Self-Employed & DPC · Straight answer

What is direct primary care?

Direct primary care (DPC) is a membership model where you pay a doctor's practice a flat monthly fee, commonly about $50 to $150 for an adult, for unlimited or near-unlimited primary care with no copays and no insurance billing. It is not insurance, so most people pair a DPC membership with an ACA health plan that covers hospitals, specialists, and major claims.

Last reviewed August 17, 2026 · Published August 17, 2026 · Mere Benefits Data Desk

The critical thing to understand before joining: a DPC membership is a service agreement with one practice, not health coverage. It pays for nothing outside that practice’s walls. A broken ankle at the ER, an oncologist, a hospital stay, an MRI at the imaging center, none of that is included. DPC also does not satisfy any coverage requirement, and joining one is not a qualifying event for marketplace enrollment. Think of it as replacing the primary care slice of your healthcare, not the whole pie.

What the monthly fee typically buys

Included in most DPC membershipsNot included, you still need coverage for
Unlimited office visits, no copaysHospital and ER care
Same-day or next-day appointments, longer visit timesSpecialists (cardiology, oncology, surgery)
Direct text, phone, or video access to your doctorAdvanced imaging (MRI, CT) beyond basic in-office services
Basic in-office procedures, stitches, joint injections (varies by practice)Maternity and hospital-based care
Wholesale-priced labs and generic medications (varies by practice)Brand-name and specialty drugs

On price, published surveys and practice listings in 2025-2026 most commonly show adult memberships around $50 to $150 per month, with children often less, though rates vary by market and practice (DPC Nation, accessed August 2026). There is typically no per-visit charge, which is the point: the practice works for you, not for claim volume.

How people actually use DPC

The standard pairing is a DPC membership plus a lower-premium, higher-deductible ACA marketplace plan. The DPC handles the 80% of medical life that is primary care: checkups, sick visits, chronic condition management, prescriptions, basic labs. The insurance sits behind it for the expensive, rare events. For self-employed people and small businesses without group coverage, that combination can deliver day-to-day access that feels like concierge medicine at a fraction of concierge prices, while keeping true catastrophic protection in place.

Two 2026 developments made the pairing cleaner. Under the 2025 federal tax law, starting January 1, 2026, a DPC membership up to $150 per month for an individual ($300 for a family) no longer disqualifies you from contributing to a Health Savings Account, and fees within those limits count as qualified medical expenses you can pay from the HSA. That removed the biggest tax objection to the DPC-plus-HDHP combination.

DPC is not concierge medicine’s twin, despite the resemblance. Concierge practices usually charge a higher retainer and still bill your insurance for visits; DPC practices charge less and bill no one. It is also not a healthcare sharing ministry, which pools members’ money for large bills but is not insurance either.

Here’s what I tell clients weighing it: price the DPC fee against what you actually spent on primary care and urgent care last year, and only join a practice after a meet-and-greet visit. The model lives or dies on whether you like and trust that specific doctor.

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