Frequently Asked Questions

What is direct primary care?

Direct primary care is a membership model that takes insurance out of the equation. You pay one flat monthly fee and get 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.

How much does membership cost?

GAHT Care (hormone therapy only) is $60 per month. Primary Care is $85 per month. Primary Care Plus is $120 per month. All memberships have a 3-month minimum. Save 5% when you prepay 6 months or 10% when you prepay 12 months. See the Direct Primary Care page for full details.

What is included in membership?

Primary Care includes unlimited telehealth visits, unlimited messaging, prescription management, care coordination, discounted lab pricing, and one 60-minute nutrition coaching session. Primary Care Plus adds priority same-day and next-day scheduling, a quarterly home visit within 10 miles of downtown Chattanooga, an annual home wellness visit, and a 30-minute nutrition follow-up session. See the side-by-side comparison on the Direct Primary Care page.

Is there a contract?

There is a 3-month minimum. After that, you can cancel any time. You pay through the end of the current month, and prepaid members receive a prorated refund.

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.

Is DPC a good fit for me?

DPC is not the right fit for everyone, but it works especially well if you are uninsured, have a high-deductible plan, are managing a chronic condition, want affirming care without gatekeeping, or simply want a provider who has time to know you. See Is DPC right for you? on the Direct Primary Care page.

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 through the patient portal. If something comes up between visits, a question, a concern, or 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 is a telehealth-first practice serving patients anywhere in Tennessee and Georgia through secure, 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 by telehealth anywhere in Tennessee and Georgia. Nutrition coaching is available anywhere in the world.

Can I have a telehealth visit while I am traveling?

Telehealth visits can only take place while you are physically in Tennessee or Georgia, where Kristin is licensed. If you will be out of state, let us know and we will plan your visit around your trip.

What if I need an in-person exam before the office opens?

If something needs to be seen in person, Kristin will help you decide where to go, usually an urgent care, and will follow up with you afterward.

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 afterward.

What happens if I need a specialist?

Kristin will coordinate referrals and work with specialists on your behalf. Members are encouraged to keep 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 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, which keeps insurance companies out of 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 plan. For patients with high-deductible insurance, membership often costs less than what they already pay out of pocket.

Can I use my HSA or FSA to pay?

In most cases, yes. Starting in 2026, federal law allows HSA funds to be used for direct primary care memberships of up to $150 per month for an individual, and having a DPC membership no longer affects your HSA eligibility. All Groundwork Health memberships fall under that limit. FSA rules vary by plan. Please confirm with your plan administrator or tax advisor.

Can I join if I have Medicare or Medicaid (TennCare)?

Groundwork Health does not currently offer primary care memberships to patients with Medicare or Medicaid. If you have Medicare or Medicaid and are interested in hormone therapy, please reach out before enrolling so we can talk through your options.

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

Yes, fully and without reservation. Every identity is welcome here. See the LGBTQIA+ Care page for details.

What is an informed consent model?

You do not need a letter from a therapist or a referral to start hormone therapy. We have an honest conversation about your goals, your health history, and what hormone therapy can and cannot do. Then you make an informed decision about your own care.

Do I need to be fully transitioning to start hormones?

No. Feminizing, masculinizing, nonbinary, and partial goals are all welcome, and so are exploratory conversations. If your goals do not fit neatly into a category, we will figure it out together.

I am already on hormones. Can I transfer my care?

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

Does GAHT Care cover menopause or perimenopause hormones?

No. GAHT Care is for gender-affirming hormone therapy only. Perimenopause and menopause care is part of the Primary Care membership.

Do you offer PrEP and STI testing?

Yes. PrEP prescribing, baseline testing, and monitoring, along with STI screening and treatment, are part of your primary care membership. Labs are available at transparent cash-pay rates.

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

No. Nutrition coaching is available as a 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. Primary Care and Primary Care 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 create a clinical relationship. It is clinically informed coaching, meaning Kristin brings her medical background to the work, but coaching sessions are separate 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?

Kristin has particular expertise with endurance athletes, people using GLP-1 medications, and anyone looking for sustainable, habit-based change. Coaching is individualized, so if you do not fit neatly into one of those groups, that is fine.

Can I bundle nutrition coaching with my DPC membership?

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

How do labs work?

Labs ordered through Groundwork Health are billed at negotiated wholesale rates and passed through to you at cost, with no markup. Payment is collected before the order is submitted, and you receive an invoice for the exact amount. Labs are not billed through insurance.

Are labs included in membership?

Lab fees are not included in membership, but they are available at transparent cash-pay rates. Kristin’s time to order, review, and discuss your results is covered by your membership. Hormone therapy labs are included in all memberships.

How do prescriptions work?

Kristin manages your prescriptions as part of your membership, including ordering, reviewing, and adjusting medications. The cost of the medication itself is separate. For compounded medications ordered through our pharmacy partners, the cost is billed through the practice at our exact cost, with payment due before the order is submitted. For all other prescriptions, you pay your pharmacy directly.

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 before prescribing and for the duration of treatment. This is a clinical requirement, not an add-on. 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 before the order is submitted.

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 Enroll to choose your membership and sign up online, 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.

Are you accepting new patients?

Yes. Groundwork Health is open and accepting new members by telehealth in Tennessee and Georgia. In-person visits in the greater Chattanooga area begin in early 2027. Nutrition coaching is available worldwide.

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.