Short answer: Medicaid is a health coverage program run by each state, and whether it works with a direct primary care practice depends on the practice and your state. Many of these practices are paid directly by patients and do not take insurance or government programs. Call the practice first and ask before you pay any fee.
Medicaid is a health coverage program. Medicaid.gov says it covers eligible low-income adults, children, pregnant women, older adults and people with disabilities. States run it by following federal rules. HealthCare.gov adds that each state sets its own income limits, coverage and costs, so the answer can be different where you live.
Direct primary care, often called DPC, is a way of paying for a family doctor with a regular membership fee instead of billing insurance for each visit. You can read more in our guide to what direct primary care is. The American Academy of Family Physicians (AAFP), a national group of family doctors, says DPC practices typically do not accept insurance or take part in government programs. Each practice sets its own rules, so ask.
Medicaid.gov does not say whether Medicaid pays DPC practices. Congress has looked at this question. A bill that would have made clear that state Medicaid programs may pay for DPC passed the U.S. House of Representatives in March 2024, but it did not become law. A newer version was introduced in February 2025 and has not passed. So no one can promise you that Medicaid will pay a DPC fee, and your state Medicaid agency is the right place to ask.
A short phone call can save you money. These are good things to ask:
A membership fee is money you pay yourself, so think about whether you can keep paying it month after month. The American College of Physicians (ACP), a national group of internal medicine doctors, asks doctors in these practices to think about how a retainer fee can make care harder to reach for lower-income patients. The AAFP says some employers pay the fee for their workers, so it is fair to ask your employer too. If a fee is out of reach, your state Medicaid agency can tell you how to find doctors who take your plan. You can also find a direct-pay doctor near you and compare practices.
Medicaid.gov has a page where you choose your state and get contact information for the state agency that runs the program. You can apply for Medicaid any time of year, either through a HealthCare.gov application or directly with your state Medicaid agency.
If you have chest pain, trouble breathing, signs of a stroke or another emergency, call 911. A membership doctor is for urgent questions that are not emergencies.
Medicaid.gov does not say that it does. Bills to clarify this have not become law, so ask your state Medicaid agency and the practice before you pay.
HealthCare.gov says you can apply for Medicaid and CHIP any time of year, through a HealthCare.gov application or directly with your state Medicaid agency.
The AAFP says DPC practices typically do not accept insurance or take part in government programs. Each practice sets its own rules, so ask.
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