Direct primary care: cost and how it works

How direct primary care works

You pay the practice a set fee each month. In return you get primary care visits and access to the care team without a bill to your insurance for each visit. DPC Frontier defines a DPC practice as one that charges a periodic fee, does not bill third parties fee-for-service, and keeps any per-visit charge below the monthly equivalent of the fee ^[2]. AAFP adds that DPC generally does not accept insurance or government programs and serves patients across income levels ^[1].

That is the main line between DPC and concierge care. Concierge practices charge an annual retainer and keep billing insurance, while DPC practices operate outside insurance ^[9]. Our concierge vs direct primary care comparison goes row by row.

What direct primary care costs

Published DPC fees, checked October 17, 2026

Practice	Adult	Child or family	Extra fees	Source
Huntington DPC, Long Island NY	$75 a month (ages 19 to 64); $115 (65+)	$50 a month (ages 5 to 19)	None listed	[3]
Plum Health, Detroit MI	$95 a month	$180 member plus spouse or child; $270 family	Labs and medicines cash-priced separately	[10]
KerixHealth, Colorado (Lone Tree in the Denver metro and other clinics)	$115 a month	$75 a month per child	$100 registration per person, up to $300 a family	[4]
KerixHealth, Virginia	$150 a month	$95 a month per child	$100 registration per person, up to $300 a family	[4]
KerixHealth, Illinois	$199 a month	$139 a month; $99 each additional under 18	$250 registration	[4]

National figures: AAFP puts DPC fees at $50 to $100 a month ^[1]. Hint Health's data showed a median individual membership of about $80 a month in 2022 and an employer-paid family-of-four median of $158 a month in 2021 ^[5]. Employer-sponsored rates have held at $55 to $65 for five years, per Hint's 2026 report ^[8].

What the fee covers and what it leaves out

• KerixHealth lists same- or next-day visits, 24/7 care team access, chronic care and mental health support, with no copays or deductibles ^[4].
• Plum Health lists in-person visits plus call, text and email access, and prices labs and medicines separately ^[10].
• For HSA purposes, the IRS excludes procedures that need general anesthesia, prescription drugs other than vaccines, and lab services not typically given in an ambulatory primary care setting from a direct primary care arrangement ^[7].
• The IRS does not treat a qualifying DPC arrangement as a health plan ^[7]. Ask the practice what happens when you need a specialist, imaging or a hospital.

Paying for DPC with an HSA in 2026

From January 1, 2026, people with an HSA can join a direct primary care service arrangement and pay its fees from the HSA ^[11][7]. The rules from IRS Notice 2026-5:

• Fees must total no more than $150 a month for one person, or $300 a month if the arrangement covers more than one person ^[7]. Rev. Proc. 2026-24 keeps the same amounts for 2027 ^[12].
• Care must come only from primary care practitioners, and a fixed periodic fee must be the only payment ^[7].
• An arrangement that bills separately through insurance or otherwise does not qualify ^[7].
• Fees over the cap can be reimbursed as medical expenses but make you ineligible to contribute to an HSA while enrolled ^[7].
• Employer-paid fees cannot be reimbursed from the HSA, and DPC fees do not count toward your plan deductible ^[7].

Employer direct primary care

Employers now fund 60% of active DPC memberships on Hint Health's platform, the first time they are a majority, and membership grew 837% from 2017 to 2025 ^[8]. Ask your HR team whether a DPC option is offered before paying on your own. If you want more access than DPC offers, our private doctor guide compares DPC, hybrid and concierge prices.

State direct primary care laws

DPC Frontier lists 32 states with an enacted law that defines DPC outside insurance regulation: AL, AZ, AR, CO, FL, GA, ID, IN, IA, KS, KY, LA, ME, MI, MS, MO, MT, NE, NH, NC, ND, OH, OK, OR, SD, TN, TX, UT, VA, WA, WV and WY. Its page carries a 2024 copyright, so laws passed since may be missing ^[13].

Direct primary care law status in states we cover

State	Law	Source
Arizona	A.R.S. 20-103(E) and 44-1799.91 to 44-1799.96 (HB 2113 / SB 1105, 2019)	[14]
California	None listed by DPC Frontier	[15]
Colorado	HB17-1115 (2017); C.R.S. section not confirmed	[16]
District of Columbia	Not confirmed	[17]
Florida	SB 80 / HB 37 (2018), signed 2018-03-23; codified section not confirmed	[18]
Georgia	O.C.G.A. 33-7-2.1 (SB 18, Direct Primary Care Act, signed 2019-04-25)	[19]
Illinois	None listed by DPC Frontier	[20]
Indiana	Ind. Code 25-1-10 (SB 303, 2017)	[21]
Louisiana	La. R.S. 37:1360.81-1360.91 (SB 516, 2014)	[22]
Maryland	None listed by DPC Frontier	[23]
Massachusetts	None listed by DPC Frontier	[24]
Michigan	MCL 500.129 (SB 1033, 2014 PA 522, signed 2015-01-10)	[25]
Minnesota	None listed by DPC Frontier	[26]
Missouri	Mo. Rev. Stat. 376.1800 (HB 769, 2015; medical retainer agreements)	[27]
Nevada	None listed by DPC Frontier	[28]
New Jersey	None listed by DPC Frontier	[29]
New Mexico	None listed by DPC Frontier	[30]
New York	None listed by DPC Frontier	[31]
North Carolina	H 471 (2019 session), signed 2020-07-01; G.S. section not confirmed	[32]
Ohio	Ohio Rev. Code 3901.95 (HB 166, 133rd GA, 2019)	[33]
Oregon	ORS 735.500, 735.510 (2011, retainer medical practice); HB 2540 (2025) credits direct payments toward deductibles	[34]
Pennsylvania	None listed by DPC Frontier	[35]
South Carolina	Not confirmed	[36]
Tennessee	Tenn. Code Ann. 63-1-501 to 63-1-504 (HB 2323, 2016)	[37]
Texas	Tex. Occ. Code ch. 162, subch. F (HB 1945, 2015)	[38]
Utah	Utah Code 31A-4-106.5 (2012)	[39]
Virginia	Va. Code 54.1-2997, 54.1-2998 (SB 800, 2017)	[40]
Washington	RCW 48.150 (2007)	[41]

How to choose a DPC practice

1. Confirm the monthly fee for each family member and any registration fee.
2. Ask which labs and medicines are priced separately, and at what price.
3. If you have an HSA, check that the total stays under $150 a month for one person or $300 for a family, and that the practice does not bill insurance ^[7].
4. Ask about same-day access and after-hours contact.
5. Check the doctor's license with your state medical board ^[42].

Direct primary care guides

• Find a direct primary care practice near you
• Concierge medicine vs direct primary care
• Concierge Fee Index with DPC fees
• Concierge medicine: how it works
• Concierge pediatricians and DPC child rates
• Functional medicine costs