Direct Primary Care vs Traditional Primary Care
Direct Primary Care (DPC) and traditional primary care both give you a doctor who manages your everyday health. The difference is how you pay and how the practice is set up. DPC is a membership with the practice for a flat monthly fee, and it is not insurance. Traditional primary care is usually billed visit by visit through your health insurance.
| Criterion | Direct Primary Care (DPC) | Traditional primary care |
|---|---|---|
| How you pay | Flat monthly membership fee paid directly to the practice (national average about $99 per member) | Copays, coinsurance or deductible for each visit, plus your monthly insurance premium |
| Insurance billing | None. DPC is not insurance, and the practice does not bill insurance for its services | Each visit is billed to your insurance plan |
| Patients per doctor | DPC doctors with full practices most often report about 400 to 700 patients | Family physicians reported an average of about 1,786 patients in 2022 |
| Time and access | Smaller patient panels can leave room for longer visits, quicker appointments and direct phone, text or video contact | Access depends on the practice; larger panels can mean shorter visits and longer waits |
| Labs and medications | Some practices offer labs and medications at posted cash prices; ask for the price list | Labs and prescriptions follow your plan's pricing and deductible |
| Specialists, hospital and emergencies | Not included; you need a separate layer such as insurance or health sharing | Handled by the same insurance plan, subject to its deductible and network |
| HSA compatibility | A qualifying DPC membership of up to $150 a month ($300 for more than one person) no longer blocks HSA contributions | Works with an HSA when your insurance is an HSA-qualified high-deductible plan |
| Often fits | People who want more time with their doctor, easy access and a predictable monthly cost | People who rarely see a doctor, have low primary care copays, or want one plan for all care |
How Direct Primary Care works
The DPC Alliance defines a DPC practice as a primary care practice that charges a fixed, periodic fee and does not bill insurance for the clinical services it provides [1]. The IRS describes these arrangements the same way: a fixed periodic fee for primary care services and items such as physical exams, vaccinations, urgent care, lab testing, and the diagnosis and treatment of some illnesses and injuries [2].
Prices vary by region and setting. In the DPC Alliance’s 2026 physician survey, the national average membership price was $98.64 per member per month. Regional averages were $98.38 in the South, $110.44 in the Northeast, $113.28 in the West and $80.36 in the Midwest, and rural practices averaged $81.56 compared with $110.00 in urban practices [1]. Most practices (76.4%) set prices by age [1]. For a fuller breakdown, see How Much Does Direct Primary Care Cost in 2026?
Why access can feel different
The biggest structural difference is how many patients each doctor looks after. Among DPC physicians who said their practice was full, panel sizes clustered around 400 to 700 patients [1]. By comparison, family physicians certified by the American Board of Family Medicine reported an average of 1,786 patients in 2022, down from 2,386 in 2013 [3].
Fewer patients per doctor can leave room for longer visits, same-day or next-day appointments, and direct contact by phone, text or video. Experience still varies by practice, so ask each one how quickly patients are usually seen.
What DPC does not do
Direct Primary Care is a membership arrangement with your doctor for primary care services. It is not insurance and doesn’t meet ACA minimum coverage requirements on its own. That is why it works as one layer, not the whole plan:
- Everyday care layer: DPC for checkups, sick visits and ongoing condition management.
- Large-event layer: health insurance, such as a Marketplace or employer plan, or a health sharing program for hospital stays, surgery, specialists and emergencies. Health sharing is not insurance, sharing is not guaranteed, and it does not count as minimum essential coverage.
Our hybrid models comparison walks through common pairings and who each one tends to fit.
DPC and Health Savings Accounts
For months beginning after December 31, 2025, a qualifying DPC arrangement no longer makes you ineligible to contribute to a Health Savings Account (HSA), and an HSA can pay the membership fee [2]. To qualify, the arrangement must provide only primary care from primary care practitioners for a fixed periodic fee, and total fees cannot exceed $150 a month for one person or $300 a month for an arrangement that includes more than one person [2]. Procedures that require general anesthesia, prescription drugs other than vaccines, and lab services not typically done in a primary care office don’t count as primary care for this rule [2]. You still need an HSA-qualified high-deductible health plan to contribute.
This is general educational information, not tax or legal advice. Talk with a qualified tax professional about how this applies to your situation.
Questions to ask a DPC practice
- What is the monthly fee for each person in my household, and is there an enrollment fee?
- Which labs and medications do you offer, and at what prices?
- How quickly can I usually be seen, and how do I reach the doctor after hours?
- How many patients does each clinician care for?
- If I plan to use an HSA, does the membership fit the IRS limits?
- How do I cancel, and is there a minimum term?
DPC for employers
Employers can offer DPC as a benefit alongside a group plan or a CHOICE Arrangement (formerly ICHRA), so employees get easy primary care access while insurance handles larger costs. Learn more on our employers page, or book a consultation to compare options for your household or team.
REFERENCES
[1] Direct Primary Care Alliance. “State of Direct Primary Care 2026.” DPC Alliance, July 2026. https://dpcnews.com/wp-content/uploads/2026/07/State_of_DPC_FINAL2026.pdf
[2] Internal Revenue Service. “Notice 2026-5: Expanded Availability of Health Savings Accounts under the One, Big, Beautiful Bill Act (OBBBA).” IRS, December 2025. https://www.irs.gov/pub/irs-drop/n-26-05.pdf
[3] Bazemore, A., and Morgan, Z. “Declines in Self-reported Panel Size among Family Physicians & Explanatory Factors, 2013-2022.” Annals of Family Medicine (NAPCRG abstract supplement), November 2024. https://www.annfammed.org/content/22/Supplement_1/6242
Frequently asked questions
Is Direct Primary Care insurance?
No. Direct Primary Care is a membership arrangement with your doctor for primary care services. It is not insurance and doesn't meet ACA minimum coverage requirements on its own.
How much does Direct Primary Care cost?
The national average is about $99 per member per month, according to the DPC Alliance's 2026 survey of DPC physicians. The Southern regional average is about $98, and averages range from about $80 in the Midwest to about $113 in the West.
Do I still need insurance if I join a DPC practice?
In most cases, yes. DPC handles primary care only, so most members pair it with health insurance, such as a Marketplace or employer plan, or with a health sharing program for hospital stays, surgery and specialists. Health sharing is not insurance and does not count as minimum essential coverage.
Can I use an HSA with Direct Primary Care?
Starting in 2026, a qualifying DPC arrangement of up to $150 a month for one person, or $300 for more than one person, no longer prevents you from contributing to an HSA, and HSA funds can pay the fee. You still need an HSA-qualified high-deductible health plan. This is general educational information, not tax or legal advice. Talk with a qualified tax professional about how this applies to your situation.
Can I keep my current doctor and insurance and still try DPC?
You can keep your health insurance and add a DPC membership. Whether you keep your current doctor depends on whether that doctor runs a DPC practice. Many people find a DPC practice near them and keep their insurance for everything outside primary care.
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