Direct primary care in Fort Collins
A family doctor with the time to know you across the seasons of your life.
Almanac is a membership practice, which means you pay one flat monthly fee, you get unhurried visits and my direct line, and I bill no insurance for any of it. One doctor, a panel I keep small on purpose, and every price set down in plain dollars, right here on the page you are reading.
- Direct primary care, practiced here in town
- Fort CollinsDirect primary care, practiced here in town
- One doctor, and a panel kept small on purpose
- 600One doctor, and a panel kept small on purpose
- No insurance billing, and no surprise bill weeks later
- $0 copaysNo insurance billing, and no surprise bill weeks later
- And my own cell number for the things that will not wait
- Same or next-dayAnd my own cell number for the things that will not wait
You already know how ordinary primary care feels by now.
A fifteen-minute appointment that is really seven. A waiting room, then a different face than the one you saw last time, then a hand already on the doorknob before you had gotten to your second question. A bill that arrives weeks later and cannot be decoded. Weeks of waiting to get in when something is actually wrong. A doctor who does not really know you, through no fault of their own, because the system handed them two thousand patients and a clock and asked them to make it work.
None of that is the doctor’s failing. It is what happens when insurance sits in the middle of the room and the visit has to pay for itself in eight minutes.
The turn
Membership medicine is the older, simpler way, brought back.
You pay Almanac a flat monthly fee, the way you would a gym or a subscription you actually use, and in return you get as much primary care as you need: visits that run thirty to sixty minutes, same or next-day when something comes up, and my cell number, so that when your child spikes a fever at nine at night you can text me instead of sitting in an urgent-care waiting room.
I keep the panel small on purpose, so I can carry your whole story in my head rather than skim a chart I have not opened in a year. I do not bill your insurance, and that single fact is the reason I have the time.
What’s included
What your membership covers
Unhurried visits, as many as you need
Thirty to sixty minutes when you need them, with no copay at the desk and no unspoken rule that you may only bring one problem to a visit.
My direct line
Text me, call me, or send an email, and for the things that will not keep, I answer in the evenings and on the weekends too.
Wholesale labs and medications
The lab that bills at $200 through insurance is about $6 here, and many of the common generics come to a few dollars a month.
Same or next-day care
Sick visits, minor injuries, and the ordinary trouble that has no intention of waiting a week for an opening.
Care coordination
When you need a specialist or the hospital, I set it up, send my notes, and stay in the loop, so the coordinating falls to me and not to you.
Telehealth for members
Often a photograph of a rash or a two-minute call settles the question and saves you the drive in.
How membership works
Joining is a conversation, not a form
- 1
Meet me first
A free twenty-minute visit, in person or over the phone, with no health forms to fill out and nothing to sign, so the two of us can simply find out whether we are a fit.
- 2
Enroll, month-to-month
A one-time enrollment and your first month, with no contract binding you and the freedom to cancel whenever you like, and we do the paperwork together, in person.
- 3
Start getting care
You have my cell number that same day, and you book your first real visit whenever it suits you, and when you come in, you take all the time the visit actually needs.
Real prices, right here
I publish every price, because hiding them until you are in the room is one of the things I left behind.
$75/ month
for most adults (ages 26 to 44)
$30/ month
per child, with a parent enrolled
$250/ month
is the most any household pays, no matter how large the family grows
Insurance and your HSA
No. Keep the coverage you have. This tends to the day-to-day.
Almanac covers your primary care. You keep a high-deductible health plan or a health share for the big, rare things, the hospital stay and the surgery and the trip to the ER and the specialist. Most people pair a membership like this with a lower-cost, higher-deductible plan and come out ahead, because I handle roughly ninety percent of what primary care is for, at wholesale, without a copay anywhere in sight.
You can pay your membership straight from your HSA now.
As of January 1, 2026, direct primary care memberships are HSA and FSA eligible, up to $150 a month for an individual and $300 a month for a family. If you keep a health savings account, your membership can come straight out of it, before tax.
Almanac for employers
Thinking about it for your team?
More than half of the direct primary care memberships in the country are now paid for by employers, and the reason is a plain one: a team that can actually reach a doctor takes fewer sick days and makes fewer trips to urgent care. If you run a small business here in the Fort Collins area, an Almanac membership makes a clean, flat-rate benefit that your people will genuinely feel.
One doctor
Mine is the only name on the door.
I am Dr. Elena Marsh, board-certified in family medicine. I spent about eight years inside a large health system, carrying a panel of more than two thousand patients, before I decided that I would rather know six hundred people well than two thousand people barely at all. That one decision is the whole practice.
Start with a conversation. It costs nothing, and there is nothing to prepare.
Come meet me for twenty minutes, in person or over the phone. No health forms, and no pressure to decide anything that day.