Direct Primary Care (DPC): the $80/month doctor membership

Direct Primary Care flips the insurance model on its head: instead of billing your insurer every time you call, visit, or message your doctor, you pay a flat monthly membership fee directly to the practice—typically $25–$150 per month for adults. In return you get unlimited visits, same-day or next-day appointments, direct cell-phone access to your physician, and wholesale-priced labs. No co-pays. No claim forms. No waiting six weeks for a non-urgent appointment. This guide explains what DPC is, what it actually costs, what it does and does not cover, which networks and platforms to know, how to pair it with a high-deductible plan to save $2,000–$3,000 per year, and what the IRS says about using your HSA to pay for it.

What Direct Primary Care is—and what makes it different

In the traditional fee-for-service model, every interaction between you and your doctor generates a billing code that flows through your insurer. The insurer pays a negotiated rate; you owe a co-pay or deductible portion. The doctor hires billing staff, spends hours on prior authorizations, and sees 25–30 patients per day to stay profitable at $15–$30 per reimbursed visit. This leaves the average primary care physician roughly 8–12 minutes per appointment.

Direct Primary Care removes insurance entirely from the primary care relationship. The practice charges a flat monthly membership fee—sometimes called a retainer or subscription—and in return provides essentially unlimited primary care services to enrolled members. Because the practice does not bill insurance for individual visits, it eliminates most of the administrative overhead. A typical DPC physician carries a panel of 400–800 patients instead of the 2,000–3,000 common in fee-for-service practices. That smaller panel means longer appointments (30–60 minutes is normal), same-day or next-day access, and a physician who actually knows your history.

DPC is not concierge medicine, though the two models are often confused. Concierge medicine typically layers a retainer on top of ongoing insurance billing; patients pay extra for enhanced access but the doctor still processes insurance claims. DPC practices do not bill insurance at all for primary care services included in the membership (though many will bill insurance if you are hospitalized and they provide coordination).

Typical DPC pricing in 2026

Membership fees vary by practice, geographic market, and member age. The national ranges as of 2026:

• Adults (18–64): $50–$150/month. The sweet spot in most mid-size cities is $75–$100/month. Rural practices may price as low as $50; practices in high-cost metro areas (San Francisco, New York, Seattle) may reach $150.
• Adults 65+: $100–$200/month (some practices charge more for older patients with higher utilization).
• Children (0–17): $10–$50/month. Many practices offer a family cap—e.g., two adults plus all children for a capped monthly rate.
• Family cap example: $150/month for two adults, $25/month for each child, capped at $200/month total for the household.

AtlasMD, one of the most well-known DPC practices (founded by Dr. Josh Umbehr in Wichita, Kansas, and widely regarded as a model for the movement), publishes rates of approximately $50–$75/month for adults and $10/month per child added to a family membership. Forward Health, a tech-forward DPC-adjacent model operating in major cities, charges approximately $149/month and includes biosensors and health screening panels. One Medical (now owned by Amazon) operates on a $199/year membership model and bills insurance for visits on top of that, making it a hybrid rather than a pure DPC practice.

What is included in a DPC membership

What you get for that monthly fee is much broader than a typical insurance co-pay covers:

Unlimited primary care visits

In-person office visits are included in the membership with no per-visit fee. Most practices offer same-day or next-day appointments for acute issues (ear infections, sinus infections, sprains, lacerations, rashes). Routine physicals, well-woman exams, sports physicals, and chronic disease management visits are included. The average DPC patient can realistically expect a 30–60 minute appointment rather than the rushed 8–12 minutes typical of fee-for-service.

Telehealth and direct communication

Phone calls, text messages, and video visits with your doctor are included. Many DPC physicians give patients their direct cell phone number. This alone is a transformative difference: rather than going to urgent care for a UTI or minor infection, you text your doctor a description and a photo and often have a prescription called in within an hour.

Labs at wholesale cost

DPC practices purchase lab tests at wholesale through direct contracts with LabCorp, Quest Diagnostics, or regional labs—bypassing the markup that flows through insurance billing. Common labs at DPC wholesale rates: a complete metabolic panel for $3–$8 (vs. $150–$300 billed through insurance), a lipid panel for $4–$10, a hemoglobin A1c for $5–$12, a complete blood count for $3–$8, thyroid panel for $10–$25. These are passed through to members at or near cost. AtlasMD publishes its wholesale lab pricing publicly as a transparency example.

Generic medications at cost

Many DPC practices maintain an in-office dispensary of the most common generic medications and dispense them at or near cost. Common examples: metformin (diabetes) at $4–$8 for a 90-day supply, lisinopril (blood pressure) for $4–$6/month, SSRIs like fluoxetine for $5–$10/month, amoxicillin (antibiotic) for $4 per course. Not all DPC practices dispense medications; check with the specific practice.

Care coordination and care management

Your DPC physician can coordinate specialist referrals, review specialist notes, help you manage hospital discharge, and handle your chronic conditions (diabetes, hypertension, hypothyroidism, asthma) through ongoing communication rather than scheduled-in-advance quarterly appointments.

Minor procedures

Many DPC practices handle minor procedures that would otherwise require a specialist visit or urgent care: laceration repair, skin tag or wart removal, joint injections, EKGs, ear wax removal, IUD/implant placement (at some practices), and basic point-of-care testing (strep, flu, mono, urinalysis).

What DPC does NOT cover

This is critical. DPC membership covers primary care only. It is not a substitute for insurance. The following are explicitly outside DPC scope:

• Hospitalizations — any inpatient stay requires insurance or self-pay at hospital rates.
• Specialist visits — dermatologist, cardiologist, orthopedic surgeon, endocrinologist, etc. Your DPC doctor may manage some conditions that would otherwise require a specialist, but specialist consultations themselves are not covered.
• Imaging — MRI, CT scan, X-ray (though some DPC practices can order imaging at negotiated cash-pay rates significantly below insurance pricing; an MRI that bills $3,000 through insurance may be $400–$600 cash at an imaging center).
• Emergency room visits — ER care is not covered; this is where catastrophic insurance or a healthsharing plan is essential.
• Surgery and anesthesia — any surgical procedure requires coverage outside of DPC.
• Brand-name prescriptions — the in-office dispensary covers generics; brand-name medications require a pharmacy benefit or self-pay.
• Mental health specialist care — psychiatrist visits and inpatient psychiatric care are outside DPC scope (though many DPC doctors prescribe basic psychiatric medications like SSRIs).
• Maternity / OB care — some DPC practices offer prenatal care within the membership, but most obstetric care and delivery is outside scope.

Major DPC networks and platforms

Hint Health

Hint Health (hint.com) is the leading practice management software platform for DPC practices—it is not a practice itself, but the technology layer that thousands of DPC physicians use to manage memberships, billing, and patient communication. Hint's locator (hint.com/find-care) is one of the most thorough ways to search for DPC practices by ZIP code. As of 2026, Hint powers more than 3,000 DPC practices across all 50 states.

AtlasMD

AtlasMD (atlasmd.com), founded by Dr. Josh Umbehr in Wichita, Kansas, is both a practicing DPC clinic and a business model evangelism effort that has inspired hundreds of physicians to leave fee-for-service medicine and launch DPC practices. Dr. Umbehr is one of the most cited advocates for the model. AtlasMD publishes its pricing and lab cost lists publicly, making it a useful reference point even for patients outside Kansas. Typical rates: $50/month (adults under 44), $75/month (adults 44–64), $10/month per child.

Plum Health DPC

Plum Health DPC (plumhealthdpc.com), based in Detroit, Michigan, is a widely cited urban DPC practice. Founder Dr. Paul Thomas practices publicly and blogs extensively about the economics of DPC, making Plum Health a good reference for what the model looks like in a Midwestern mid-size city context. Pricing runs approximately $79/month for adults.

One Medical

One Medical (onemedical.com), acquired by Amazon in 2023, operates a hybrid model: $199/year membership fee, then bills your insurance for individual visits. It is more accurately described as a premium primary care network than a pure DPC practice. One Medical has over 100 locations in major cities. Because it still bills insurance, it lacks the wholesale lab and medication cost advantages of true DPC. However, it delivers the enhanced access (same-day, extended hours, telehealth) that is the other defining feature of DPC.

Forward Health

Forward Health (goforward.com) operates at approximately $149/month and positions itself as a tech-first primary care membership. Forward includes wearable biosensors, in-office biometric screening panels, and AI-assisted health monitoring. It does not bill insurance. As a pure membership model it qualifies as DPC, though it operates at a higher price point than most DPC practices.

Qliance: a cautionary tale

Qliance was a Seattle-based DPC network that became one of the most visible examples of the model in the early 2010s, eventually partnering with Medicaid and commercial insurers to test DPC at scale. Despite promising outcomes data, Qliance shut down in 2017 after losing a major insurance contract. The lesson from Qliance is that DPC practices that become financially dependent on a single payer—even if that payer is a commercial insurer contracting DPC rather than fee-for-service—carry concentration risk. The most resilient DPC practices are those with diversified direct membership rosters.

Iora Health (now One Medical)

Iora Health was a Boston-based DPC-model company focused on Medicare and high-utilization patients, using health coaches alongside physicians. Iora was acquired by One Medical in 2021, which was subsequently acquired by Amazon. Iora's research contributed significant outcomes data supporting the DPC model for complex, high-utilization patients.

How to find a DPC doctor

Two primary directories:

• DPC Frontier (dpcfrontier.com/mapper) — the most complete independent directory of DPC practices in the United States. Maintained by DPC advocates; searchable by ZIP code and specialty. Listings include pricing where practices choose to publish it.
• Hint Health locator (hint.com/find-care) — covers the large subset of practices running on the Hint platform. Often includes current enrollment status (open vs. closed panels).

When evaluating a DPC practice, ask: Is the practice currently accepting new members? What is the panel size? What does the monthly fee include vs. charge separately? Does the practice have a dispensary? What imaging and specialist referral pathways do they use? What happens if you need hospitalization—does the physician coordinate?

The DPC + HDHP pairing: how the math works

DPC covers roughly 80–90% of primary care needs. What it does not cover—hospitalizations, specialist visits, ER, surgery—is precisely what insurance is designed for. This makes DPC a natural pairing with a high-deductible health plan (HDHP) that provides catastrophic coverage at a lower premium than a full-coverage PPO.

Here is a realistic cost comparison for a 35-year-old individual in a mid-size city:

The DPC + HDHP combination saves approximately $2,700–$3,200 per year in a relatively healthy year compared to a PPO with similar catastrophic coverage. When the HDHP is paired with an HSA, those savings can be invested and compounded tax-free—which is where the real long-term value accumulates. See our HSA tax savings calculator to model the tax benefit on your specific contribution and income.

The catastrophic HDHP covers you for the scenarios DPC does not: a surgery, a hospitalization, an unexpected specialist cascade. If you go a year without a major event, the premium savings and DPC membership together put you significantly ahead versus the PPO.

DPC + healthsharing plans

An alternative to the DPC + HDHP pairing is DPC combined with a healthsharing plan (also called a health cost-sharing ministry). Healthsharing plans like Medi-Share, Sedera, Liberty HealthShare, and Zion Health are not insurance but member-funded pools that share the cost of major medical events among members. They are not regulated as insurance and have specific eligibility requirements (often Christian faith-based, though Sedera and others are secular).

Several major healthsharing plans explicitly partner with or recommend DPC as a companion arrangement. The logic is clean: DPC handles 80–90% of primary care needs at a predictable monthly cost; the healthsharing plan handles the large, unpredictable events (surgeries, hospitalizations, specialist cascades) through member-to-member sharing. Medi-Share, for example, has published guidance recognizing DPC as compatible with its model.

Sedera Health has formalized a DPC partnership model through its "Sedera + DPC" offering, explicitly pairing a DPC membership with a Sedera health share plan. The combined monthly cost for an individual might be $100–$150/month DPC + $150–$300/month Sedera share, totaling $250–$450/month—still below many ACA marketplace premiums for comparable catastrophic coverage.

Important caveat: healthsharing plans are not insurance. They do not guarantee payment, they typically exclude pre-existing conditions for an initial period, they do not have the ACA's guaranteed-issue protections, and they are not subject to state insurance commissioner oversight. Evaluate carefully before treating a healthsharing plan as an insurance substitute.

IRS rules: can you use an HSA to pay DPC membership fees?

This changed in 2026. Yes — you can now use HSA funds to pay DPC membership fees, up to $150/month for one person ($300/month for more than one), thanks to the One Big Beautiful Bill Act (OBBBA), enacted July 2025 and effective for months beginning after December 31, 2025. Before 2026 the answer was no. Here is how the rule evolved and exactly what it allows today.

The old rule: IRS Notice 2017-67

For years the governing guidance was Notice 2017-67 (issued October 2017), which treated a Direct Primary Care arrangement as not insurance and concluded the monthly membership fee was not a "qualified medical expense" eligible for HSA reimbursement under IRC §213(d). Under that reading, DPC fees could not be paid from an HSA, and a DPC arrangement could even be argued to count as disqualifying coverage. That was the law through 2025.

What OBBBA changed for 2026

The One Big Beautiful Bill Act overrode that result on two fronts, effective for months beginning after December 31, 2025: (1) a qualifying DPC service arrangement no longer counts as disqualifying coverage, so it never threatens your HSA eligibility; and (2) DPC membership fees are now treated as qualified medical expenses payable from an HSA, capped at $150/month for one person and $300/month for more than one. To qualify, the arrangement must be limited to primary care services and cost no more than those monthly caps. Most DPC memberships ($25–$150/month) fall within the individual cap, so the full fee is now HSA-eligible.

Can you still contribute to an HSA if you have DPC?

Yes. To contribute to an HSA you must be enrolled in a qualifying High-Deductible Health Plan (HDHP) and have no other disqualifying coverage. As of 2026, a qualifying DPC arrangement (one within the $150/$300 monthly caps) is explicitly not disqualifying coverage, so DPC + a qualifying HDHP cleanly preserves your HSA eligibility. You can contribute up to the 2026 annual HSA limit ($4,400 individual / $8,750 family, with $1,000 catch-up for 55+) and use those funds for qualified medical expenses — now including the DPC membership fee itself, up to the monthly cap.

FSA eligibility

FSA treatment of DPC fees is less settled than the HSA rule. Because OBBBA reframed qualifying DPC fees as amounts paid for medical care, some FSA administrators now reimburse them, but practice remains inconsistent across plans. Do not rely on FSA reimbursement for DPC fees without written confirmation from your plan administrator.

How the law got here: the Primary Care Enhancement Act

Congressional advocates pushed the Primary Care Enhancement Act (informally the Federal DPC Act) for years to let HSA holders pay DPC fees. Its core provisions were ultimately folded into the One Big Beautiful Bill Act and signed into law in July 2025, taking effect for 2026. The long-debated change — HSA-payable DPC fees plus DPC as non-disqualifying coverage — is now active law, which is why the DPC + HDHP + HSA combination is more financially attractive than it was through 2025.

State regulatory landscape

A significant legal concern in DPC's early years was whether the monthly membership model constituted the unlicensed practice of insurance—which would subject DPC practices to state insurance commissioner regulation, minimum benefit mandates, and actuarial reserve requirements that would make the model economically unviable.

The DPC community has largely resolved this through state-level legislation. As of 2026, more than 35 states have enacted DPC-specific statutes that explicitly exempt DPC agreements from state insurance regulation. These statutes typically define a DPC arrangement by its key features—flat periodic fee, primary care services only, not for the purpose of spreading risk—and declare that such arrangements do not constitute insurance contracts. States with such statutes include Texas, Kansas, Utah, Virginia, Michigan, Tennessee, and many others.

In states without DPC statutes, practices operate in a legal gray zone. Most state insurance commissioners have not moved to regulate DPC, but the absence of a statute creates uncertainty. Physicians in non-statute states should work with healthcare attorneys before launching a DPC practice.

Who DPC is best for

• Self-employed individuals and freelancers who buy their own insurance and are highly cost-sensitive. The DPC + low-premium HDHP combination is often the optimal cost structure for a healthy self-employed person in their 30s or 40s.
• Small business owners offering DPC as an employee benefit. A $75/month DPC membership costs less per employee than the employer contribution increase required to move to a richer PPO, and employees often value the access improvement more than a slightly lower deductible.
• Patients who frequently use primary care and want longer visits, same-day access, and direct physician communication. If you visit your primary care doctor 6–10 times per year, DPC membership often pays for itself in avoided co-pays and urgent care visits alone.
• Patients with manageable chronic conditions (controlled diabetes, hypertension, hypothyroidism, asthma) who need frequent medication management and labs but not intensive specialist care. DPC's wholesale lab pricing and in-office dispensary pricing can save hundreds per year for this group.
• Families with young children who generate high primary care utilization (frequent sick visits, well-child checks, sports physicals). At $10–$25/month per child, DPC membership is often cheaper than the co-pays and urgent care visits it replaces.
• People who want a real relationship with their physician and are frustrated by the revolving-door nature of fee-for-service primary care.

Who DPC is NOT the right fit for

• Heavy users of specialists. If your primary health concerns are managed by a cardiologist, rheumatologist, or oncologist rather than a primary care physician, the DPC membership adds cost without covering your main healthcare consumption.
• People with complex chronic conditions requiring frequent specialist coordination. DPC physicians can coordinate care, but if you need monthly specialist visits, expensive brand-name medications, or frequent imaging, your cost is driven by factors entirely outside DPC coverage.
• Employees on employer-sponsored PPO plans with low primary care co-pays. If your employer-sponsored PPO has a $20 co-pay and covers your primary care visits at low cost, paying $75/month additional for DPC rarely pencils out financially. DPC makes the most economic sense as a replacement for expensive individual or small-group coverage.
• Patients who rarely see a doctor. If you visit a primary care physician once every two years for a routine physical, the monthly DPC fee may exceed what you would have paid in co-pays under traditional insurance.
• People who need coverage continuity above all else. DPC practices can close, physicians can leave, and panels can grow unwieldy. DPC does not have the network breadth or regulatory consumer protections of insurance.

Questions to ask a DPC practice before signing up

1. What is your current panel size and are you accepting new patients? A practice with 700 patients and a 600-patient target is different from one with 1,200 patients and a burned-out physician.
2. What is the monthly fee by age tier, and is there a family cap? Get the full fee schedule in writing.
3. What is included vs. billed separately? Are minor procedures included? In-office testing? Vaccines?
4. Do you have an in-office dispensary? What medications do you stock and at what prices?
5. What are your lab costs? Ask for a sample price list of common panels.
6. What is the notice period to cancel membership? Most practices require 30 days' notice.
7. What happens if I need specialist care? Does the practice have preferred referral relationships with cash-pay or discounted-rate specialists?
8. How do you handle after-hours calls and weekends? Direct cell access to the physician, or a covering physician?
9. What is your policy on prescribing controlled substances? Some DPC practices have stricter policies than fee-for-service physicians.
10. What is the contract term? Month-to-month or annual? Month-to-month is preferable for new members.

DPC and your broader tax-advantaged account strategy

The DPC + HDHP combination is most powerful when the premium savings are channeled into an HSA. Here is how the strategy fits together:

1. Switch from PPO to HDHP + DPC. Your monthly fixed cost drops by roughly $200–$250/month.
2. Contribute the savings to your HSA. At $225/month in HSA contributions, that is $2,700/year invested pre-tax. At a 22% federal bracket plus state taxes, the immediate tax savings is $600–$800/year.
3. Use DPC for 80–90% of primary care needs at low cost. Labs at wholesale ($30–$50/year for routine panels), generics at cost, unlimited visits included.
4. Let the HDHP handle catastrophic events. Your HSA accumulates for years when you are healthy, and is available for deductible and out-of-pocket costs in a bad year.
5. Long term, the invested HSA compounds tax-free and can be used in retirement for any expense (after 65) or for qualified medical expenses at any age—including Medicare premiums.

One detail to plan around: as of 2026, HSA reimbursement of DPC fees is capped at $150/month for one person ($300/month for more than one). For the typical $25–$150/month membership the full fee is now HSA-eligible — a real improvement over the pre-2026 rule, when none of it qualified. If your membership costs more than the cap, only the excess comes out of post-tax income. Even before this change the combination usually beat a high-premium PPO for most healthy-to-moderately-healthy individuals and families; now the after-tax math is stronger still.

For a full comparison of HSA vs FSA and how each interacts with plan type choices, see HSA vs FSA: which one wins for your situation. To quantify your specific HSA tax savings under the HDHP + DPC scenario, use the HSA tax savings calculator.

Is DPC right for your situation?

Direct Primary Care is not a fringe experiment anymore. With more than 35 states having passed DPC-enabling statutes, thousands of practices operating on mature platforms like Hint Health, and a growing body of outcomes data from practices like AtlasMD and former Iora Health, DPC is an established alternative delivery model for primary care. For the right person—self-employed, family on an HDHP, anyone frustrated by inaccessible fee-for-service primary care—the math often works strongly in its favor. The $75/month membership fee buys something the traditional system rarely delivers: a physician who knows your name, answers your texts, and has time to think about your care. Pair it with a qualifying HDHP, fund your HSA aggressively, and you have a primary care and savings strategy that outperforms the default PPO for many households by thousands of dollars per year.

Shirley Chia — Researcher & Editor

Editor of HealthCostHub. Researches healthcare pricing, financing, and tax-advantaged accounts.

LinkedIn · Profile

Reference information only — not tax, insurance, or financial advice. IRS guidance, state DPC statutes, and practice pricing change; verify current rules with a tax professional and confirm pricing directly with any DPC practice before enrolling. Last updated June 2026.