FOR THE PUBLIC
Why Direct Primary Care
Direct Primary Care is an innovative health care model that offers full service primary care for a flat monthly fee.
Membership benefits typically include unlimited visits and a direct line of communication with your chosen physician.
Direct Primary Care enables physicians to have the time to fully evaluate health issues, which leads to higher quality care and better health outcomes. It prioritizes developing a personalized connection between the patient and the physician, while also seeking to provide care at an affordable price.
We believe these to be core values in medicine, and they have become increasingly difficult to implement in the current insurance-driven healthcare system. In our model, patients have easy access to the physician via phone, text, video chat (zoom) and in-person visits.
How can this model work? It turns out, there is an incredible amount of waste in our current healthcare system. By stepping out of the insurance ecosystem, we can greatly reduce overhead costs and pass those savings on to our patients. Cutting out the middlemen and keeping things simple allows us to have more time to do what we love….spending time with our patients!
90% of Direct Primary Care patients are satisfied with their healthcare, as opposed to 67% in a traditional practice.
Physicians spend, on average, five times longer with each and every patient in the Direct Primary Care model.
Direct Primary Care patients have 40% fewer ER visits and 26% lower hospitalizations rates, compared to traditional practices.
Frequently Asked Questions
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Direct Primary Care practices do not bill insurance or contract with any other private or pubic health insurance plans, because stepping away from insurance-based care is what allows them to offer affordable, transparent, up front pricing and extended appointment times.
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While insurance is not required, it is recommend. A membership with a Direct Primary Care office should cover most of your primary care needs. However, insurance is still helpful for services we do not directly provide such as specialty care, ER visits, hospitalizations and surgery.
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In both models, patients enjoy the individual attention and communication they deserve from their physicians. In addition, both concierge and Direct Primary Care practices work off memberships models.
However, concierge practices still contract with insurance companies, and as a result are required to collect copays and deductibles, in addition to the membership fee. Concierge membership fees also tend to be more expensive, tailoring to only one subset of our patient population.
Lastly, concierge offices are unable to sell wholesale medications and lab services. Direct Primary Care practices are able to do all of this because they don’t take insurance.
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The process for seeing a specialist does not change if you join a Direct Primary Care Practice in that you can use your insurance for the consultation. This is also true for hospitalizations.
However, some insurance plans (particularly HMO’s) do require prior authorizations from your primary care provider. Who can provide this authorization is also dependent upon the state in which you live and receive your care. We always recommend discussing this with your Direct Primary Care physician when you enroll.
Most practices offer heavily discounted cash prices for labs and have knowledge on affordable cash pay imaging services for those with high deductible health plans though you can always choose to use your insurance at a location of your choice.
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This varies state by state and we recommend discussing this with your personal accountant.
As of January 1, 2026 The "One Big Beautiful Bill Act" (OBBBA) officially federally recognizes Direct Primary Care (DPC) as a qualified medical expense.
You can now use your pre-tax HSA funds to pay for monthly DPC membership fees, subject to limits of $150/month for individuals and $300/month for family.
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The New England Direct Primary Care Alliance and its members believe that everyone benefits from medical care personalized directly for them.
Primary care providers are committed to preventive health maintenance which is a long term investment in you!
Physicals are not just routine, they are opportunities for early disease detection. And every visit, regardless of the reason, will give your physician the opportunity to get to know you better and to build a long standing relationship over time. As a result, individual care plans can be developed that are tailored to the individual needs of each and every patient.
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DPCNation.org is a wonderful educational resource.