Short answer: To join a direct primary care practice, you usually choose a practice, read its membership agreement, and then pay a fixed fee on a schedule the practice sets. The American Academy of Family Physicians says that schedule is typically monthly, quarterly or yearly. Ask the practice exactly what the fee covers and when it is charged.
Direct primary care (DPC) is a membership model. You pay your doctor's office a regular fee, and the fee covers all or most of your primary care services, according to the American Academy of Family Physicians (AAFP). Each practice sets up its own sign-up process. In general, the steps look like this:
You can find a direct-pay doctor near you and compare two or three offices first. If you want the basics, read what direct primary care is.
The AAFP says DPC practices typically charge patients a monthly, quarterly or annual fee. The Tennessee Department of Commerce and Insurance describes the same idea, saying fees are agreed on ahead of time and may be monthly, annual or per visit. Familydoctor.org, the AAFP's patient website, adds that some practices also charge a one-time enrollment fee. It also says many employers have agreements with DPC doctors that cover all or some of an employee's membership. To see what the fee might be, look at what direct primary care costs, then ask the practice for its own price.
Each practice writes its own payment terms, so ask about the details before you pay. For example, ask whether there is a discount for paying a year ahead, how a partial first month is charged, and how the practice helps patients who are moving over from another doctor.
Possibly. A health savings account (HSA) is a tax-favored account for medical costs. Starting January 1, 2026, a person in a qualifying direct primary care arrangement can still contribute to an HSA, and HSA money can pay the regular fee. The IRS explained the rule in Notice 2026-5. To qualify, the arrangement must provide only primary care services, the only payment must be a fixed periodic fee, and the fees must not be more than $150 a month for one person or $300 a month for an arrangement covering more than one person. Those limits are adjusted for inflation after 2026. Ask the practice whether its arrangement meets this definition, and check with a tax adviser before you rely on it. Our page on using an HSA with direct primary care explains these rules in more detail.
No. Familydoctor.org says a DPC membership is not insurance, so you should still have coverage for emergencies and hospital care. The Tennessee department also says DPC fees will not count toward an insured person's yearly deductible, the amount you pay before insurance starts paying. In an emergency, call 911.
Some do. Familydoctor.org says some practices charge a one-time enrollment fee, so ask before you join.
Familydoctor.org says many employers have agreements with DPC doctors that cover all or some of the membership. Ask your employer and the practice.
Starting in 2026, HSA money can pay the regular fee of a qualifying arrangement, which must provide only primary care and cost no more than $150 a month for one person. Ask the practice and a tax adviser.
