Yes. Our Spokane Valley clinic is centrally located at Pines just off of I-90 to conveniently serve residents of the Spokane Metro area. We are licensed to provide telehealth services anywhere in Washington, with a focus locally serving Spokane, Spokane Valley, Liberty Lake, Otis Orchard, Millwood, Airway Heights, Deer Park, and the surrounding area residents.

Yes. Our Spokane Valley clinic is minutes from the border, and we are licensed to provide telehealth services anywhere in Idaho, with a local focus serving Post Falls, Hayden, Coeur d'Alene and the surrounding area. Idaho patients are also welcome to visit our Spokane Valley clinic in person!

Yes! As of January 1, 2026, federal law (The One Big Beautiful Bill Act - OBBBA) officially classifies Direct Primary Care memberships in Washington and Idaho as qualified medical expenses.

• HSA Payments: You can now use your HSA funds to pay for ShillMed membership fees tax-free, up to $150/month for individuals and $300/month for families.

• HSA Eligibility: Having a DPC membership no longer prevents you from contributing to a Health Savings Account, provided you have a qualifying high-deductible health plan (HDHP) or a Bronze/Catastrophic marketplace plan.

• FSA Usage: DPC fees are also eligible for reimbursement through most Flexible Spending Accounts (FSA).

Note: While federal law now clearly allows this, we always recommend keeping your receipts and briefly confirming with your specific plan administrator or tax professional to ensure compliance with your individual tax strategy.

Yes. DPC covers your Primary Care needs, but it is not a substitute for catastrophic insurance. We strongly recommend all patients maintain a high-deductible health plan (HDHP) or a cost-sharing ministry plan to cover emergencies, surgeries, hospitalizations, rehab, and specialist visits.

Under Washington State law, ShillMed cannot currently accept Medicaid (Apple Health) patients for our recurring Direct Primary Care (DPC) membership.

However, we can provide specific, one-time services (such as FibroScan) to Medicaid beneficiaries on a cash-pay basis, provided certain legal requirements are met to protect your benefits.

If you have Apple Health and wish to pay out-of-pocket for a specific service at ShillMed, the following steps are required by the Washington Healthcare Authority (HCA):

1. HCA Form 13-879: You must sign the "Agreement to Pay for Healthcare Services" form before any services are rendered.

2. Informed Choice: We must ensure you are aware of alternative options that may be covered by your Apple Health plan.

3. Transparent Pricing: You must agree to the specific cost of the service in advance.

Washington Administrative Code (WAC 182-502-0160) prohibits providers from charging Medicaid patients for "boutique" or "concierge" style monthly fees as a condition for receiving care. We follow these regulations strictly to ensure our patients' coverage remains secure.

Questions about a specific procedure? Please Contact Us to discuss your options or to see if a specific service qualifies for the HCA self-pay agreement.

Yes, we do! However, the way we process your coverage depends on your specific plan. Here is a breakdown of how we currently work with Medicare:

Medicare Coverage Breakdown

• Original Medicare: We can bill Original Medicare directly for services provided in our office.

• Medicare Advantage (PPO): Depending on your specific plan, we may be able to bill your provider as an out-of-network participant. Please note this can lead to higher co-pays and co-insurance. Check with your plan for details.

• Medicare Advantage (HMO): Unfortunately, due to Federal law, we cannot provide Primary Care for patients with certain restricted Medicare Advantage plans (such as Kaiser Medicare Advantage) who do not allow out of network care at this time.

Important Note on Direct Primary Care

While we accept Medicare for standard billing, our Direct Primary Care (DPC) membership is not currently available to Medicare patients.

Stay Informed: We are working on a future Medicare Direct Primary Care Program. Join our Medicare and Medicare Advantage Waitlist to receive updates as soon as our Primary Care and Direct Primary Care (DPC) offerings expand!

At ShillMed, your physician acts as your dedicated health advocate. If your care requires a specialist, we don't just "hand you off"—we coordinate the entire process to ensure a smooth transition and clear communication.

Your Referral Options

• Using Your Insurance: We can provide traditional referrals to in-network specialists, ensuring they receive all necessary medical records and context from our office to streamline your visit.

• Direct Care Specialists: For those without insurance or with high deductibles, we can often connect you with "Direct Care" specialists right here in the Spokane-Coeur d'Alene Metro. These providers offer transparent, cash-pay pricing that is frequently lower than the "discounted" rates billed through traditional insurance.

• Expert Coordination: We help you navigate the healthcare maze to find high-quality, affordable specialists who align with your medical needs and financial preferences.

The ShillMed Advantage

Unlike traditional offices, where referrals can get lost in a "black hole" of paperwork, we stay involved. We help you prep for your specialist appointment and review their findings with you afterward to integrate them into your overall wellness plan.

We offer customized billing for businesses in Spokane, Deer Park, and Liberty Lake. Contact us for a consultation on how to integrate DPC into your benefits package. The answer varies according to state law.