Key takeaways:
Direct primary care (DPC) is one option for accessing medical care. DPC is a billing and payment arrangement you make directly with your healthcare professional that doesn’t involve insurance.
DPC typically covers the cost of routine screenings, management of chronic conditions, care coordination, and acute-care visits.
If you have a DPC arrangement, you also may need a high-deductible health plan or other health insurance to cover emergency and hospital services.
As health insurance gets more confusing and costly, new models of care have emerged. Some people are turning to direct primary care (DPC) as an option to access and afford basic medical services. Here’s what you need to know about DPC, so you can decide if this practice and payment model is right for you.
What is direct primary care, and how does it work?
DPC, or direct primary care, is a financial arrangement made directly between you and your healthcare professional. It cuts insurance providers out of the process — eliminating the need to file health insurance claims. It's a form of cash-pay healthcare.
With DPC, you don’t pay monthly health insurance premiums or copays. Instead, you pay your healthcare professional a monthly fee. And because DPC practices don’t bill insurance companies, they don’t accept any form of insurance. That said, many people who use DPC are also enrolled in a high-deductible health plan.
Most DPC professionals come from the primary care medical specialties:
Internal medicine, which produces internal medicine physicians or internists, who treat adults
Family medicine, which produces family medicine physicians, who treat people across the lifespan from infants to seniors
Pediatrics, which begets pediatricians, who treat babies, children, and adolescents
Depending on where you live, DPC practices may include the following healthcare professionals as part of the care team and with full or partial practice authority to diagnose people, order tests, and prescribe medications:
Physician associates (PAs), who are also known as physician assistants and may be using that title where you live
Advanced practice registered nurses, such as nurse practitioners
Some people distinguish between DPC and concierge medicine, which offers premium services to consumers who tend to have higher incomes. Both offer extended visits with physicians and other care team members. Concierge medicine practices typically charge higher monthly fees and accept insurance.
The benefits of direct primary care
There are many advantages to using DPC. Here are a few benefits of entering into a financial agreement with a healthcare professional.
More time with your healthcare professional
DPC practitioners do not have to prepare and file insurance paperwork. This allows them to have more in-depth visits and spend more time with you. DPC offices typically treat fewer people than practices that accept insurance. Healthcare professionals can take time to get to know your health history in detail, which creates an atmosphere conducive to more personalized care.
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Upfront pricing
With a traditional health insurance plan, you have little knowledge of exactly how much your insurance will be billed and your out-of-pocket responsibility. Deductibles loom, and copays and coinsurance are applied. Discounts are negotiated between the healthcare professional or practice and your insurance company. Then you get an explanation of what you’re expected to pay for the visit.
DPC eliminates that uncertainty. You’ll know the exact monthly cost of membership for basic care and specific additional fees for enhanced services.
Accessibility and convenience
With DPC, you’ll usually have access to many perks. These may include:
Same-day and next-day visits
Appointments lasting 30 to 60 minutes
Telehealth options with your healthcare professional, such as phone calls, emails, texts, and video visits
Around-the-clock access to your healthcare professional
You can now use health savings account (HSA) funds
Starting January 1, 2026, people can use their HSA funds to pay for DPC membership fees. Previously, DPC was considered similar to health insurance and typically did not qualify as an HSA-eligible expense.
To qualify for payment with HSA funds, the DPC membership must:
Charge a fixed monthly fee: Individual DPC memberships should not exceed $150 per month. Family memberships are capped at $300 monthly.
Cover routine primary care services: This includes wellness visits, preventive care, follow-ups, and basic office procedures.
Not function like insurance: The membership cannot include major medical services, such as specialty care, emergency services, hospital care, and other benefits that exceed primary care.
The disadvantages of direct primary care
DPC has a few challenges. You’ll have to consider these drawbacks before making a DPC arrangement with your healthcare professional.
You may still need an insurance plan
The monthly fee for DPC covers consultations, office visits, and basic care. But, depending on your contract, you may have additional costs for lab work, imaging, or procedures. That’s why you’ll probably need to pair your DPC membership with some sort of insurance plan. Many people using DPC also have a high-deductible health plan.
If you have a health plan, you can use DPC. But if you have government health coverage, such as Medicare or Medicaid, you have to sign an agreement stating that any and all services provided will not be billed to those insurance plans.
Membership doesn’t count toward a deductible
If you itemize deductions and have enough medical expenses, you can deduct your monthly membership fees on your taxes, according to the IRS. But your cost for DPC cannot be counted toward your insurance deductible if you also have a high-deductible health plan or other coverage.
What are the direct primary care costs and payments?
The monthly fee for most DPC practices is typically around $100. That fee gives you unlimited and direct access to your primary care provider (PCP), also known as a primary care professional. Some DPC practices charge an additional visit fee at the time of service.
In general, fees are based on your age, the type of practice, and the number of family members on your plan. The monthly fee may cover all or some of these typical primary care services:
Preventive care (such as routine screenings)
Laboratory tests (such as blood tests or urinalysis)
Management of chronic conditions (medication checkups)
Acute-care visits (for strep throat or the flu, for example)
Consultations
The monthly fee doesn’t include visits to specialists, urgent care, or hospital services. And medications — prescription or over the counter — are also not part of a DPC financial agreement.
You can access discounted dental, vision, lab, and imaging services with a GoodRx Companion subscription. The program includes other benefits to cut your self-pay costs, such as lower prices for telehealth, prescriptions, and other health services.
Why do you sometimes need insurance with DPC?
Although DPC’s monthly fee may be less than a health insurance premium, having DPC alone may leave you at risk of medical debt. That’s because you will lack coverage for other health-related expenses, such as emergency care, hospital services, and prescription medication. To avoid medical bills you can’t pay, DPC is typically paired with one or more of the following options:
A high-deductible health plan (HDHP): This covers services such as surgeries or catastrophic health issues. These plans also cover emergency room treatment or hospitalization. An HDHP is one way to prevent financial devastation if you need emergency or extensive care. And you can access preventive care without out-of-pocket costs, including meeting your high deductible, as long as the services are within your plan's network.
A health savings account (HSA): Anyone enrolled in an HDHP is eligible to contribute money to an HSA. You make contributions before income tax is deducted from your earnings. This lowers the amount of your taxable income. In addition to using HSA funds for health-related eligible expenses, such as prescriptions, copays, deductibles, vision care, and dental care, you can also pay for DPC membership fees as of 2026.
Prescription coverage and/or coupons: Whether you have health insurance or have enrolled in DPC, you can use GoodRx to save on medication. Using GoodRx.com or the GoodRx app, type your medication into the search bar, adjust your dose and quantity, set your location, and find the lowest price near you. You can print the free coupon, send it to your phone or email, or save the coupon on your app to use at participating pharmacies to save on prescription medications and over-the-counter medications with a prescription. You may even pay less by skipping your prescription plan and using GoodRx.
GoodRx Companion: You can access discounted dental, vision, lab, and imaging services with a GoodRx Companion subscription. The program includes other benefits to cut your self-pay costs, such as lower prices for telehealth, prescriptions, and other health services.
Is direct primary care worth it?
People using DPC can typically contact their provider at any time, which may be appealing to:
Families with small children
People who travel frequently
Older adults with limited mobility
Because DPC arrangements are often paired with high-deductible health plans, they might not be the best choice for everyone. A DPC may not be ideal for people who need specialized care or people who have complex medical issues. A DPC may work best for people who are generally healthy or for people who want improved access to a primary care provider for routine visits or short-term health issues.
So, if you’re considering a high-deductible health plan — or already have one — adding a DPC membership may be a good option for you.
How can you find a direct primary care professional?
If you have a primary care professional, ask if they’re willing to enter into a DPC agreement. If that doesn’t work, look for a DPC practice near you.
The Direct Primary Care Coalition and DPC Frontier Mapper are two resources to help you locate a DPC practice in your area.
The bottom line
If you’re having trouble affording medical care or health insurance — or are hesitant about accessing care because of possible medical debt — direct primary care (DPC) may be an option for you. But before entering into a DPC plan, it’s best to weigh all the pros and cons. You’ll want to be sure it makes sense financially. You may also want to consider enrolling in a high-deductible health plan and health savings account (HSA) to keep your medical expenses in check. If you’re considering DPC, talk to your primary medical professional to see if this plan could be a good fit for your health and budget.
You can also access discounted dental, vision, lab, and imaging services with a GoodRx Companion subscription. The program includes other benefits to cut your self-pay costs, such as lower prices for telehealth, prescriptions, and other health services.
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References
American Academy of Family Physicians. (n.d.). Direct primary care: What is direct primary care?
American Academy of Family Physicians. (n.d.). Direct primary care.
American Association of Nurse Practitioners. (2023). State practice environment.
American Nurses Association. (n.d.). Advanced practice registered nurse (APRN).
Internal Revenue Service. (2024). Topic no. 502, medical and dental expenses.
Robinson-Walker, D., et al. (2023). What is concierge medicine and is it worth the price tag? Forbes Health.
Tou, L. C., et al. (2022). Understanding patient perceptions towards direct primary care: A focus group study. Journal of Patient Experience.
