Frequently Asked Questions

What is Direct Primary Care?

Direct primary care is a membership model that removes insurance from the equation entirely. You pay a flat monthly fee and receive unlimited visits, direct messaging with your provider, and care that is coordinated around your life. No copays. No surprise bills. No waiting weeks for an appointment that feels rushed the moment it starts.

What is included in membership?

All primary care memberships include unlimited telehealth visits, unlimited direct messaging, prescription management, care coordination, access to transparent cash-pay lab pricing, and complimentary nutrition coaching session. PC Plus members also receive priority same and next-day scheduling, quarterly home visits within 15 miles, an annual home wellness visit, and two complimentary nutrition coaching sessions.

What is the difference between Primary Care and Primary Care Plus?

Primary Care is the core membership and includes everything most patients need for comprehensive primary care. PC Plus adds priority scheduling, quarterly home visits, an annual home wellness visit, and two complimentary nutrition coaching sessions.

Is there a contract?

No long-term contract. Membership is billed monthly and can be canceled with 30 days notice.

What are founding member rates and how long are they available?

Founding member rates are permanently locked for 12 months for the first 30 primary care members. Primary Care founding rate is $75 per month versus the standard $85. PC Plus founding rate is $105 per month versus the standard $120. Once 30 members enroll, founding pricing closes permanently and standard rates apply.

What if I cannot afford the membership?

Financial accessibility matters here. A limited number of reduced-fee memberships are available for patients with financial hardship. Reach out to Kristin directly to ask about availability.

Do you see minors?

No. Groundwork Health is an adult-only practice serving patients 18 and older. This applies to all services including primary care, hormone therapy, and nutrition coaching.

DPC is not the right fit for everyone, but it is a great fit for many. It tends to work especially well if you:

Have a high-deductible insurance plan

If your deductible is $3,000 or higher, there is a good chance you are already paying more out of pocket than a Groundwork Health membership costs. DPC gives you unlimited access to a provider for a predictable flat fee, with no surprise bills on top of it.

Have no insurance

DPC is not a substitute for catastrophic coverage, but it covers the vast majority of what most people actually need from a primary care provider. Paired with a low-cost catastrophic plan, it is often a smarter and more affordable approach than traditional insurance alone.

Want affirming safe care

If you are transgender, non-binary, or gender-diverse and have experienced gatekeeping, dismissal, or outright hostility in a healthcare setting, Groundwork Health was built with you in mind. Hormone therapy is offered under an informed consent model. No letters required. No justifying yourself at the door.

Want more out of your provider relationship

If you have ever left a doctor's appointment feeling like a task that got completed rather than a person who got cared for, DPC is a different experience. Our provider knows your name and your story. You have direct access between appointments without going through a phone tree.

Want whole-person care

Groundwork Health integrates primary care, hormone therapy, and nutrition coaching under one provider. If you want a care relationship that looks at your full picture, including what you eat, how you move, what medications you take, and how you feel, this is built for that.

Want to manage a chronic condition with a real partner

Managing a chronic condition in a 15-minute visit is nearly impossible. DPC gives you the time and access to actually work through what matters, adjust your plan, and stay ahead of problems before they escalate.

Yes, affirming care is just good care, and most of what I do is everyday primary care and nutrition coaching.

How do I reach you between visits?

All members have direct messaging access through the patient portal. If something comes up between visits, a question, a concern, a symptom you are not sure about, you do not have to wait for your next appointment.

How quickly will you respond to messages?

During business hours, same-day response is the goal. For urgent concerns, message or call directly and Kristin will respond as quickly as possible.

Do you offer telehealth?

Yes. Groundwork Health launches as a telehealth-first practice on August 1, 2026, serving patients anywhere in Tennessee via HIPAA-compliant video visits. In-person visits in the greater Chattanooga area begin in early 2027.

I do not live in Chattanooga. Can I still join?

Yes. Primary care and hormone therapy are available via telehealth to patients anywhere in Tennessee. Nutrition coaching is available to clients anywhere in the world. You do not need to be local to become a member.

What happens if I need emergency care?

DPC does not replace emergency care. If you have a medical emergency, call 911 or go to your nearest emergency room. Groundwork Health can help with follow-up care and coordination after an emergency visit.

What happens if I need a specialist?

Kristin will coordinate referrals and work with specialists on your behalf. Members are encouraged to maintain a catastrophic or wraparound insurance plan for hospitalizations and specialist services.

What happens if I am hospitalized?

Kristin does not have hospital admitting privileges, but she can consult, coordinate with your hospital care team, and support your transition back to outpatient care.

Do you take insurance?

No. Groundwork Health does not bill insurance for any services. You pay a flat monthly membership fee directly. This keeps the relationship between you and your provider, with no insurance company involved in your care decisions.

Do I still need insurance?

For most patients, yes. DPC does not cover hospitalizations, emergency care, or specialist services. Many members pair a Groundwork Health membership with a high-deductible plan, a health share, or a catastrophic coverage plan. For patients with high-deductible insurance, membership often costs less than what they pay out of pocket under their existing plan.

Can I use my HSA or FSA to pay?

Many patients use HSA or FSA funds for DPC membership fees. We can provide documentation to support your submission. Please confirm eligibility with your tax advisor or plan administrator as rules vary.

Can I be a member if I am on Medicaid?

Medicaid requires providers to bill through its system, which is incompatible with the DPC model. If you are on Medicaid and want to self-pay, you are welcome to join and Kristin will work to keep your costs as low as possible.

Can I be a member if I am on Medicare?

Groundwork Health does not currently accept Medicare patients. Please reach out to Kristin directly if you have questions about your situation.

Can I pay per visit without joining?

For primary care, a one-time visit is available at $100. For nutrition coaching, an initial single session is $200. Follow-up sessions are available at $95 each. Membership is not required for either, though members receive significantly more access and value over time.

Do you provide care for transgender and gender-diverse patients?

Yes, fully and without reservation. Groundwork Health offers hormone therapy under an informed consent model for transgender, non-binary, and gender-diverse patients of all kinds. Every identity is welcome here. No referrals required. No gatekeeping.

What is an informed consent model?

Informed consent means you do not need a letter from a therapist or a referral from another provider to begin hormone therapy. We have an honest conversation about your goals, your health history, and what hormone therapy can and cannot do. You make an informed decision about your own care. That is it.

Do you offer feminizing and masculinizing hormone therapy?

Yes. Kristin works with patients across the full spectrum of gender experience, including transfeminine patients, transmasculine patients, non-binary patients, and anyone with nuanced or partial transition goals. If your goals do not fit neatly into a category, that is fine. You will figure it out together.

I am already on hormones. Can I transfer my care to Groundwork Health?

Yes. If you are an established patient on hormone therapy and need a knowledgeable, affirming provider to continue your care, you are welcome to join.

Do I need to be transitioning to access hormone therapy here?

No. Hormone therapy looks different for every person. You do not need to be pursuing a complete gender transition to receive care. Partial transition goals, non-binary affirming care, and exploratory conversations are all welcome.

Do you offer PrEP?

Yes. Kristin prescribes and manages PrEP within your primary care membership, including baseline testing, ongoing monitoring, and prescription management.

Do you offer STI testing and treatment?

Yes. STI screening and treatment are part of whole-person primary care at Groundwork Health. Labs are ordered at transparent cash-pay rates through partner labs.

How is Groundwork Health different from Plume or FOLX?

Plume focuses exclusively on hormone therapy. FOLX offers hormone therapy and primary care. Groundwork Health offers hormone therapy and primary care as well, but with the addition of integrated nutrition coaching, a local provider relationship, and in-person care coming in the greater Chattanooga area in early 2027. Kristin is also a member of the LGBTQIA+ community herself, which means this is not just affirming care by policy. It is affirming care by design.

Do I need to be a DPC member to access nutrition coaching?

No. Nutrition coaching is available as a completely standalone service to clients anywhere in the world. You do not need to be a primary care patient to work with Kristin on nutrition.

Can I do DPC without adding nutrition coaching?

Yes. Nutrition coaching is an optional add-on, not a requirement. Primary care and PC Plus memberships stand fully on their own.

What is the difference between nutrition coaching and clinical nutrition advice?

Nutrition coaching at Groundwork Health is not medical advice and does not constitute a clinical relationship. It is clinically informed coaching, meaning Kristin brings her medical background to the work, but coaching sessions are distinct from primary care visits. If you are a DPC member, your primary care and coaching are complementary but separate.

What populations do you specialize in for nutrition coaching?

Kristin has particular expertise working with endurance athletes, patients using GLP-1 medications, and patients looking for sustainable habit-based change. Coaching at Groundwork Health is individualized. If you do not fit neatly into one of those categories, that is fine.

Can I bundle nutrition coaching with my DPC membership?

Yes. Weekly and biweekly coaching packages are available to DPC members at approximately 25% off standalone rates. Sport packages and single sessions are not discounted. See the Nutrition Coaching page for full bundle pricing.

Do you offer GLP-1 prescriptions?

Yes. Kristin prescribes GLP-1 medications for weight management as part of a comprehensive care approach. Active enrollment in a Groundwork Health coaching package is required prior to prescribing and must remain active for the duration of treatment. This is a clinical requirement, not an add-on — the evidence is clear that GLP-1 medications work best when paired with ongoing behavioral and nutrition support.

Medication is sourced through our compounding pharmacy partners where clinically appropriate, billed at our exact cost with no markup, and payment is required prior to order submission.

How do labs work?

Labs ordered through Groundwork Health are billed to the practice at negotiated wholesale rates and passed through to you at cost. Payment is collected prior to your order being submitted. You will receive an invoice from Groundwork Health for the exact amount charged to the practice. Labs are not billed through insurance.

Are labs included in membership?

Lab fees are not included in the Primary Care membership fee but are available at transparent cash-pay rates. Kristin's time to order, review, and discuss your results is covered by your membership. Labs ARE included in the GAHT Care membership to enhance accessibility.

How do prescriptions work?

Kristin manages your prescriptions as part of your membership, including ordering, reviewing, and adjusting medications as needed. The cost of the prescription itself is separate and paid directly by you. For compounded medications ordered through Groundwork Health's pharmacy partners, the cost is billed through the practice at our exact cost with no markup, and payment is due prior to the order being submitted. For all other prescriptions, you pay your pharmacy directly. Compounding options are offered where they make clinical and financial sense.

Do you offer GLP-1 prescriptions?

Yes. Kristin prescribes GLP-1 medications for weight management as part of a comprehensive care approach. Active enrollment in a Groundwork Health coaching package is required prior to prescribing and must remain active for the duration of treatment. This is a clinical requirement, not an add-on — the evidence is clear that GLP-1 medications work best when paired with ongoing behavioral and nutrition support.

Medication is sourced through our compounding pharmacy partners where clinically appropriate, billed at our exact cost with no markup, and payment is required prior to order submission.

Who has access to my medical records?

Your records are private and protected under HIPAA. Kristin will never share your information without your consent except as required by applicable law.

Will my insurance company have access to my care records?

No. Because Groundwork Health does not bill insurance, your insurer has no claim to your records or information about the care you receive here.

I have concerns about privacy related to my gender identity or hormone therapy. What should I know?

Kristin takes your privacy seriously and handles your records with care and professionalism. Groundwork Health complies with all applicable Tennessee law. The legal landscape is dynamic. If you have specific questions about how your records are handled or what may be reportable under current law, reach out before enrolling and Kristin will walk you through it honestly.

How do I join?

Click the Join the Waitlist button to get on the founding member list, or book a free discovery call to talk through which services are the right fit for you. There is no commitment required to have that conversation.

What happens at a discovery call?

A discovery call is a free 15-minute conversation to learn about your goals, answer your questions, and figure out whether Groundwork Health is the right fit. No pressure, no sales pitch.

When does DPC launch?

August 1, 2026 via telehealth. In-person visits in the greater Chattanooga area begin in early 2027. Nutrition coaching is available now.

I have a question that is not answered here.

Reach out directly at kristin.evans@groundwork-health.com. Kristin reads and responds to every message.