What is Direct Primary Care?
Direct Primary Care (DPC) is a membership-based alternative to insurance-billed primary care. Patients pay a flat monthly fee directly to a physician's practice for unlimited access — no co-pays, no claim forms, no surprise bills. Here is how it works, what it covers, and how it compares to the insurance-based system most Americans are used to.
What is Direct Primary Care?
Direct Primary Care (DPC) is a healthcare delivery model in which patients pay a flat monthly or annual fee directly to their primary care physician's practice in exchange for unlimited access to that physician — office visits, virtual visits, text messages, and care coordination — with no insurance company in between. Because the physician does not bill insurance for primary care services, there are no co-pays, no claim denials, and no EOBs.
Is Direct Primary Care the same as concierge medicine?
They are related but not identical. Concierge medicine practices typically charge an annual retainer and still bill insurance for each visit. DPC practices charge a membership fee and do not bill insurance for primary care. DPC is usually lower-cost and designed for everyday primary care rather than VIP amenities.
Is Direct Primary Care insurance?
No. DPC is a membership, not insurance. It does not satisfy minimum essential coverage under the Affordable Care Act (ACA). Most DPC members pair their membership with a high-deductible health plan, a health-share program, or catastrophic coverage to handle hospitalizations, surgery, and complex specialty care.
How much does Direct Primary Care cost?
DPC memberships typically range from roughly $50 to $150 per month per adult in the United States. CashPrice Health's CarePass Go membership is $83/month billed annually (or $99/month billed monthly) for virtual DPC; CarePass Pro is $125/month billed annually (or $149/month billed monthly) for in-person + virtual DPC with a local CashPrice Health DPC partner physician, plus a 24/7 personal care coordinator. Both tiers include $0 generic prescriptions, discounted labs, hospital bill negotiation, and cash-pay directory access for specialists, imaging, and surgeries.
What does a DPC membership cover?
A DPC membership covers unlimited primary care with your physician: routine check-ups, acute care (e.g. coughs, infections, minor injuries), chronic disease management (diabetes, hypertension, thyroid), preventive screening, basic procedures, and coordination of specialist care. It does not cover services performed outside the practice (imaging, hospital care, surgery, specialist visits) — those are paid separately, usually at negotiated cash prices.
How does DPC save money?
Three ways. First, the DPC physician has a smaller panel (typically 400–800 patients vs. 2,000–3,000 in insurance-based practice), so they spend longer with each patient and catch problems before they become ER visits. Second, members avoid co-pays, deductibles, and surprise bills for routine care. Third, DPC practices typically pass through wholesale pricing on labs, generics, and in-office procedures — often 50–90% below retail.
Can I use my HSA or FSA to pay for DPC?
As of 2026, the IRS does not explicitly classify DPC monthly fees as qualified medical expenses for HSA/FSA purposes, although bipartisan legislation (the Primary Care Enhancement Act) has been repeatedly introduced to change that. HSA and FSA funds can still be used for most lab fees, procedures, and prescriptions not covered by the DPC fee itself. Consult your tax professional for current guidance.
What happens if I need a specialist or hospital care?
Your DPC physician refers you, often after handling the diagnostic workup in-house. With CashPrice Health, your personal care coordinator finds a specialist, retrieves a transparent cash price up-front, and books the appointment. For hospital or surgical care, you can use insurance, a health-share program, or negotiated cash rates. The goal is never 'insurance solves everything' — it is 'you always know the price before you go.'
Where is DPC available?
Direct Primary Care is available in all 50 U.S. states. Regulation varies — roughly 35 states have enacted DPC-specific statutes clarifying that DPC is not insurance — but the practice model itself is legal everywhere. CashPrice Health is opening state-by-state, starting with the Houston / The Woodlands area in Texas through the founding DPC partner Meridian Springs Primary Care; virtual Go membership follows telehealth-regulation permissibility state by state.
Who is a good fit for DPC?
DPC works particularly well for: self-employed people and small business owners who pay for their own coverage; families who want predictable healthcare costs; people with chronic conditions who benefit from longer visits and ongoing texting access; anyone tired of rushed 7-minute appointments; and households already on a high-deductible plan who want routine care handled without hitting the deductible.