prevent neurodegeneration
Slow biological aging

By the time insurance medicine intervenes, damage has often already occurred.