By Dr. Julie McKenzie, DO | Grateful Living Medicine | Summit County, CO
Let me tell you something I’ve been wanting to say for years.
You are not imagining it. Your healthcare bills are getting worse. Your access to your doctor is getting worse. The time your doctor actually has for you is getting worse. And none of it is because anyone stopped caring – it’s because the system was never built to prioritize you in the first place.
I spent years practicing inside that system. I genuinely loved my patients. But the model made it nearly impossible to do the job the way I wanted to do it. Packed schedules, insurance paperwork, rushed visits, and a billing process so opaque that neither my patients nor I could fully explain what anything actually cost.
So when Holly and I decided to build Grateful Living Medicine, the first thing we asked ourselves was: what if the pricing was just… honest?
The Hidden Math of the Insurance Model
Here’s how a standard lab order works in the traditional healthcare system:
A patient comes in for a yearly physical. The doctor orders a routine metabolic panel – a standard blood draw to check kidney function, blood sugar, and cholesterol. That panel might cost a lab anywhere from $15 to $30 to actually run.
By the time it passes through the insurance billing system, the ‘list price’ billed to insurance might be $300 to $400. Insurance negotiates it down. The patient’s portion depends on their deductible, their copay, and their specific plan. In some cases, the patient pays a share that’s still multiple times what the test actually cost to run.
Nobody is trying to scam you. This is just how the system works. List prices, negotiated rates, and patient responsibility calculations layer on top of each other until the bill you receive has almost nothing to do with the actual cost of the service.
And here’s the part nobody tells you: routine labs at cost – what it actually costs the lab to run them – are often a fraction of what insurance bills.
| The number most patients miss: annual out-of-pocket. Monthly premiums get all the attention. But what you actually spend – the deductibles, the co-pays, the bills that arrive six weeks later – is the number that tells the real story. We ran it three ways. |
The Real Math
What care actually costs you. Three real options, side by side.
| MedicareOriginal + supplement & drug plan | Private Insurance Moderate premium, high deductible | Grateful Living Direct Primary Care | |
|---|---|---|---|
| Monthly cost | ~$350-$500/mo | ~$700-$1,200/mo | $150/mo |
| Typical out-of-pocket per year | ~$5,000-$7,500 | ~$10,000-$18,000 | ~$1,800 |
| Typical deductible | ~$1,000-$7,000 | High $5k-$9k typical | None for included care |
| Primary care visit | Often $0-$40 | Applied to deductible | Included |
| Preventive & lifestyle care | Nearly zero coverage | Limited by billing structure | Included |
| Chronic disease coaching | Limited – chronic-care visits only | Variable | Included |
| Coordination of specialists | Limited time | Limited time | Time built in |
| Basic office procedures | Sometimes covered, copays + prior auth | Deductible-based + prior authorization | Minor procedures included |
Numbers reflect moderate outpatient use – a few primary care visits, screening labs, a minor procedure or two, one urgent issue – across a year. Typical ranges for Summit County. Your actual costs vary by plan and use.
What’s Wrapped In
Each of these typically gets billed separately through insurance – even after your deductible. At Grateful Living, they’re folded into your membership.
| What it usually costs you | What’s covered at Grateful Living |
|---|---|
| ~$200+ | Standard screening labs – comprehensive panels, billed separately by most plans. |
| ~$500 | Urgent care visits – same-day issues handled in-house instead. |
| ~$125 | In-office visit bill – the line item that still arrives even after your deductible is met. |
| ~$400 | In-office procedures & ultrasounds – minor procedures and imaging billed through specialty channels elsewhere. |
| Included | Osteopathic manipulation & dry needling – body-work treatments insurance routinely refuses to cover. |
| At-cost | IV fluids, GLP-1, peptides – forward-thinking therapies at our cost, never marked up. |
It’s Not Just About Labs
The cost problem isn’t only about blood work. It’s about how you access care in the first place.
How many times have you tried to get a same-day appointment for something that really couldn’t wait a week – and ended up in urgent care instead? That urgent care visit has a facility fee, a provider fee, maybe a prescription. If something requires a specialist, add a referral, a wait, another copay, another facility fee.
We’re not blaming urgent care. We love urgent care. But a lot of what ends up there doesn’t need to be there. It ends up there because people couldn’t get to their primary care doctor in time.
Direct primary care was built to solve exactly that. When you’re a Grateful Living member, you have a direct line to us – call, text, or message. Same-day or next-day appointments. If something comes up on a Tuesday evening, you don’t have to decide between waiting it out or spending $500 at urgent care. You just text your doctor.
The Math Works Differently Here
We know what you’re thinking: adding a monthly membership fee on top of insurance sounds like more money, not less.
We get it. But look at the out-of-pocket column again. At $150/month, Grateful Living membership runs about $1,800 a year in total care costs for most members – compared to $10,000-$18,000 for a typical private insurance plan with a high deductible. That’s not a small gap.
Some of our members have been able to move to a higher-deductible, lower-premium insurance plan and use Grateful Living as their primary care home. The premium savings cover a good chunk of the membership. The actual access improves dramatically. And when something genuinely needs insurance – a hospitalization, a specialist, major surgery – they still have it.
This isn’t a pitch. It’s math. The right combination looks different for everyone, and we’re always happy to talk through what makes sense for your situation.
Why We Tell You All of This
Because we built this practice on the belief that you deserve to understand what you’re paying for.
- Not a bill that shows up six weeks after your appointment.
- Not a list price that no one ever actually pays.
- Not a system that makes you feel like you need a translator to understand your own healthcare.
Radical transparency isn’t just a tagline for us. It’s the reason we left our old practice. It’s the reason we capped our patient panel – so we can give every member our actual attention, not just a rushed slot between 40 other appointments.
Medicine should feel like a relationship, not a transaction. And a good relationship starts with honesty about how it all works.
| Ready to run the math for your situation? The full cost comparison lives on our Why Us page – all three scenarios, side by side. And if you want to talk through what direct primary care might look like for your family specifically, reach out. We’re real people who answer. View the Cost Comparison | Contact Us to Learn More |
Dr. Julie McKenzie, DO, is a Summit County native, family medicine physician, and co-founder of Grateful Living Medicine. She completed her family medicine residency at St. Anthony’s North Hospital and holds a medical degree from Rocky Vista University. When she’s not in the clinic, she’s usually on a trail or a ski run somewhere in this county she loves.
