Older Adult Primary Care · Fort Worth Area
Time to go through everything, carefully
Complex histories do not fit in a short appointment. Older adult care at Presence means unhurried visits, a genuine medication review, and one provider who keeps track of what every specialist has changed.
Adult-Gerontology Primary Care Nurse Practitioner · Same provider each visit · 24/7 access included
The short answer
Presence primary care for older adults is delivered by a board-certified Adult-Gerontology Primary Care Nurse Practitioner — medication review, chronic-condition follow-up, longer visits and caregiver-friendly access. Household virtual membership starts at $19.99 a month, while scheduled local care follows the selected plan's terms. Dues are a private fee; Medicare and commercial coverage must be verified plan by plan.
- Who it is for
- Older adults, and the adult children arranging their care, who want medication review and continuity rather than a new face each visit.
- When it may not fit
- Anyone needing a specialist, hospital-based care, or someone who expects membership dues to be billed to Medicare.
- What it costs
- From $19.99 a month; local visits are $129 each on the $19.99 plan, two included annually then $99 each on the $29.99 plan, and included without a per-visit charge on Unlimited plans; one-time $49 onboarding before the first in-office visit.
- What to do next
- Join, or ask us to check what a Medicare or commercial plan covers first.
In an emergency call 911 or go to the nearest emergency department.
Prices and material terms
- Member in-person visit$99In the Dallas–Fort Worth area, on Virtual plans.
- One-time clinical onboarding$49Medical history review before a first in-person visit.
- Without a membership$149A single in-person visit, no commitment.
Local in-person care is for ages 13 and older. Unlimited plans include medically appropriate local visits with no per-visit charge. Membership is not insurance and does not cover hospital, surgical, specialist or emergency care.
What does this older adult need first?
- Talk to us about membership
Nobody has looked at the whole medication list in years
A medication review is part of ongoing membership care: every prescription, supplement and over-the-counter product looked at together, including what may no longer be needed.
- Longer primary care visits
Several conditions, and appointments never cover them all
Longer visits are the point of membership care rather than an upgrade to it.
- Get care now
Something acute is happening this week
A virtual visit from $19.99 starts it, with a straight answer about whether they need examining in person.
- Care for aging parents
You are the adult child arranging all of this
Consent, logistics and long-distance caregiving are covered separately.
Deprescribing and any medication change is a clinical decision made with the patient and, where relevant, their other prescribers. Nothing is stopped or changed on the basis of a web page.
Why older adults get short-changed by fast medicine
Caring for older adults is a privilege and an honor. Every season brings a different story and different needs. When care needs more time, Presence believes that time should be given gladly—with dignity, patience and respect.
By the time someone has four diagnoses, three specialists and eight prescriptions, a brief visit cannot do the job. Something always gets deferred — usually the medication list, the question about dizziness, or the fact that two prescribers each changed a dose and neither knows about the other. The failure is not clinical skill. It is time.
Presence is built around having that time: a smaller panel per provider, longer in-person visits, and unlimited 24/7 virtual access so questions between visits do not have to wait for the next opening.
Full medication review
Everything you take, including over-the-counter products and supplements, reviewed for duplication, interactions and whether each one is still needed.
Multiple conditions together
Blood pressure, cholesterol, diabetes, thyroid, kidney function and heart conditions managed as one picture instead of separate silos.
Specialist coordination
Referrals, and help making sense of what each specialist recommended — including when two recommendations conflict.
Fall and mobility concerns
Balance, dizziness, vision, footwear and home hazards discussed before a fall happens rather than after.
Memory and mood
Cognitive and mood changes taken seriously and evaluated, with referral for specialty assessment when appropriate.
Family involvement
With your permission, adult children or caregivers can be part of the conversation so instructions do not get lost on the drive home.
Your provider's training matters here
Local care at Presence is provided by Melissa Presence, a board-certified Adult-Gerontology Primary Care Nurse Practitioner. That certification is specifically focused on adults across the lifespan into older age — the population where multiple conditions, polypharmacy and function-first thinking are the daily work rather than the exception.
She is a nurse practitioner, not a physician, and practices in accordance with Texas requirements for nurse practitioners. Her full background is on the provider page.
Bring the whole picture
Onboarding includes a one-time $49 clinical history review — bring your medication bottles, specialist names and recent test results.
A long first in-person visit
Exam, vitals, functional questions and the medication list, in one appointment that is not racing a clock.
A written plan you and your family understand
What each medication is for, what we are watching, and what warrants a call versus a 911 call.
Access between visits
Call 817-900-6368 any hour — unlimited virtual visits are included, with no per-visit charge for included care.
Being straight about what membership is
Presence membership is a healthcare membership, not health insurance. It does not cover hospitalization, emergency care, surgery, skilled nursing or specialty fees, and Presence does not bill insurance for membership care. We do not make claims about coverage or reimbursement, and you should keep whatever coverage you have for large medical costs.
Older adults choose Presence for
- Unhurried visits with the same provider
- A real medication review across all prescribers
- Someone reachable by phone at any hour, including nights and weekends
- Coordination when several specialists are involved
- Predictable monthly cost with no copays for included care
Presence membership does not
- Replace health insurance or pay hospital, surgical or emergency bills
- Bill insurance for membership care
- Provide emergency services — call 911 for emergencies
- Cover specialty visits or the facilities you are referred to
- Prescribe controlled substances through virtual visits
Individual Unlimited is $109/month for ages 65+ and includes medically appropriate local visits with no per-visit charge. Age-based pricing is designed to support the time, attention and ongoing care each stage deserves. All plans: billed monthly · 12-month commitment · one-time $49 onboarding before a first in-person visit. See pricing.
Older adult care questions
Which plan is best for someone with several conditions?
Individual Unlimited is $109/month for ages 65+ and includes medically appropriate local primary care visits with no per-visit charge. Virtual Family Care at $19.99 works when most needs are virtual and local visits at the member rate fit your needs.
Can a family member join the visit?
Yes, with your permission — in the room or on the phone. Many members prefer a second set of ears for the plan and medication changes.
Do you coordinate with my cardiologist and other specialists?
Yes. Coordination is part of the work: referrals, reviewing what specialists recommend, and keeping one accurate medication list across prescribers.
Can you manage my prescriptions?
Your provider manages the prescriptions within primary care scope, including refills and periodic review. Controlled substances are not prescribed through virtual visits.
Do you take Medicare or insurance?
Presence does not bill insurance for membership care, and we make no claims about coverage or reimbursement. Membership is paid directly and is not insurance. Keep your existing coverage for hospital, emergency and specialty costs.
What if I cannot easily drive to Fort Worth?
Virtual visits can carry much of the relationship — see virtual primary care — with local visits reserved for exams and testing.
About this information
Written by the Presence care team for patients considering care with us. Presence care is delivered by licensed providers, including a board-certified Adult-Gerontology Primary Care Nurse Practitioner — not by a physician, and not by software. Meet your provider.
This page explains how our service works. It is general information, not a diagnosis, and it is not a substitute for an evaluation of your own situation. Whether testing, treatment or a prescription is appropriate is decided during a visit.
If this is an emergency — chest pain, trouble breathing, stroke symptoms, severe bleeding, or thoughts of harming yourself — call 911 or go to the nearest emergency department. See our emergency care notice.
Bring the whole list. We have time.
Call to schedule local care, or start a membership and get a provider who keeps track of everything.