Direct Primary Care

What Does Direct Primary Care Cost - Is It Really Worth It?

March 13, 2021

Harsha Moole, M.D., MBBS

As these new membership-based models start to gain traction all over America, more and more patients are starting to become interested in direct primary care cost and whether it is worth the investment?

The simple answer here is this: direct primary care cost is offset by the priceless benefits it provides and can even serve as a valuable investment in the long run.

To help you determine whether direct primary care is the right fit for you, here are important answers to some frequently asked questions patients like you may have:

How does direct primary care membership work?

Unlike the traditional, insurance-based health care model where patients are charged for every service they avail of, direct primary care cost is based on a membership fee, which can be paid on a monthly, quarterly, or annual basis.

This membership fee covers a clear set of primary care services, including unlimited clinic visits, virtual consultations, direct access to your physician's personal line, and so much more. Think about your Netflix or Apple Music subscription – the concept of direct primary care is very similar to that.

How much does direct primary care cost?

A direct primary care membership cost ranges typically from $30-$300 a month. For as much as a couple of dinners out, patients no longer have to worry about unexpected or hidden charges every time they visit their doctor.

Like direct primary care, membership-based models have been a real game-changer for the healthcare industry in terms of restoring the quality of patient care it was known for before third parties, such as insurance companies and corporate hospitals, took over.

Does direct primary care membership count as insurance?

Time to set the record straight: No, your direct primary care membership does not replace your health insurance. direct primary care membership may seem like an added expense on top of your insurance plan, but the reality is the opposite.

There are many crucial points to cover when it comes to the question, "Does direct primary care count as insurance";

The most important one being: having a direct primary care membership lets you reduce your insurance plan to a cheaper one, which only covers catastrophic expenses and in-patient services.

This is possible because direct primary care cost already covers everything about primary/routine care. Clinic visits are unlimited and no longer need copay fees. Even better, patients gain access to exclusive discounted out-patient services and medication, as well as many other valuable benefits.

What does direct primary care membership fee cover?

Direct primary care is a refreshing alternative to the frustratingly complicated insurance-based health care model we have come to loathe. For one, direct primary care membership covers a significant factor that is vital to improved health outcomes and overall patient satisfaction, and that is enough time with your doctor.

Forget wasting time queuing – you are not just another number waiting to be called with direct primary care. What doctors and patients appreciate about direct primary care is that they can sit down and hash out everything about their health and well-being. Rushed, robotic appointments are unheard of in direct primary care.

There is a highly individualized, sincere form of patient care that comes with your direct primary care membership. This is because patients have direct, 24/7 access to their primary care physician's personal line, giving them a chance to build a more tight-knit doctor-patient relationship.

In contrast to the traditional, insurance-based healthcare model, direct primary care can build a level of trust between doctor and patient. It is not uncommon for direct primary care physicians to check up on you regularly and vice versa. You are most welcome to seek medical advice from your physician via text message, video call, and the like.

In a nutshell, direct primary care is designed to improve the whole primary care experience for patients. This is why direct primary care cost includes benefits such as flexible payment terms, individual and family plans, virtual care options, and get this: out-patient services and medication at discounted rates.

Thanks to direct primary care, out-patient services, such as CBC tests and vaccines, are offered at more affordable costs. A Complete Blood Count (CBC) test will cost you $50-$60 in a corporate hospital, whereas a DPC clinic offers the same test for only $1-$2.

Moreover, direct primary care cost is incredibly worth it for people who have chronic conditions as DPC memberships dispense medication at wholesale cost. Antihistamine medicine like Cetirizine can cost you up to $14.43 for a 10-mg dosage in most primary care clinics, while DPC clinics can dispense it for only $1.08.

The savings you incur from discounted maintenance medication alone is enough to cover your monthly membership fee already!

What are direct primary care services included in a membership?

As direct primary care practices continue to spring up all over the country in recent years, DPC Nation has standardized a set of essential services each membership can include.

While memberships can significantly differ from one another (some memberships are DPC-Concierge Medicine hybrids, meaning they offer premium services at slightly higher costs), direct primary care cost should generally cover the following basic services:

  • Address common medical problems like colds, flu, rashes, joint injuries, and the like
  • Keep recommended preventive screenings and tests updated, such as colonoscopies, pap smears, and EKGs
  • Come up with a tailored, long-term management plan for chronic conditions
  • Execute minor procedures like mole removal, joint injection, and stitches
  • Offer additional services, like chronic pain treatments, sleep disorder treatments, migraine treatments, and more
  • Coordinate any specialized care needed outside of primary care

Is direct primary care tax deductible?

As of writing, there are no clear-cut tax treatments implemented for direct primary care cost. Per the latest update from Commissioner Koskinen, the IRS has declined to decide whether periodic fees, such as direct primary care membership fees, should be recognized as a qualified medical expense under section 213(d) of the Internal Revenue Code.

Does medicare cover direct primary care?

Any direct primary care cost is kept between doctor and patient alone. On the other hand, some Concierge Medicine practices are still able to bill your affiliated insurance company for any covered services incurred.

Given that some practices are DPC-Concierge Medicine hybrids make sure to study a membership's terms and conditions when settling direct primary care costs.

How does direct primary care work with Medicare?

Another great thing about direct primary care is that it does not work with Medicare. True to its name, any direct primary care cost is settled between doctor and patient alone, without intermediaries' interference like insurance companies.

This makes health care transactions smoother, more convenient, and, yes, a whole lot cheaper. You will be surprised how much cheaper out-patient services can be without a parade of administrative staff on the clinic payroll.

In the direct primary care model, the doctors work directly for their patients. Doctors are no longer restricted by the punitive workflows mandates of insurance companies and healthcare corporate companies.

What direct primary care fees need to be paid?

The only recurring direct primary care cost is your monthly membership fee plus taxes. Like CBC tests, vaccines, or medicine memberships, other costs are only charged as they are incurred. For DPC-Concierge Medicine hybrids, your physician can bill your insurance company for any covered services incurred.

Is direct primary care worth it?

In many respects, direct primary care membership cost is considered a worthwhile long-term investment as it encourages patients to prioritize primary/routine care. Studies show that consistent quality routine care keeps any debilitating illnesses at bay.

And managing existing conditions before leading to ER trips, hospital confinement, and major surgeries, which cost twice as much. So, YES, direct primary care is worth every dollar as an investment towards your health.

Do you think you would benefit from a DPC doctor? We have the most extensive collection of DPC doctors in the US. Find your nearest DPC doctor in your area today at –

Authored by Harsha Moole, M.D., MBBS

Advocate of healthcare models that promote direct relationship between patients and doctors. Founder @ FindMyDirectDoctor, LLC.

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