What is Direct Primary Care?
Direct Primary Care (DPC) is a primary-care model in which patients pay a monthly fee directly to their practice for defined primary-care services, instead of the practice billing insurance for routine visits. Removing insurance billing for routine care lowers administrative overhead, which is what allows a smaller patient panel, longer appointments and direct access to the physician.
How does DPC work day to day?
You enroll, complete an initial visit that establishes your history and plan, and then use the practice as your medical home: preventive and wellness visits, sick visits, chronic condition management, medication management, and direct communication with the practice between visits. Telemedicine is used when a virtual visit is clinically appropriate.
How much does Direct Primary Care cost?
Costs vary by practice and by household size. At Direct Prime Care, membership is billed monthly with individual, couple, children and family options, and there is no enrollment fee. Current pricing is published on the membership page rather than quoted only by phone.
What does DPC membership include?
Inclusions are defined by the membership agreement. At this practice that means the primary-care services described in the agreement — preventive and wellness care, acute visits, chronic disease management, medication management, longer appointments, direct communication, and coordination of outside care. It does not mean unlimited care or every service imaginable.
Does Direct Primary Care replace health insurance?
No. DPC membership is not health insurance and is not a substitute for it. Members should keep appropriate coverage for emergencies, hospitalization, surgery, specialty care and imaging. DPC covers the primary-care layer; insurance covers catastrophic and specialty costs.
Can you have DPC and insurance at the same time?
Yes, and most members do. Your coverage continues to apply to care obtained outside the practice. Some members pair a DPC membership with a higher-deductible plan; whether that is financially sensible depends on your health, household and plan.
Can a DPC membership be paid with an HSA or FSA?
This depends on your plan administrator and current tax rules, which have changed over time and continue to be debated. Ask the practice how fees are documented, then confirm eligibility with your plan administrator before assuming a membership fee qualifies.
How is DPC different from traditional primary care?
Traditional practices depend on insurance reimbursement, which pushes toward larger panels and shorter visits. DPC practices are paid directly by patients, so panels are smaller, visits are longer and access is more direct. The clinical medicine is the same family medicine — the difference is time, access and billing.
How is DPC different from concierge medicine?
Concierge practices typically charge a retainer in addition to billing insurance for visits. DPC practices generally do not bill insurance for routine primary care at all, and membership fees are usually lower than concierge retainers. Direct Prime Care follows the DPC model and does not currently accept insurance for membership primary care.
Can families and children join?
Yes. Children can be enrolled individually or through a family membership, so one physician can follow the whole household.
Does DPC include telemedicine?
At this practice, yes — virtual visits with your own physician are used when a video or phone visit is clinically appropriate. Some problems require an in-person examination, and you will be told when that is the case.
What happens if a DPC patient needs a specialist?
Your physician refers you, sends the relevant records, and reviews the specialist's findings with you afterward. Specialty visits are billed by that specialist and may be covered by your insurance.
Are laboratory tests included in DPC membership?
This differs by practice, so ask directly. Laboratory testing is offered through Direct Prime Care; where a test is not included in membership, it is billed separately and the cost is explained before it is ordered.
Is Direct Primary Care worth it?
It depends on what you value. If you rarely need care and want the lowest possible monthly spend, it may not be. If you have ongoing conditions, unanswered questions, or you have been unable to reach a physician when something changed, the access and time are usually the deciding factors.
This guide is general education, not medical advice, and does not create a physician-patient relationship. Direct Primary Care membership is not health insurance. Members should maintain appropriate insurance or other coverage for services outside the membership, including emergencies, hospitalization, specialists, imaging, and other services not included in the membership.