What do you mean by a “Membership Practice”?
The “Membership Practice” model is one in which each patient who is a member of the medical practice of Zhanna Kalikhman, M.D. (the”Practice”) pays an Annual Fee that covers most of the primary care received in-office, as well as enhanced services not normally available in a traditional medical practice, such as extended hours; direct access to Dr. Kalikhman by cell phone and email; same day or next-day sick appointments; unhurried office visits; short in office wait time; and house calls, hospital visits, and acute rehabilitation facility visits when clinically indicated. This new approach is really a return to old-fashioned care. It is a smaller, more intimate practice that allows you to have a personal relationship with your physician. The goal is to provide care that is more responsive, thorough, and individualized.
What does the Annual Fee cover?
View our Medical Care Page to see a detailed description of all services covered by the Annual Fee.
How much is the Annual Fee, and what payment options are available?
The Annual Fee is $2,000 for the first adult patient in the family, payable by credit card on an annual basis. (If paid by check, the Annual Fee is discounted to $1,950.)
- If both spouses join, then the Annual Fee is discounted to $1,750 for the second adult member, payable by credit card on an annual basis. (If paid by check, then the Annual Fee for the second adult member is further discounted to $1,700.)
- If a young adult dependent (ages 16-26) of an adult member wishes to join , then the Annual Fee for the young adult is discounted to $500, payable by credit card or check on an annual basis. (If paid by check, then the Annual Fee for the young adult is further discounted to $450.)
Is the Annual Fee refundable if I move or simply decide that this Practice is not right for me?
Yes, the Annual Fee covers services available to you while you are a member of the Practice. If you leave the Practice for any reason, a prorated portion of the Annual Fee will be returned to you. If you have already received your annual comprehensive preventive health assessment and exam for the year, then a fee for the annual comprehensive preventive health assessment and exam will be deducted from any prorated refund owed to you ($1,000 for adult members; $150 for young adult members).
Do I have to pay a co-pay?
There are no co-pays for services included in the Annual Fee. The Annual Fee covers the annual comprehensive preventive health assessment and exam and 11 additional office visits per year. (House calls, inpatient visits at Howard County General Hospital, and acute rehabilitation facility visits are provided when clinically indicated and each such visit counts as 2 office visits.) In the event that Dr. Kalikhman is on vacation or attending a continuing medical education seminar, she will be covered by a qualified colleague who may submit a claim to your insurance company and may charge you a co-pay.
What if I need to see Dr. Kalikhman more than the visits included in the Annual Fee?
For any office visits beyond those 11 included in the Annual Fee, the Practice will collect a fee of $50. For any house call, inpatient visit at Howard County General Hospital, or acute rehabilitation facility visit beyond those included in the Annual Fee, the Practice will collect a fee of $300 per visit.
I already have good health insurance- why should I pay extra to join this Practice?
While most insurance plans cover primary care office visits and other services, patients often have difficulty in obtaining timely appointments with their doctor, and rarely have adequate time for their concerns to be fully heard and addressed. Despite their best intentions, physicians are frequently left feeling rushed and unable to fully address wellness and preventive health approaches. Dr. Kalikhman’s membership model provides a level of personal service not generally found in a traditional primary care medical practice, including: direct access to Dr. Kalikhman by cell phone and email; office visits of more than 15 minutes; house calls, inpatient visits at Howard County General Hospital, and acute rehabilitation facility visits; and true coordination of your care with specialists handled personally by Dr. Kalikhman.
Is this an insurance plan? Do I need to keep my existing health insurance?
This membership model is NOT an insurance plan, and you will need to keep your existing health insurance to pay for specialist physician services, laboratory tests not covered under the Annual Fee, x-ray and other diagnostic services not covered under the Annual Fee, prescription drugs, and hospitalizations.
Can the Annual Fee be applied towards my insurance plan deductible?
Because the Annual Fee pays for some services that are not covered by insurance, your insurance plan might not apply the Annual Fee towards your deductible. Each insurance plan may approach this issue differently, so if you have more specific questions, you should contact your insurance company representative. Dr. Kalikhman may provide you with paperwork at the time of your annual comprehensive preventive health assessment and exam, or office visit, which you may be able to submit to your private insurance plan, but not to Medicare, TRICARE, or any HMO, to seek out-of-network reimbursement. (Again, different insurers approach this differently, so check with your plan.)
I’m covered by Medicare. Can I still join Dr. Kalikhman’s new Practice?
Yes; however, because Dr. Kalikhman will be opted out of the Medicare program, Medicare will not cover any portion of the Annual Fee or any services provided by Dr. Kalikhman that are charged separately outside the Annual Fee (e.g., office visits exceeding 11 per year). Dr. Kalikhman will not submit any claims to Medicare and you may not submit claims to Medicare for payment for any services provided by Dr. Kalikhman. Dr. Kalikhman will continue to write prescriptions and orders for lab, x-ray,and other services needed outside of her Practice, and your Medicare coverage will continue to cover all other physicians, hospitals, and labs. Participation in Dr. Kalikhman’s Practice will not affect your Medicare coverage for these other services in any way.
I’m covered by an HMO. Can I still join Dr. Kalikhman’s new Practice?
Yes; however, it is important to understand that Dr. Kalikhman does not participate in any HMOs; she will not submit any claims to your HMO; and you may not submit claims to your HMO for payment for any services provided by Dr. Kalikhman. If your HMO requires prior authorization from an in-network physician for referrals and labs, then Dr. Kalikhman will not be able to provide services to you in her newPractice, and you will need to select a new physician.
I’m covered by TRICARE. Can I still join Dr. Kalikhman’s new Practice?
It depends. TRICARE For Life (TRICARE’s Medicare “wrap-around” product) specifically permits Medicare beneficiaries to privately contract with concierge physicians; however, due to TRICARE For Life billing limitations, Dr. Kalikhman will not submit any claims to TRICARE For Life and you may not submit claims to TRICARE For Life for payment for any services provided by Dr. Kalikhman. If you are covered by any of the other TRICARE plans (including but not limited to: TRICARE Prime, TRICARE Prime Remote, TRICARE Select, TRICARE ReserveSelect, TRICARE Retired Reserve, and US Family Health Plan), Dr. Kalikhman will not able to provide services to you in her new Practice and you will need to select a new physician.
I’m covered by Maryland Medical Assistance. Can I still join Dr. Kalikhman’s new Practice?
Unfortunately, Dr. Kalikhman is unable toprovide services to Maryland Medical Assistance patients in her new Practice, and you will need to select a new physician.
What if I need to be hospitalized?
You may be hospitalized at the hospital of your choice. Although the hospitalise service will be the attending physician of record, Dr. Kalikhman will coordinate your inpatient care as your personal physician. In most instances, Dr. Kalikhman will visit you at Howard County General Hospital to help facilitate this process. Each hospital visit will count as two office visits under the Annual Fee, and any hospital visits in excess of those included in the Annual Fee will be $300 each. If you are admitted to any other hospital, then Dr. Kalikhman will be available for phone consultations.
What do I do if I need to see a specialist?
Dr. Kalikhman will coordinate your appointment with the appropriate specialist to best address your particular medical condition, and she will closely monitor your progress while you are under the specialist’s care.
I have a Health Spending Account, Flexible Spending Plan, or a Medical Savings Plan through work. May I use that to pay for the Annual Fee?
In many cases, you may be able to use such funds to pay for all or a portion of the Annual Fee, but policies differ from plan to plan, so please check with your plan administrator.
How may I reach Dr. Kalikhman after hours and on weekends?
Dr. Kalikhman will be available by cell phone and email after hours and on weekends, except when she is on vacation or attending a continuing medical education seminar, in which case the Practice will be covered by a colleague. When the Practice is covered by a colleague, you may be charged a co-payment for any necessary visits, but there will not be a charge for any telephone advice.
May I meet with Dr. Kalikhman prior to signing a contract to join the Practice?
Absolutely! Please call the office for a no-obligation meeting to find out if this Practice is a good fit for you.
How do I join?
Upon request, Dr. Kalikhman will mail you an enrollment package. You will need to sign a Physician-Patient Agreement and submit payment of the Annual Fee in order to become a member. Patients will be accepted in the order in which they join, and once the Practice reaches capacity, Dr.Kalikhman will not accept any additional patients into the Practice until an existing spot opens up.
What If I choose not to join?
You will need to select another primary care physician. You should be able to receive assistance from the Customer or Member Service office of your health plan. Additionally, Howard County General Hospital has a referral service that may assist you with finding a suitable physician:
(410)740-7750 or https:/ / www.hopkinsmedicine.org/ howard_county_general_hospital/doctors/index.html
I have a few more questions. What should I do?
Send Dr. Kalikhman an email at: zmk@crystalmedical.com. You may also schedule an appointment to meet with Dr. Kalikhman by calling the office.