How to tell if direct primary care is right for you

Everyone needs a primary care doctor who knows their history and health goals. Joining a direct primary care practice, also known as DPC, is one good way to have a primary care doctor as your partner in health.

Direct primary care can make it easier to see your doctor quickly and more often. You’ll pay differently for direct primary care compared to costs at a traditional practice. Direct primary care pricing is simple and straightforward, and you can check with direct primary care practices to see what they’ll charge.

Here’s what you need to know to see whether direct primary care is right for your finances and health needs.

What is direct primary care?

At traditional primary care offices, patients usually use insurance to help pay for doctor’s appointments. Doctors at direct primary care practices are unique because they rarely or never take insurance.

The direct primary care membership fee often gets patients longer visits with their doctor, and special services like same-day appointments and texting.

What direct primary care doctors can do

Direct primary care doctors provide primary care, just as traditional primary care doctors do. They also usually see patients of all ages—treating babies, children and adults.

All primary care doctors help you be as healthy as possible. That means they try to keep you from getting sick, and they help you figure out what’s wrong and how to get better when you are sick. Primary care doctors take care of both your mental health and your physical health. They prescribe medicine, run certain tests and perform many medical procedures.

Primary care doctors help patients with many issues, like:

• Wellness and lifestyle
• Chronic disease management
• Preventing illness
• Minor procedures
• Weight management
• Urgent care

Some of the procedures that direct primary care doctors perform are:

• EKGs to test your heartbeat
• Stitches for cuts
• Biopsies to check for skin problems

Direct primary care costs

The price for direct primary care averages $20 to $49 a month for children, $50 to $100 a month for adults and $100 or more for a family. Some practices also charge a one-time enrollment fee.

The cost of direct primary care membership varies, but pricing is straightforward and you can find out the exact amount from the direct primary care practices you’re considering.

Your monthly fee will cover certain things at your direct primary care doctor’s office, like routine care and easy access to your doctor. Other services, such as prescriptions, some lab tests and some procedures, may have additional costs, but prices are often highly discounted at a DPC office. Your DPC doctor will know how much everything you need will cost and they can give you prices before your visit.

Ways to help pay for DPC

There are options for paying direct primary care fees without handling them as costs direct from your bank account.

• Employee benefit: Many employers have agreements with direct primary care doctors that cover all or some of your membership.
• Health savings account (HSA): You can use your HSA to pay direct primary care fees, up to $150 per month for yourself or up to $300 per month for your family. But you can’t pay for prescriptions you buy from your direct primary care doctor using a health savings account.
• Low-income discount: Some direct primary care practices offer discounts or some free care for patients who have low income.

Does direct primary care count as insurance?

No, a direct primary care membership is not insurance. You should have insurance for services that DPC doesn’t offer, like emergency room or hospital care.

Remember, though, that having a regular family doctor helps you avoid the ER, urgent care and hospital.

Direct primary care pros and cons

When you’re considering whether direct primary care or a traditional doctor’s office is right for your health needs and budget, think about how the benefits and drawbacks of DPC apply to you.

Pros:

• More time with your doctor at appointments than you’d typically get an office that takes insurance
• Easy to reach your doctor by text, phone or email
• More affordable to pay DPC fees than co-pays in many cases 
• Most of your health needs are things that primary care doctors are trained to handle

Cons:

• Hospital visits or other specialist care not covered by direct primary care fees
• Health savings accounts limit how much can be used for DPC fees
• Health insurance (or a healthshare) is still recommended to cover other medical expenses

Is direct primary care right for me?

Direct primary care is a great choice if it meets your health and financial needs. Consider DPC if you:

• Want fast access to your family doctor and are comfortable paying the monthly fee
• Don’t have insurance but can afford a monthly fee for regular primary care
• Have medical insurance mostly for big emergencies and want to self-pay for regular primary care
• Work for an employer who offers direct primary care benefits at low or no cost
• Need to see your primary care doctor often

How can I find direct primary care doctors near me?

There are direct primary care practices in many cities, big and small. You can find one near you with the DPC Alliance Physician Directory or the DPC Frontier Mapper, or just search online.