Frequently Asked Questions
Frequently Asked Questions
Have questions about UpStream?
Our FAQ covers the essentials — from how our care works to what you can expect — so you feel informed, confident, and supported.
Have questions about UpStream+?
Our FAQ covers the essentials — from how our care works to what you can expect — so you feel informed, confident, and supported.
What is UpStream – Root Cause Medicine?
UpStream is a functional primary care practice based in Omaha. We focus on identifying and treating the root causes of chronic disease, rather than simply managing symptoms. Our name reflects both our approach and our home: Omaha means “upstream people”—and we help you move upstream in your health journey.
How is functional medicine different from conventional medicine?
Conventional medicine often intervenes downstream—suppressing symptoms or rescuing people during a crisis. Functional medicine goes upstream. We ask why the problem developed, trace it back to underlying causes, and help restore balance. Instead of covering the dashboard warning lights so we cannot see them, we look under the hood.
What kinds of conditions do you treat?
We see patients with a wide range of concerns, from fatigue, digestive issues, hormone imbalances, and autoimmune conditions, to weight management, brain fog, and chronic pain. But we also see people who want to optimize their health, prevent disease, and increase resilience.
Do I have to be sick to join?
Not at all. Many of our members come to us for prevention, longevity, or performance. Functional primary care is about flourishing, not just surviving.
But I already have insurance—why pay more?
Because this is different. With UpStream DIRECT™ you get:
- Direct access to your doctor, not office staff.
- Same/next-day visits and after-hours care.
- More time with your physician, not rushed appointments.
- Lower costs on labs and imaging. In short: better care, shorter wait times, and higher satisfaction—often at a lower overall cost than relying on insurance alone.
How is UpStream DIRECT™ different from concierge medicine?
Concierge practices often charge $200–$300 per month, still bill insurance, and add copays and deductibles. UpStream DIRECT™ delivers the same personalized, concierge-style experience—without the extra costs or insurance hassle.
What if I’m healthy and rarely need a doctor?
That’s the goal! Staying healthy is success. But even healthy people sometimes need urgent care—antibiotics, stitches, or other treatment. A single visit can cost as much as a year of UpStream DIRECT™ membership, and many issues can be prevented with ongoing care. Plus, by pairing UpStream DIRECT™ with a lower-cost insurance plan, even healthy members save money while building a long-term, trusted relationship with their doctor.
How does membership work?
At UpStream, you can choose the level of access and support that fits you best. Membership isn’t required — but it unlocks extra benefits and savings.
Non-Members – $0/month
Anyone can use our services without joining. You simply pay for the time you use — $360 per hour (for example, $180 for a 30-minute visit). It’s flexible and affordable for occasional care.
UpStream CONNECT™ – $25/month
Our entry-level membership gives you priority access and member discounts:
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10% off wholesale labs, supplements, and IV infusions
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Same-day or next-day appointments
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Required if you’d like to upgrade to UpStream DIRECT™
UpStream DIRECT™ – $125/month
Our full-access membership adds unlimited visits with your primary care provider — no per-visit charges. It’s designed for ongoing care, continuity, and predictable costs.
In short: Non-members pay as they go, CONNECT™ members get preferred rates and priority scheduling, and DIRECT™ members enjoy complete, unlimited access to their provider.
Is UpStream health insurance?
No. UpStream is not insurance. Membership provides access to functional medicine services, but it does not replace comprehensive health coverage.
Do I still need health insurance?
Can I drop my insurance if I join?
Will my membership fees count toward my insurance deductible?
Typically, no. Because we do not bill insurance, membership fees and visit charges do not apply toward your insurance deductible. However, some services may be reimbursable through your HSA or FSA.
What is not included?
Lab fees, imaging, medications, supplements, and IV therapy are not bundled in membership, but we provide them at transparent, often lower-than-retail prices.
How do labs and imaging work?
We partner with local labs and imaging centers to ensure the lowest cost. You can use insurance if you wish, but cash rates are often cheaper—and we make pricing transparent upfront, so there are no surprise bills weeks later.
Are there medications you don’t prescribe?
Yes. We do not prescribe opioids for chronic pain, or controlled medications like sedatives and stimulants without proper specialty evaluation and documentation. These are best managed through pain or psychiatric specialists.
Do you bill insurance?
No. We are a membership-based practice and do not submit claims to insurance. However, your membership may complement a high-deductible health plan (HDHP), giving you both upstream care and financial flexibility.
Can I use my HSA or FSA?
Yes. Under recent IRS guidance (2025), many functional medicine services and memberships are eligible expenses with a Health Savings Account (HSA) or Flexible Spending Account (FSA). We can provide detailed receipts for your records. Please note that UpStream is not a tax or legal adviser; please consult with your professional advisers in this area.
What about emergencies?
UpStream does not provide emergency or urgent care services. In the event of a medical emergency, members must call 911 or go to the nearest emergency department.
Do you cover specialty or hospital care?
No. Membership does not cover specialty consultations, hospitalizations, surgeries, or procedures performed outside of UpStream. Patients remain responsible for those costs through their insurance or direct payment.
How does the consent process work?
All patients review and sign a consent package before starting care. This covers membership terms, billing transparency, privacy, and consent to AI-assisted transcription and documentation to improve efficiency and accuracy.
What about privacy?
UpStream uses HIPAA-compliant systems to protect your health information. Any use of AI transcription or documentation tools is fully HIPAA-compliant.
Can I cancel my membership?
Yes. Membership is month-to-month unless otherwise specified. If you cancel and later wish to rejoin, a short waiting period may apply before renewal.
What if I already have a primary care doctor?
That’s fine. Many of our members keep their conventional primary care doctor and use UpStream as their upstream health partner. More of our members choose the $125/month UpStream DIRECT™ option and have us deliver all of their primary care needs.
Do you see children or families?
Yes. Functional medicine can benefit patients across the lifespan, though the approach may differ by age. Family memberships are available on request.
Is there a guarantee of results?
No. While functional medicine is evidence-based and rooted in systems biology, outcomes vary by patient. Membership does not guarantee specific results.
How do I get started?
Simply go to our Contact page and schedule your first consultation. During this visit, we’ll review your health history, goals, and design a personalized plan to move you upstream.
Transparent Membership Pricing
Non-Members
$0
Monthly
- Anyone can use our services
- Membership is optional
- Lowest costs in Omaha for functional medicine
- $350 per hour - pay only for the time you use (e.g. 30 minute visit + $175)
UpStream Connect™
$25
Monthly
- 10% off wholesale labs
- 10% off supplements
- 10% off IV infusions
- Same day / next day appointments
- Required for UpStream Direct™
UpStream Direct™
$125
Monthly
- UpStream Connect™ membership required
- Unlimited access to your primary care provider
- No additional payments for visits
- Ensures continuity and keeps costs predictable