Concierge medicine vs direct primary care

Quick answer

Pick by how you want to pay. Concierge care is a higher yearly fee for extra services and access on top of your insurance. Direct primary care is a lower monthly fee that covers primary care without billing insurance for it ^[2][8]. Both are covered in depth in our concierge medicine guide and direct primary care guide.

Side by side

Concierge medicine vs direct primary care

	Concierge medicine	Direct primary care
How you pay	Annual contract with a higher fee [2]	Low monthly fee [2]
Published prices	$2,250 to $3,600 a year (MDVIP physicians, PartnerMD); Sollis Health from $4,000 [3][5][4]	$75 to $199 a month per adult at practices we read; AAFP range $50 to $100 [9][10][2]
Insurance billing	May accept insurance and bill for covered services [2]	Does not bill third parties fee-for-service [8]
Medicare	Membership fee not covered [11]	Generally does not accept government programs [2]
HSA (2026 rules)	Arrangements that bill insurance separately do not qualify [7]	Qualifies if fees are no more than $150 a month (one person) or $300 (more than one) [7]
Built around	In-depth physical and screenings [2]	A flat periodic fee in place of fee-for-service billing [8]
Who it tends to serve	Typically higher-income patients [2]	Patients across income levels [2]
State law	No concierge-specific state law in our research; Medicare.gov says state laws and consumer protections may apply [11]	32 states have a DPC law, per DPC Frontier [14]. Some use retainer language, such as Missouri's medical retainer agreement law and Oregon's retainer medical practice law [12][13]

Where the two overlap

Both charge a membership, both promise easier access, and they are growing together. A Health Affairs study counted 3,036 concierge and DPC practices combined in 2023, up from 1,658 in 2018 ^[1]. Some hybrid models sit in between: One Medical charges $199 a year and bills insurance for scheduled visits, which makes it neither concierge nor DPC ^[15].

The HSA difference in 2026

Since January 1, 2026, a direct primary care service arrangement is not treated as a health plan, so joining one does not stop an otherwise eligible person from contributing to an HSA, and the fees can be paid from the HSA ^[7][16]. The arrangement must use primary care practitioners only and be paid solely by a fixed periodic fee ^[7]. A concierge practice that bills insurance on top of its retainer is not a direct primary care service arrangement under Notice 2026-5 ^[7]. The $150 and $300 monthly caps stay the same for 2027 ^[17].

Who each model fits

• Concierge fits people who want to keep using insurance for visits and are willing to pay a yearly fee for added access and an annual in-depth assessment. Read is concierge medicine worth it before you sign.
• Direct primary care fits people who want a predictable monthly price for primary care, including those with a high-deductible plan and an HSA, as long as the fees stay under the IRS cap ^[7].
• Medicare enrollees should read our Medicare guide first, since the concierge fee is never covered ^[11].

Concierge medicine vs regular primary care

In regular insurance-based primary care you pay no membership; you pay your premium and the cost sharing on each visit. Concierge care keeps that insurance billing and adds the membership fee for extra access and services ^[1][18].

Switching between models

• Check the exit terms of your current practice. PartnerMD asks for 30 days' notice and gives a prorated refund ^[5].
• Budget for sign-up fees. KerixHealth charges $100 to $250 to register depending on the state ^[10].
• If you use an HSA, keep DPC fees under the cap. Fees over it can still be reimbursed but make you ineligible to contribute while enrolled ^[7].
• Ask what is billed separately. Plum Health prices labs and medicines apart from its membership ^[19].

If you are weighing both because you want a doctor of your own, see our private doctor guide. To find practices near you, see find a concierge doctor and find a direct primary care practice.