Key takeaways:
Direct primary care (DPC) is a self-pay option for accessing medical care. Under the DPC model, you make a billing and payment arrangement with your healthcare professional that doesn’t involve insurance. Sometimes, employers will cover DPC fees.
DPC typically includes routine screenings, management of chronic conditions, care coordination, and acute-care visits.
If you have a DPC arrangement, you may still want 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?
DPC, or direct primary care, is a form of cash-pay healthcare. Under this model, you make a financial arrangement directly with your healthcare professional. This cuts insurance out of the billing process — eliminating the need to file claims. DPC could be a new way of handling healthcare costs in your household whether or not you have insurance.
How does direct primary care work?
You may be accustomed to medical practices charging you copays or coinsurance for services billed to your insurance plan. But with DPC, you pay your healthcare professional a monthly fee. DPC practices don’t file claims with health plans, so there aren’t the usual out-of-pocket costs associated with using insurance. That said, it’s not unusual for a person who uses DPC to be enrolled in a high-deductible health plan and have a health savings account (HSA).
Most DPC professionals come from primary care medical specialties:
Internal medicine, which produces internal medicine physicians or internists who treat adults
Family medicine, which produces general medicine physicians who treat people of all ages, from infants to seniors
Pediatrics, which begets pediatricians who treat babies, children, and adolescents
Depending on where you live, DPC practices may also include the following healthcare professionals in their care teams. These individuals may have full or partial practice authority to diagnose people, order tests, and prescribe medications:
Physician associates (PAs), also commonly known as physician assistants
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 self-pay healthcare options offer extended visits with physicians and other care team members. Concierge care practices typically charge higher monthly fees and may accept insurance, while DPC is cash-pay care offering more health equity and accessibility.
The benefits of direct primary care
DPC has many advantages. 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 spend more time with you and have more meaningful visits. DPC offices typically treat fewer people than practices that accept insurance. So your healthcare professional can take time to get to know your health history in detail, which creates an atmosphere conducive to more personalized care.
Up-front pricing
When using health insurance, you may not know exactly how much your plan will be billed for a medical appointment, or how much you’ll have to pay out-of-pocket, in advance. 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.
DPC eliminates that uncertainty. You’ll know the exact cost of your monthly membership covering basic care and any additional fees for advanced services.
Accessibility and convenience
With DPC, you’ll likely have access to many perks. These may include:
Same-day and next-day visits
Appointments lasting 30-60 minutes
Telehealth options with your healthcare professional, such as phone calls, emails, texts, and video visits
Around-the-clock access to your healthcare professional
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HSA-eligible fees
Since January 1, 2026, consumers have been able to use HSA funds to pay DPC membership fees. Previously, monthly payments for DPC were considered similar to health insurance premiums and typically did not qualify as HSA-eligible expenses.
To qualify for payment with tax-free HSA funds, a DPC membership must:
Be covered by a fixed monthly fee: Individual DPC membership fees cannot exceed $150 per month in 2026 or 2027. 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 offer access to major medical services, such as specialty care, emergency services, hospital care, and other benefits that exceed the scope of primary care.
The disadvantages of direct primary care
DPC comes with a few challenges. You’ll want 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 to go outside of the DPC practice for lab work, imaging, or certain procedures, resulting in additional costs. That’s why you’ll probably need to pair your DPC membership with some sort of insurance.
Many people who use DPC have a high-deductible health plan. But you can also pair a membership with government-sponsored health coverage, such as Medicare or Medicaid. You’ll just have to sign an agreement stating that any and all services provided will not be billed to that insurance plan.
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 tax return, according to the IRS. But the fees won’t count toward your insurance deductible if you also have a high-deductible health plan or other coverage.
How much does direct primary care cost?
The monthly fee for most DPC practices is typically around $100. That fee gives you unlimited direct access to your primary care provider. Some DPC practices charge an additional visit fee at the time of service.
In general, fees are based on your age, the type of DPC practice, and the number of family members included in your agreement. The monthly fee may cover some or all of these typical primary care services:
Preventive care (such as routine screenings)
Management of chronic conditions (such as 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 arrangement.
Why do you sometimes need insurance with DPC?
Although your DPC monthly fee may be less than a health insurance premium, having a DPC membership 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 medications.
To avoid unaffordable medical bills, DPC memberships are typically paired with one or more of the following options:
A high-deductible health plan: This can help you cover costly health issues and procedures, such as surgeries. These plans also cover emergency room treatment and hospitalization, which can be extremely expensive without insurance. And you can access preventive care without meeting your deductible, as long as the services are within your plan's network.
An HSA: Anyone enrolled in a high-deductible health plan is eligible to contribute money to an HSA. With 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 eligible expenses such as prescription medications, 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, a DPC arrangement, or both, you can use GoodRx discounts to save on prescription medications and prescribed over-the-counter medications. Use the GoodRx website or app to search for your medication, dose, and quantity, then set your location, and find the lowest price near you. You can print out the free coupon, send it to your phone or email, or save it in the app.
GoodRx Companion: GoodRx Companion, a subscription service with a low monthly price, can help you pay less for self-pay healthcare. You can save on prescription medications, telehealth, and other everyday healthcare services such as dental and vision care, lab work, and imaging and diagnostics. In addition, this program gives you access to more than 250 generic medications at no additional cost — and hundreds more for less than $10 per fill.
Is direct primary care worth it?
You can typically contact your DPC healthcare professional or a team member 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. DPC may not be ideal for people who need specialized care or who have complex medical issues. The model may work best for people who are generally healthy and want improved access to a primary care professional 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 DPC Frontier Mapper is one resource that can 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 arrangement, it’s best to weigh all the pros and cons. You’ll want to be sure it makes sense financially.
You may want to pair a DPC membership with a high-deductible health plan and health savings account (HSA) to keep your medical expenses in check. And there are other options to consider, including a GoodRx Companion subscription. You can access discounted dental, vision, lab, and imaging services through GoodRx Companion. And the program includes other benefits to cut your self-pay costs, such as lower prices for telehealth, prescription medications, and other health services.
If you’re considering DPC, talk to your primary medical professional to see if this option could be a good fit for your health needs and budget.
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References
American Academy of Family Physicians. (n.d.). Direct primary care.
American Academy of Family Physicians. (n.d.). Direct primary care: What to know.
American Academy of Physician Associates. (n.d.). Title change.
American Association of Nurse Practitioners. (2026). State practice environment.
American Nurses Association. (n.d.). Advanced practice registered nurse (APRN).
HealthInsurance.org. (n.d.). Direct primary care.
Internal Revenue Service. (2026). 26 CFR 601.602: Tax forms and instructions.
Internal Revenue Service. (2026). Topic no. 502, medical and dental expenses.
Medicare.gov. (n.d.). Concierge care.
Robinson-Walker, D., et al. (2023). What is concierge medicine and is it worth the price tag? Forbes.
Roeser, R. (2026). Direct primary care vs. concierge medicine: What’s the difference? Integrity Medicine.
Tou, L.C., et al. (2022). Understanding patient perceptions towards direct primary care: A focus group study. Journal of Patient Experience.
