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Answers for members, employers, and providers.
APC+ (Advanced Primary Care Plus) is a membership program that gives you access to high-quality primary care; it's not insurance. Your employer pays a monthly membership fee on your behalf, and in return you get benefits like same-day or next-day appointments, longer visits with your provider, and 24/7 virtual care access. You'll still keep your regular health insurance for things like specialists, hospital stays, and prescriptions.
APC+ works alongside your health insurance, not as a replacement. Your APC+ membership covers primary care services (see our Scope of Services page for details), while your health insurance continues to cover specialists, hospital visits, surgeries, and other medical needs. You don't need to notify your insurance carrier about joining APC+.
Most of the time it isn't a bill. Here's how to tell what you're looking at.
If none of these explain it, email support@apaly.com and we'll figure it out with you.
Your employer covers the full monthly membership fee at $0 to you.
Regardless of which health plan you are on:
PPO/EPO Plans:
HSA/HDHP Plans:
Note: IRS deductibles are separate from your health plan deductibles and are set by federal law to maintain the tax-advantaged status of HSA accounts. Costs may vary by employer and plan. For details specific to your coverage, contact your HR department or refer to your benefits guide.
Your APC+ membership covers primary care. That includes preventive care, sick visits, yearly physicals, school and sports physicals, prescription renewals, mental health support, and ongoing management of chronic conditions like diabetes and high blood pressure. The full list is on our Scope of Services page.
APC+ does not cover vision, dental, specialist care, hospital care, or surgery. Those go through your health plan like they do today. Your APC+ provider can refer you when you need care beyond primary care.
Labs and imaging are outside the APC+ membership. Your provider can order them and send you to a lab or imaging center, where they run through your health plan like any other covered service. Some practices also offer in-office lab draws, X-rays, or common medications at a cash-pay rate as a convenience. Your provider will tell you up front before anything outside the membership is needed, and you can always ask them or your health plan for a cost estimate first.
Writing and renewing prescriptions is part of your membership at no charge. The medication itself, filled at a pharmacy, goes through your health plan.
Advanced Primary Care Plus (APC+) is a monthly membership program that is covered for you and your family. You do not have to pay for the monthly membership since your employer is covering that for all eligible employees, spouses, and dependents. You can see our Scope of Services page for details on what is covered under your monthly membership. Any services needed outside of the scope of services, or any specialist-related visits, may have additional charges after going through your employer's health insurance. You can always ask your doctor or call your insurance for an estimate before using any services not provided under the APC+ membership.
Advanced Primary Care Plus (APC+) is a monthly membership program that is covered for you and your family. You do not have to pay for the monthly membership since your employer is covering that for all eligible employees, spouses, and dependents. You'll just be responsible for any visit fees based on your health plan, which are $0 for most preventive services.
If you're on a high-deductible (HSA) plan, in-person sick visits may have a charge until you've met the IRS minimum deductible for the year. The charge averages $95 and is billed at most once per month per person. Wellness visits and virtual visits are always $0. Once you've met the IRS minimum deductible, in-person sick visits are $0 too. The IRS sets these minimums each year; see the current IRS limits. They're separate from your plan's own deductible, and the membership fee itself doesn't count toward either one.
No. There is no cap on the number of covered visits. See your provider as often as you need, virtually or in person.
No. There is no fee to join a participating practice through the Apaly marketplace. Your employer covers the membership in full, and billing only begins once your membership is active.
No. Your employer pays the membership, so it doesn't apply to your deductible or out-of-pocket maximum.
No. APC+ is optional, and you don't have to switch doctors to sign up. To get the full benefit, though, you'll want to establish care with an APC+ provider. That's where the same-day access and 24/7 reach come from.
Want to check if your doctor is already an APC+ provider? Visit the marketplace and search your address. If they're listed, you can sign up with them right there. If not, email support@apaly.com with your doctor's name and practice, and we'll reach out to them about joining.
Yes to both. Each family member picks their own provider, so you might choose an adult primary care physician for yourself and a pediatric provider for your kids. Many of our providers care for both adults and kids, so your whole family could see the same doctor under one roof.
Switching providers depends on whether your membership is active yet.
Two things to know if you're switching while active. The switch takes effect on the first of the next month, since memberships are billed monthly. Until then you keep full access to your current provider. And you'll need to schedule a new Hello Visit with your new provider, since Apaly doesn't hold your health records. Talk with your old and new providers about transferring your records so your new doctor has your past history. Your membership may not be active with the new provider until you schedule a Hello Visit with them.
You can still access APC+ through virtual care, schedule video visits, get prescriptions, message your provider, and handle urgent issues online anytime. If you'd like us to find physical locations near you, email support@apaly.com with your zip code and we'll work on adding providers in your area.
Visit https://member.apaly.net/marketplace and search for clinics near you. You can filter by location, provider type, languages spoken, and more to find the best fit. Once you've selected your doctor, click to create your member profile and complete a brief enrollment.
While having a traditional Primary Care Physician (PCP) is a great thing, many people are finding that they aren't getting the care they need, appointment times that are convenient for them, and some find it difficult to pay the co-pays or other fees when visiting with a traditional PCP.
Employees who want to participate in their employer-paid APC+ program pay $0 for the monthly subscription to APC+ and get most services included in the monthly cost with no co-pays. For any services needed that are not within the scope of services provided in the APC+ program, doctors engage in finding fair-market-value (FMV) specialists, treatments, and procedures. Each APC+ clinic will go over any costs outside of the APC+ program so members can make informed decisions alongside their care team and doctor. To view all services included in the monthly member fee, visit our Scope of Services page.
Yes. First, let your provider know you want to switch to the membership your employer pays for, so they understand what's happening and can make sure your records aren't lost. Then cancel the membership you're paying for directly and sign up with that same provider through the Apaly marketplace so your employer-paid membership takes over. Email support@apaly.com before you start so we can coordinate with your provider and make sure your visit history carries over.
If your provider is One Medical, follow these steps:
Yes. Eligibility follows your health plan enrollment. Any spouse, domestic partner, or dependent enrolled on your employer's plan is eligible, and your employer pays their membership too. Each family member enrolls individually and picks their own provider. Some providers care for both adults and kids, so your whole family could see the same doctor if you'd like.
A few details. A spouse can enroll even if you don't. Dependents over 18 can create their own account. College students can pick a provider near school, or choose one near home and see them virtually. A family member on a different health plan (like one through their own employer) isn't eligible through your benefit, but can join the practice directly as a cash-pay member.
Visit our marketplace to browse and select a provider. After you choose your provider, schedule a Hello Visit with them. Once that visit happens, your provider reports it to Apaly, which activates your employer-paid membership. From there, you'll have full access to all APC+ services. If you run into any issues during signup, email support@apaly.com and our team will help you get enrolled.
You cannot use the services or get same/next day appointments without first establishing with your provider. To check if your membership is active you can either login to your Apaly portal or contact your provider.
You probably haven't completed your Hello Visit yet. Your membership isn't active until you've had that first visit and your provider reports it to Apaly. Same-day and next-day appointments are for active members, so book your Hello Visit right away rather than waiting until you're sick. To check if your membership is active, log in to your Apaly portal or contact your provider.
No. You sign up through your browser. Once you have a provider, you'll use that provider's own app or portal to book visits and message your doctor.
Email support@apaly.com and we'll sort it out. The most common causes are a typo in your Member ID or Plan ID, or an eligibility file that hasn't updated yet for a new hire or a recent plan change.
Not at all. You can keep seeing your current specialists as long as they're in network with your current health plan and deliver high quality care.
APC+ combines the best of both, and fills the gaps each leaves behind.
vs. Traditional Primary Care:
vs. Teladoc and other telehealth services:
Think of APC+ as your own primary care provider who's actually accessible: available virtually when convenient, in-person when needed, and familiar with your health history either way.
Many APC+ providers do prescribe GLP-1 medications, though individual prescriptions are at the clinician's discretion. Contact us at support@apaly.com with your name and zip code, and we can connect you with the nearest APC+ provider to verify they write GLP-1 prescriptions.
Yes. That's a big part of what primary care and APC+ are for, and it can help you earn any wellness credits your employer offers for the year. If you have forms that need to be completed to prove you had the visit, bring them to your appointment so your provider can fill them out for you. Your provider can also do school and sports physicals for your kids.
Yes. Your provider is available virtually by text or video wherever you are.
You can keep seeing your APC+ provider, but your membership would switch to cash pay. You'd be responsible for the monthly membership directly with your provider. If you'd like to continue, contact your provider's office directly and they'll set that up with you.
Reach out to Apaly's member support team at support@apaly.com for help with enrollment, finding a provider, or any questions about your APC+ benefit.
Apaly offers seamless nationwide coverage with a broad selection of providers, ensuring every member has access to care, along with our coverage guarantee.
We are happy to show your projected ROI to demonstrate measurable savings and clear financial benefits, and you can take advantage of our cost savings guarantee.
No, there's no legal risk because Apaly is not a provider network. We are a technology platform that creates direct contracts between providers and self-funded employer health plans. Unlike other vendors in the industry, we are the ONLY APC+ solution that is NOT creating and operating a network, and we don't take on risk or operate in any way that requires network licensure. We don't put you at risk.
Implementation is straightforward, with setup completed in just a few days.
Our innovative model combines nationwide coverage, direct contracts, and a focus on cost savings, ensuring a superior experience for employers and employees alike.
No, there's no legal risk because Apaly is not a provider network. We are a technology platform that creates direct contracts between providers and self-funded employer health plans. Unlike other vendors in the industry, we are the ONLY APC+ solution that is NOT creating and operating a network, and we don't take on risk or operate in a way that would require network licensure. We don't put your business at risk.
You get paid through the Apaly platform via ACH transfer directly to your bank account.
You must report your patient encounters on the Apaly platform, which can be done with one click.
That's not a problem. Apaly is built for providers like you who prefer subscription-based care models. There's no need to submit claims or deal with insurance. Apaly enables you to operate under a subscription-based model, and Apaly translates your services into claims that are submitted to the carriers/TPAs that administer the employer health plans.
The employer's role is to pay the APC+ membership for their employees and families. This removes the financial barriers for patients, enabling them to access your services without worrying about copays, deductibles, or membership fees. It makes the APC+ subscription-based model a benefit that is available to everyone, not just the wealthy.
From a legal, compliance, and operational basis, the large regional and national employers have to pay for healthcare services through their health plan funds account. Plus, there isn't anyone at a large employer who can simply swipe a credit card to pay APC+ membership fees.
Not at all. Apaly is a technology platform that facilitates direct contracts between providers and employers. Apaly is NOT a party to these agreements. As a matter of fact, Apaly is the ONLY APC+ solution in the world that isn't creating and operating a Network. We eliminate the middlemen.
APC+ by Apaly enables providers to tap into the regional and large employer market. By participating on the Apaly platform with other APC+ providers, collectively these providers can support a broader geographic coverage area to make APC+ possible for these employers' plan members.
The employer's role is to pay the APC+ membership for their employees and families. This removes the financial barriers for patients, enabling them to access your services without worrying about copays, deductibles, or membership fees. It makes the APC+ subscription-based model a benefit that is available to everyone, not just the wealthy.
From a legal, compliance, and operational basis, the large regional and national employers have to pay for healthcare services through their health plan funds account. Plus, there isn't anyone at a large employer who can simply swipe a credit card to pay APC+ membership fees.
You get an email as soon as a member selects you, and their contact information appears in your Apaly account. Reach out to welcome them and schedule a first visit. That first encounter starts their 12-month membership and your monthly payments. The first payment can take up to six weeks. After that, payments arrive monthly by ACH and cover the previous month, so a payment on July 1 covers June.
Please don't contact employers directly. Apaly manages those relationships, and we are always building new marketing opportunities with them. When there is a fit for your practice, we will reach out to you.
When an employer wants a provider involved, we contact you and coordinate it. Common examples are webinars, on-site meet and greets, and clinical events like flu shots or biometric screenings. Participation is always optional.
The member can either pay your discounted cash price or use their insurance. Both work.
That works either way. For labs, many practices draw in the office and pass the member's insurance information to the lab, so the lab bills their plan directly. If you are not set up for that, give the member the order and they can take it to a lab themselves. Medications work the same way: dispense on site, which is often only a few dollars, or send the prescription to their pharmacy. Imaging is the same, on-site or by outpatient order.
Email support@apaly.com for anything on the member side, including account setup, eligibility checks, and members having trouble getting started.