Short answer: A cash-pay doctor charges you directly instead of billing an insurance company. The price may be a fee for each visit or a monthly membership. Direct primary care and concierge medicine are two kinds of cash-pay care. Ask for the full price list and what it covers before you book.
The American College of Physicians (ACP) describes practices that contract directly with patients to pay out of pocket for some or all services, or that charge a retainer, which is an extra fee, sometimes called a concierge fee, often paid in return for more personal and easier-to-reach care. Their paper counts concierge, direct primary care and cash-only practices in this group. In plain words, you pay the doctor, not an insurance company.
With regular billing, the office sends a claim to your insurance company, and you pay a copay or a share of the bill. With a cash-pay doctor, you agree on the price with the practice. The American Academy of Family Physicians says direct primary care practices typically rely only on patient fees and do not accept insurance.
Direct primary care (DPC) means a flat monthly, quarterly or yearly fee for primary care. Read more about what direct primary care is. Concierge medicine usually means a retainer fee for extra access and attention. Read more about what concierge medicine is.
The ACP says doctors are drawn to these models partly because of frustration with insurance payments and billing problems, and partly because they want more time with each patient. The ACP also raises a concern. It says practices that do not accept insurance may create barriers for people with lower incomes, and it asks those doctors to think about ways to reduce that barrier. This is one reason to look at the price carefully before you join.
Keep your receipts and any written estimate. You can find a direct-pay doctor near you. If you have no insurance, see how to see a doctor without insurance.
Direct primary care is one kind of cash-pay care. The American Academy of Family Physicians says DPC practices typically rely only on patient fees and do not accept insurance.
CMS says providers usually must give a good faith estimate to people who do not have or use insurance, when care is scheduled in advance or when you ask for one.
