Family Access Medical

1. Membership Model & Purpose

Family Access Medical operates as a membership-based primary care clinic. Membership provides access to defined medical services and benefits as outlined in these Terms.

Membership does not guarantee specific medical outcomes, diagnoses, or availability of services beyond those expressly stated.

2. Membership Term & Calendar-Year Structure

Memberships are issued on a 12-month, calendar-year basis, unless otherwise stated in writing.

• Memberships begin on the Member's start date
• Memberships renew annually
• Changes to coverage types, extras, pricing, or surcharges take effect at renewal unless otherwise specified

Early enrollment does not extend the membership beyond the defined calendar year.

3. Essential Care Membership Scope

The Essential Care membership includes access to the following services when medically appropriate and provided at the clinic:

• Unlimited in-office primary care visits
• Same-day or next-day appointment availability, subject to clinic capacity
• Annual wellness examination
• On-site diagnostic imaging, including X-Rays and MRIs
• No deductibles, co-pays, or co-insurance for services included with membership
• Pharmacy Access – Basic (upgrades available)

Essential Care does not include emergency services, hospital-based care, surgical procedures, or specialty services unless expressly stated.

4. Coverage Types & Eligibility

Coverage type must be selected at enrollment and remains in effect for the full membership term.

Individual Coverage

Covers one adult member.

Couple Coverage

Couple coverage is available only to legally married spouses.

Requirements:

• Both individuals must be legally married at the time of enrollment
• Both individuals must be listed on the same membership account

Family Access Medical may require documentation to verify marital status.

Family Coverage

Family coverage includes two adults and eligible dependents, up to the limit defined at enrollment.

To qualify as an eligible dependent, the individual must:

• Be a legal dependent of a covered adult
• Be no older than 24 years of age as of the end of the membership term
• Meet residency or dependency requirements as defined by applicable law

Family Access Medical reserves the right to request documentation to verify dependent eligibility at enrollment or renewal.

Eligibility Verification

Family Access Medical may:

• Verify coverage eligibility at enrollment and renewal
• Adjust or deny coverage if eligibility requirements are not met
• Modify coverage if household composition changes

Failure to meet eligibility requirements may result in coverage adjustment, additional fees, or termination of membership.

Our goal is to keep coverage fair and consistent for all members.

5. Scheduling, Access & Availability

Appointments are subject to clinic hours, provider availability, and operational capacity.

• Same-day or next-day appointments are not guaranteed
• Extended visits may be limited
• Missed or late appointments may result in rescheduling or additional policies

Family Access Medical reserves the right to manage scheduling to ensure equitable access across the membership base.

6. Extras & Add-On Services

Extras are optional services that expand access beyond the Essential Care membership.

Selection Rules

• Extras must be selected at enrollment or during annual renewal
• Extras are locked for the calendar year
• Extras cannot be added, removed, paused, or modified during the active calendar year, except through a formal upgrade process

7. Mid-Year Activation of Extras (Formal Upgrade Process)

In limited cases, a Member may request to activate an Extra mid-year.

Mid-year activation requires:

• Payment of the remaining annual balance of the Extra
• Retroactive charges for elapsed months
• A 50% fee applied to the elapsed portion of the year
• A one-time administrative fee

All costs and terms must be reviewed and approved before activation. Approval of mid-year upgrades is at the sole discretion of Family Access Medical.

8. Specialty & Care Access Programs

Specialty services (including but not limited to chiropractic care, physical therapy, behavioral health, and similar services) may be offered through optional Care Access Programs.

These services:

• Are not included in Essential Care
• May be delivered by third-party providers
• Are subject to separate pricing and scheduling
• Do not create a provider-patient relationship with Family Access Medical unless expressly stated

9. Imaging & Diagnostic Services

On-site diagnostic imaging (X-Rays and MRIs) is included with Essential Care when ordered by a provider and deemed medically appropriate.

Family Access Medical reserves the right to:

• Determine medical necessity
• Limit frequency of imaging
• Refer Members externally when appropriate

Imaging is not provided for elective, non-medical, or screening-only purposes unless expressly stated.

10. Emergency & Urgent Care Disclaimer

Essential Care is not intended for emergency medical situations.

In the event of an emergency, Members must call 911 or visit the nearest emergency department.

Optional Urgent & Emergency Coverage may be offered separately and follows standard deductibles, co-insurance, and related terms.

11. Tobacco Use Policy

Family Access Medical applies a tobacco use surcharge to memberships that include individuals who use tobacco products.

Definition of Tobacco Use

Tobacco use includes, but is not limited to:

• Cigarettes
• Cigars
• Pipes
• Chewing tobacco
• Nicotine-containing products, including vaping and e-cigarettes

Surcharge Application

• Tobacco surcharges may be applied per individual
• Surcharge amounts are disclosed at enrollment and renewal
• Surcharges apply for the full membership term

Disclosure & Changes

Members must accurately disclose tobacco use at enrollment and renewal.

• Failure to disclose may result in retroactive surcharge application and administrative fees
• Changes in tobacco use status may be reported at renewal
• Tobacco surcharges cannot be removed mid-term

Family Access Medical reserves the right to request reasonable verification of tobacco use status.

12. Member Responsibilities

Members agree to:

• Provide accurate and complete information
• Comply with clinic policies and care guidance
• Treat staff and providers respectfully
• Maintain current and valid payment information

Violation may result in suspension or termination.

13. Payments, Fees & Billing

Membership fees, extras, surcharges, and administrative fees are billed according to the terms disclosed at enrollment.

• Fees are non-refundable except where required by law
• Failure to maintain payment may result in suspension or termination of services

14. Suspension & Termination

Family Access Medical may suspend or terminate membership for non-payment, policy violations, abuse, or unsafe behavior.

Termination does not eliminate outstanding financial obligations.

15. Changes to Services & Pricing

Family Access Medical may modify services, pricing, or policies. Material changes will be communicated in advance and applied at renewal unless legally required sooner.

16. Limitation of Liability

Family Access Medical is not responsible for outcomes related to third-party services, non-compliance with medical advice, or services outside the defined scope of membership.

17. Governing Law

These Terms are governed by the laws of the State of Ohio.

18. Acceptance & Pending Status

Enrollment constitutes acceptance of these Pending Terms & Conditions. These Terms are subject to modification prior to final legal review and clinic launch.