Short answer: It can be, for some families. Many direct primary care (DPC) practices see people of all ages, and monthly fees for children are often lower than for adults. DPC is not insurance, so you still need coverage for the hospital and emergencies. Compare the fee with what your family spends now.
Direct primary care is a membership model. You pay a monthly fee to a doctor's office, and the office does not bill an insurance company for each visit. Familydoctor.org, the patient website of the American Academy of Family Physicians (AAFP), says DPC doctors usually see patients of all ages, including babies, children and adults. That means some practices care for children and parents under one roof.
Every practice makes its own choices, though. Some may not see newborns or may only take children whose parents are also members. You will need to ask.
According to familydoctor.org, DPC averages $20 to $49 a month for children and $100 or more a month for a family. The site also says some practices charge a one-time enrollment fee, and that the exact price depends on the practice. Our report on what direct primary care costs in each state shows typical adult prices near you.
To decide if it is worth it, add up what your family now pays in copays (the fixed amount you pay at each visit), urgent care visits and time off work. Then compare that total with the monthly fee.
familydoctor.org says the monthly fee covers routine care and easy access to your doctor. It also says membership often brings longer visits, and that it can be easier to see your doctor quickly. Same-day appointments are one of the extras some practices offer. Some DPC doctors can also do things like stitches for cuts and skin biopsies in the office.
Prescriptions, some lab tests and some procedures may cost extra. familydoctor.org says these are often highly discounted at a DPC office. The pages we read do not say which vaccines a practice gives or whether they are part of the fee. Please ask each practice for its list.
familydoctor.org says patients can reach their doctor by text, phone or email. How late a practice answers, and what happens on weekends, differs from one office to the next, and the sources we read do not describe it. Ask for the rules in writing.
A DPC doctor can be a good first call for a mild fever or an earache. It is not the right place for a true emergency. If your child has trouble breathing, a seizure that does not stop, or a severe allergic reaction, call 911.
You can find a direct-pay doctor near you and call two or three offices to compare. If you want the basics first, read what direct primary care is.
Some families wonder about paying the fee with a health savings account (HSA, a tax-favored savings account paired with some insurance plans). A qualifying arrangement can work with an HSA only if its total fees are no more than $150 a month for one person or $300 a month for an arrangement that covers more than one person. Read more about using an HSA for direct primary care, and please check with a tax adviser.
familydoctor.org says DPC averages $20 to $49 a month for children and $100 or more for a family, but each practice sets its own price. Ask the practice for its fee list.
No. Familydoctor.org, the AAFP's patient website, says a DPC membership is not insurance. You still need coverage for emergency room and hospital care.
The sources we read do not say. Some practices may include them and some may not, so ask for a list of what is covered.
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