How is direct primary care different from concierge medicine?

Direct primary care does not bill insurance for the services covered by the membership. Most concierge practices do bill insurance for clinically covered services AND charge a separate membership fee. DPC tends to be less expensive ($100 to $200 per month versus $1,800 to $5,000+ per year for concierge), simpler in structure, and more transparent about what is included. Concierge practices often offer more comprehensive annual physicals and longevity-focused testing as part of the membership.

Is direct primary care worth it?

DPC is worth it for patients who value time with their physician, transparent pricing, and a closer relationship with their primary care doctor. The math typically works for adults who see their doctor more than two or three times per year, anyone managing chronic conditions, families wanting consistent care across members, and self-employed adults wanting to decouple primary care from insurance complexity. Patients who rarely see a doctor and are on robust employer insurance may not see the value.

Can I use my HSA or FSA to pay for direct primary care?

Yes — DPC membership fees are HSA and FSA eligible under current IRS guidance. The IRS classifies DPC fees as qualified medical expenses. Some employers also offer DPC as a benefit, paying the membership directly or reimbursing employees through an ICHRA or QSEHRA arrangement.

What's included in a DPC membership?

Inclusions vary by practice but typically cover: office and telehealth visits with the physician, preventive care, chronic disease management, basic procedures (joint injections, skin procedures, suturing, etc.), care coordination with specialists, prescription management, wholesale-cost lab pricing, and direct communication with the physician. Some practices include in-house labs at no cost; others pass through wholesale lab pricing.

Can Medicare patients use direct primary care?

Yes, but the structure depends on whether the DPC physician is enrolled in Medicare. If the physician has formally opted out of Medicare, Medicare patients can pay the DPC fee but Medicare cannot be billed for any service from that physician. If the physician is Medicare-participating, the DPC arrangement must be structured carefully to comply with Medicare assignment rules — fees can only be allocated to genuinely non-covered services, not to services Medicare should cover. Private MD's Medicare-eligible patients are served through our Longevity Internal Medicine Program rather than DPC.

How is DPC different from One Medical or Forward Health?

One Medical and Forward Health are membership-based primary care chains, but they operate with much larger panels (1,500 to 2,000 patients per physician at One Medical) and bill insurance on top of the membership fee. True DPC practices cap panels much smaller (typically 300 to 600), do not bill insurance for primary care, and are independently owned rather than operated as venture-backed chains. Forward Health shut down in 2024; many former Forward members have transitioned to DPC.

How do I find a direct primary care doctor near me?

The DPC Frontier Mapper (mapper.dpcfrontier.com) is the most comprehensive directory of DPC practices in the United States. Search by ZIP code to find practices in your area. When evaluating practices, ask about panel size cap, what's included in the membership, lab pricing, after-hours communication, cancellation policy, and whether the practice offers a no-obligation meet-and-greet before enrollment.

Educational Guide

What Is Direct Primary Care?

Q: How much does direct primary care cost?

DPC monthly fees typically range from $75 to $200 per month for adults, with most practices charging $100 to $150 per month. Children are often included free or at reduced rates with a parent membership. Some DPC practices charge separately for visits beyond a defined number per year. Private MD's DPC membership is $149 per month for adults under 55, with the first 50 founding members locked at that rate.

Q: Do I still need health insurance with direct primary care?

Yes — DPC is not a replacement for health insurance. DPC covers primary care: office visits, preventive care, chronic disease management, basic procedures, and care coordination. You still need insurance (or a health-sharing plan) for hospitalization, surgery, specialty care, expensive imaging, ER visits, and catastrophic events. Many DPC patients pair the membership with a high-deductible health plan, an HSA, or a health-sharing ministry to keep total healthcare costs manageable.

A plain-English guide to direct primary care (DPC) — how it works, what it costs, and how it compares to concierge medicine, One Medical, Forward Health, and traditional insurance-based primary care. Written by a board-certified internist running a small-panel DPC practice in Folsom & El Dorado Hills, CA.

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Direct Primary Care, Defined

Direct primary care (DPC) is a primary care model in which patients pay a flat monthly membership fee directly to the practice — and the practice does not bill insurance for the services included in that membership. The fee covers office visits, preventive care, chronic disease management, basic in-office procedures, care coordination, and direct communication with the physician.

The DPC model emerged in the early 2000s as a direct response to two structural problems in insurance-based primary care: short visits (15 to 20 minutes) driven by reimbursement economics, and large patient panels (2,000 to 3,000 patients per physician) that make any one patient’s care necessarily rushed. By stepping outside the insurance billing system for primary care, DPC practices can carry much smaller panels (300 to 600 patients), offer longer visits, and price the relationship transparently.

DPC is sometimes called “membership medicine,” “subscription medicine,” or “cash-pay primary care.” These are the same model under different marketing names.

Important: DPC is not health insurance. It covers primary care. You still need insurance (or a health-sharing plan) for hospitalization, surgery, specialty care, expensive imaging, ER visits, and catastrophic events. Most DPC patients pair their membership with a high-deductible health plan and an HSA, an ICHRA from their employer, a health-sharing ministry, or a marketplace catastrophic plan.

How Direct Primary Care Works

1. Flat monthly membership

Patients pay the practice directly each month. Typical fees are $100 to $200 per month for adults; some practices price by age. There are no copays, no deductibles, no coinsurance, no surprise bills for primary care services. Many practices include children at reduced rates ($25 to $50 per child).

2. Insurance is not billed for membership-included services

This is the defining feature of DPC. The practice does not file insurance claims for primary care visits, basic procedures, or chronic disease management. Patients still keep their insurance for things outside primary care — but the primary care relationship is paid for directly, transparently, and without insurance company involvement.

3. Smaller panel

DPC practices typically cap panels at 300 to 600 patients per physician — versus 2,000 to 3,000 in traditional insurance-based primary care. The smaller panel is what makes everything else (longer visits, faster appointments, direct communication) economically possible.

4. Longer visits, faster availability

Routine visits are typically 30 to 60 minutes. Same-day or next-day availability is the norm. Telehealth is included. Direct phone, text, or secure-messaging access to the physician is standard.

5. Wholesale labs, transparent pricing

Most DPC practices either include common labs in the membership or pass through wholesale lab pricing — $4 to $6 for a comprehensive metabolic panel, $3 to $5 for a CBC, $4 to $6 for a lipid panel, $8 to $12 for an A1c, $17 to $25 for a comprehensive annual panel. This is dramatically less than hospital lab pricing, which can run $200 to $500 for the same panel.

6. Continuity

Same physician every visit. Care plans build across visits. The physician knows you and your history without re-reading the chart from scratch each time.

DPC vs Traditional Insurance-Based Primary Care

The differences are largely structural — driven by panel size and payment model.

Feature	Traditional Primary Care	Direct Primary Care
Panel size	2,000–3,000 patients	300–600 patients
Visit length	15–20 minutes	30–60+ minutes
Wait for routine appointment	2–6 weeks	Same- or next-day
Physician communication	Through portal/staff	Direct phone, text, or secure message
Cost transparency	Copay + deductible + coinsurance + surprise bills	Flat monthly fee, all-inclusive
Lab pricing	Hospital rates ($200–$500/panel)	Wholesale ($17–$25/comprehensive panel)
Continuity of physician	Variable — system-driven	High — same physician every visit
Insurance role	Insurance billed for everything	Insurance for catastrophic + specialty only

DPC vs Concierge Medicine

The terms are often used interchangeably, but they describe different structures.

DPC does not bill insurance for the services included in the membership. The patient pays a flat monthly fee, and that’s the entire cost of primary care.

Concierge medicine is a broader category. Most concierge practices bill insurance for clinically covered services AND charge a separate membership fee for additional services not covered by insurance. The membership is in addition to insurance copays, deductibles, and coinsurance for clinical visits.

Feature	DPC	Concierge Medicine
Insurance billed for primary care	No	Yes (for covered services)
Typical monthly cost	$100–$200/month	$150–$2,000+/month (plus insurance)
HSA/FSA eligible	Yes (DPC fees explicitly qualified)	Varies
Annual physical depth	Standard comprehensive	Often expanded (executive physical, advanced testing)
Best for	Adults wanting transparent, affordable, comprehensive primary care without insurance complexity	Adults wanting concierge-level access PLUS insurance billing for covered care (especially Medicare-eligible)
Compliance complexity	Lower	Higher (Medicare assignment rules)

Practically: if you’re under 55 and want straightforward, affordable, comprehensive primary care, DPC is usually the cleaner fit. If you’re Medicare-eligible (typically 65+) or want longevity-focused testing and interpretation as part of the membership, the concierge or hybrid concierge model often fits better. See our concierge medicine guide for more on hybrid concierge structures.

DPC vs One Medical, Forward Health & Other Membership Chains

Several venture-backed primary care chains are sometimes confused with DPC. They aren’t.

One Medical (Amazon)

One Medical, now owned by Amazon, charges approximately $200 to $250 per year as a membership fee in addition to insurance billing. The practice still bills insurance for every visit, including copays, deductibles, and coinsurance. Panels are typically 1,500 to 2,000 patients per physician — roughly the same as traditional primary care. The membership fee primarily buys access to a polished mobile app and same-day appointments. This is not DPC — DPC does not bill insurance for primary care.

Forward Health

Forward Health was a venture-backed primary care subscription operating approximately 2018 to 2024 at $149/month. Forward did not bill insurance, which made it look like DPC, but the panels were larger than typical DPC and the financial model was venture-backed rather than physician-owned. Forward shut down in late 2024. Many former Forward members have transitioned to independent DPC practices.

Function Health

Function Health is a direct-to-consumer testing service ($499/year) that runs an extensive lab panel and provides results with limited physician interpretation. It is not a primary care practice and does not provide medical care, prescriptions, or continuity. DPC + Function pairs well for some patients who want extensive baseline testing plus an actual physician to interpret and act on results.

Independent DPC practices

Independent DPC practices like ours are physician-owned, panel-capped, transparent about pricing, and do not bill insurance for primary care. Most are listed in the DPC Frontier directory — the most comprehensive map of DPC practices in the United States.

How Much Does Direct Primary Care Cost?

DPC pricing is consistently transparent — most practices publish exact monthly fees on their websites.

Patient Type	Typical Monthly Fee	Annual Cost
Adults (18–64)	$100–$200/month	$1,200–$2,400
Children (with parent member)	$0–$50/month	$0–$600
Couples	$180–$300/month combined	$2,160–$3,600
Family of four	$200–$350/month	$2,400–$4,200

Private MD’s Direct Primary Care is $149/month for adults under 55 — a founding-member rate locked for 24 months for the first 50 members. Couples may inquire about combined pricing. The practice serves adults only (18+) and does not accept pediatric patients.

For comparison: traditional insurance-based primary care often costs more in net out-of-pocket once copays, deductibles, prescription markups, and lab markups are added together — patients are often surprised that DPC + a high-deductible health plan + an HSA frequently totals less than a comprehensive PPO with low deductibles.

DPC, HSA, and How to Pair It with Insurance

HSA / FSA eligibility

DPC membership fees are HSA and FSA eligible under current IRS guidance — they qualify as medical expenses. This means you can pay your DPC membership with pre-tax dollars from your HSA, effectively reducing the cost by your marginal tax rate (often 25 to 35%).

Pairing DPC with insurance

Most DPC patients pair the membership with one of:

High-deductible health plan (HDHP) + HSA. Common pairing. The HDHP covers catastrophic events and specialty care; the HSA pays the DPC fee tax-free; primary care is handled directly through DPC.
ICHRA (Individual Coverage Health Reimbursement Arrangement). Some employers offer ICHRA to fund individual marketplace plans, and the DPC membership can be reimbursed.
QSEHRA (Qualified Small Employer HRA). Small employers can use QSEHRA to reimburse DPC fees and individual insurance premiums.
Health-sharing ministry. Christian Healthcare Ministries, Samaritan, Sedera, etc. — patient pays the DPC membership directly and the ministry covers larger medical events. Cheaper than insurance for healthy adults but with religious and underwriting restrictions.
Marketplace catastrophic plan. For under-30 adults or those qualifying for hardship exemption.
Standard PPO/HMO. Many DPC patients keep their existing insurance and use it for specialty/hospital care, paying the DPC fee separately.

Self-employed and small business

DPC fees may be deductible as a business expense for sole proprietors, partnerships, and S-corp owners — consult a tax advisor. Some small employers (under 50 employees) offer DPC as a stipend or through QSEHRA, which is often more economical than employer-sponsored health insurance for small panels.

Is Direct Primary Care Right for You?

DPC is most valuable for:

Adults managing chronic conditions. Hypertension, diabetes, hyperlipidemia, hormone issues, anxiety/depression — conditions where attentive longitudinal care meaningfully changes outcomes.
Self-employed adults and small business owners. Decouples primary care from health insurance complexity; pairs well with high-deductible plans + HSA.
Couples wanting consistent care. Same physician for both partners; predictable monthly cost. (Private MD serves adults only — pediatric patients are not accepted.)
Adults frustrated by short visits. If 15-minute visits aren’t enough time to actually address what brought you in, DPC’s 30 to 60 minute visits change the experience.
Adults wanting transparent pricing. No surprise bills, no copays, no deductibles for primary care.
Adults paired with high-deductible insurance. Routine primary care visits don’t count toward insurance deductibles anyway — DPC handles them more comprehensively for the same or less money.
Adults under 55 who don’t need Medicare. DPC is the cleanest fit for working-age adults.
Adults wanting to avoid corporate medicine. Independent physician-owned practice; relationships not algorithms.

DPC may not be the best fit for:

Adults with no chronic conditions who rarely interact with the medical system (traditional insurance may be sufficient).
Medicare patients (consider concierge or longevity-focused models structured for Medicare-participating physicians instead).
Patients preferring a large insurance-based health system with extensive ancillary services in one location.

How to Evaluate a DPC Practice

Before enrolling in any DPC practice, ask:

Panel size cap. A real DPC practice should have a defined cap. 300 to 600 is typical. Some are smaller.
What’s included. Office visits, telehealth, basic procedures, care coordination, prescription management, lab pricing — get this in writing.
Lab pricing. Are labs included, or pass-through wholesale, or charged separately? Hospital-priced labs inside a DPC membership defeats much of the value.
After-hours communication. What are the response time commitments? Who responds — the physician, a nurse, a portal team?
Cancellation terms. How long is the contract? What’s the cancellation policy?
Founding-member rate lock. Some practices offer founding-member rate locks (Private MD locks the first 50 founding members at $149/month for 24 months).
Physician training and tenure. Board certification, training program, years in practice.
Meet-and-greet. Most DPC practices offer a no-obligation introductory call before enrollment. If they don’t, that’s a flag.
HSA-eligible billing. Confirm the practice provides documentation that supports HSA reimbursement.

Where to find DPC practices

The DPC Frontier Mapper is the most comprehensive directory of DPC practices in the United States. Search by ZIP code. Filter by acceptance of new patients, languages, and specialties.

If This Sounds Like What You're Looking For

Private MD is a small-panel, physician-owned direct primary care + longevity practice serving Folsom, El Dorado Hills, Granite Bay, Roseville, Sacramento, and the surrounding area. Direct Primary Care is $149/month for adults under 55, with the first 50 founding members locked at that rate for 24 months. Longevity Internal Medicine ($299/month) is available for adults 55+ or as an add-on at any age.

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Founder Nishant Sahni, MD — board-certified internist; former Mayo Clinic and University of Minnesota faculty.