Q: Can I change levels later?

Yes. You can move up to a more comprehensive level at any time. Because moving up means beginning that level’s full assessment, the new level’s initiation fee applies in full. You can also step down to a lighter level going forward. Fees already paid are non-refundable when you change levels, so it’s worth choosing the level that fits your goals now, and if you only want one extra piece, you can add an individual assessment rather than moving up.

Q: Is this covered by MSP or private insurance?

No. Pacifica MD’s hormonal and metabolic care and the associated blood work are private services, not covered by the BC Medical Services Plan (MSP). Your scheduled visits and included hormone panels are covered by your subscription. Medications, if prescribed, are not included, and prescription coverage varies by plan, your extended health insurance may reimburse some costs, so it’s worth checking with your provider. For women’s testosterone treatment, the baseline total testosterone + SHBG panel is a private-pay safety/dosing requirement because testosterone testing is not MSP-covered when used to investigate low libido/HSDD.

Q: Does Pacifica MD replace my family doctor?

No. Pacifica MD provides focused care for your hormones and metabolism; we don't provide or replace the longitudinal primary care your family physician or nurse practitioner offers. We strongly recommend every patient maintain an ongoing primary-care relationship. We do, however, provide care that often falls outside a primary-care provider's usual scope, for example, prescribing testosterone for women.

Question 1

Can I change levels later?

Accepted Answer

Yes. You can move up to a more comprehensive level at any time. Because moving up means beginning that level’s full assessment, the new level’s initiation fee applies in full. You can also step down to a lighter level going forward.

Fees already paid are non-refundable when you change levels, so it’s worth choosing the level that fits your goals now, and if you only want one extra piece, you can add an individual assessment rather than moving up.

Question 2

What’s included in my plan, and what costs extra?

Accepted Answer

Your subscription (Comprehensive Hormone & Metabolic Health or Focused Hormone Health) includes two scheduled follow-up visits and two hormone lab panels per year. The panels are drawn at LifeLabs and covered by your subscription, with no separate lab bill.

You also have two optional Short Symptom Check-ins with our RN each year, brief visits for when a specific issue comes up between your scheduled follow-ups. The two scheduled follow-ups are part of your ongoing care, and are there if you need them. Beyond the two included, additional follow-ups are $115 each.

Beyond that, additional follow-up visits are $375 each (30 min); a Cardiometabolic Assessment is $675 (45 min); and a Micronutrient & Methylation Assessment is $375 (30 min). Comprehensive Hormone & Metabolic Health includes one of each assessment in the first year.

Women’s Sexual & Genitourinary Health is pay-as-you-go, with no subscription. This program is $375 to start and $115 per additional visit. Most GSM care is symptom-based and does not require routine lab work. If testosterone is considered, a baseline total testosterone + SHBG blood panel is required before the first dose and is billed separately to the patient, approximately $77, payable directly to the lab.

Question 3

Is this covered by MSP or private insurance?

Accepted Answer

No. Pacifica MD’s hormonal and metabolic care and the associated blood work are private services, not covered by the BC Medical Services Plan (MSP). Your scheduled visits and included hormone panels are covered by your subscription. Medications, if prescribed, are not included, and prescription coverage varies by plan, your extended health insurance may reimburse some costs, so it’s worth checking with your provider.

For women’s testosterone treatment, the baseline total testosterone + SHBG panel is a private-pay safety/dosing requirement because testosterone testing is not MSP-covered when used to investigate low libido/HSDD.

Question 4

What can I expect during my initial consultation?

Accepted Answer

Your first appointment is with Dr. Crisci. You’ll leave with a clear picture of where you stand and what your options are.
Before your first treatment appointment, you’ll complete your medical intake and have baseline labs drawn at LifeLabs, ideally at least seven days ahead so results are ready. At the visit she reviews your history and results, explains what they mean, and builds your initial plan with you.

Question 5

What is the schedule of follow-up visits and lab work?

Accepted Answer

Subscription members have two scheduled follow-up visits and two hormone lab panels every 12 months, usually spaced to track how you’re responding and fine-tune treatment, plus two optional Short Symptom Check-ins with the RN for issues that come up in between. If you need
to be seen more often, additional follow-up visits are $375 each and additional labs are payable directly to LifeLabs. Care is highly personalized, some patients need closer monitoring than others, and your clinician will recommend what’s appropriate for you.

Question 6

Who will I see at my appointments?

Accepted Answer

Your initial consultation and all Cardiometabolic Assessments are with Dr. Crisci. Your routine follow-up visits, your Short Symptom Check-ins, and your Micronutrient & Methylation Assessments are with a registered nurse working under her direct clinical supervision. Dr. Crisci oversees your care throughout, and remains responsible for your treatment plan, so a physician stays at the centre of your care even when a nurse conducts the visit.

Question 7

Does Pacifica MD replace my family doctor?

Accepted Answer

No. Pacifica MD provides focused care for your hormones and metabolism; we don't provide or replace the longitudinal primary care your family physician or nurse practitioner offers. We strongly recommend every patient maintain an ongoing primary-care relationship. We do, however, provide care that often falls outside a primary-care provider's usual scope, for example, prescribing testosterone for women.

Question 8

Who do you treat?

Accepted Answer

Our focus is women ages 40 to 65, approximately a decade before and after the onset of menopause, the window where hormonal and metabolic changes shape long-term health, and where focused care makes the biggest difference.

We also consider men aged 40 to 65 on a case-by-case basis; contact us for details.

Question 9

What are the add-on assessments, and what do they include?

Accepted Answer

There are two in-depth assessments included in the first year of Comprehensive Hormone & Metabolic Health, and available à la carte in later years, or any time on Focused Hormone Health. They address the metabolic, cardiovascular, and nutritional markers that ordinary checkups often miss.

The Cardiometabolic Assessment is 45 minutes with Dr. Crisci, and includes a review and treatment plan around fasting glucose and insulin, HOMA-IR, HbA1c, full lipid panel, lipoprotein(a), ApoB, atherogenic index of plasma (AIP), and hs-CRP, plus other tests where clinically appropriate based on your cardiovascular risk; $675, labs included.

The Micronutrient & Methylation Assessment is 30 minutes with our RN under Dr. Crisci, and includes recommendations around vitamin D, B12, ferritin, TIBC, and homocysteine; $375, labs included.

What's Included	Comprehensive	Hormone Care	Focused Care
	Comprehensive Hormone & Metabolic Care	Focused Hormone Care	Sexual & Genitourinary Health
Initial cost	$1,899	$895	$375
Subscription or per-visit cost	$125/mo ($1,500/yr)	$125/mo ($1,500/yr)	$115/visit No Subscription
Initial comprehensive lab testing and personalized MD consultation & plan
GSM and HSDD screening and management
Testosterone optimization based on symptoms
Peri/Menopause Care: LH, FSH, estradiol, progesterone (± DHEAS, testosterone)			Not Included.
Thyroid optimization; TSH, TPO & anti-thyroglobulin, free T3 (± free T4)			Not Included.
Comprehensive Cardiometabolic Assessment 45 min. with MD; fasting glucose, fasting insulin, HbA1c, advanced lipid panel, Lp(a), ApoB, HOMA-IR, atherogenic index of plasma (AIP), hs-CRP, + other tests as deemed appropriate		Not Included.	Not Included.
Micronutrient & Methylation Assessment 30 min. with RN; vitamin D, B12, homocysteine		Not Included.	Not Included.
Clinical follow-ups (per year)	2	2	Not Included.
Hormone lab panels (per year)	2	2	Not Included.
Who this is for:	If you want your hormones, metabolism, cardiovascular, and micronutrients fully assessed and optimized.	If your focus is hormonal and peri/menopause care, with deeper assessments optional as add-ons.	If you want focused, pay-as-you-go care for GSM and HSDD exclusively and are comfortable with symptom-based care.

A medical Doctor

Who looks at the whole picture

Integrated care for perimenopause, menopause, hormones, Genitourinary and Sexual health, metabolism, sleep, weight, mood, and long-term health.

PHYSICIAN-LED CARE
Evidence-based. Personalized. Whole-person focused.

Dr. Elisabeth Crisci, MD

Heather Gagnon, RN

Virtual Care Available

BC-wide

No physical exam

Program-specific lab coverage included

Which level of care is right for me?

What's Included

Who this is for:

Frequently Asked Questions

"If you've been told, 'It's just menopause,' but you know something deeper is changing, that's exactly why I built this care model."

- Dr. Elisabeth Crisci

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