Direct Primary Care Cost in 2026: DPC Membership Fees, Concierge Care and HSA Rules

What Direct Primary Care Is

The AAFP's commonly accepted definition of a DPC practice has three parts. The practice charges patients or their employers a periodic fee, usually monthly, for a contracted set of services. It does not bill insurance companies or government programs on a fee-for-service basis. And if it charges anything per visit, that charge is less than the monthly equivalent of the periodic fee (AAFP policy). The AAFP says the fee covers all or most primary care services, including clinical and laboratory services, consultative services, care coordination and comprehensive care management (AAFP practice model).

In practice, that usually means you can book visits, message or call your doctor and get an annual physical without a copay. Atlas MD in Wichita, for example, lists unlimited access to your doctor, annual physicals, wholesale prices on medication and after-hours support as membership benefits (Atlas MD benefits), and says its direct arrangement lets it offer wholesale prices on lab tests, imaging and medications (Atlas MD FAQ). There is no single DPC model, so what is included varies by practice.

DPC Monthly Fees by Age: Published Examples

DPC prices are set practice by practice, and many charge more for older adults. The table below uses each practice's own fee page or its listing on the DPC Frontier mapper, where practices report their own fees. These are examples, not a national survey, and listings can lag behind a practice's current prices.

The pattern: most of these adult fees fall inside the AAFP's typical $50-$100 range, with higher fees in expensive metros. The AAFP's 2024 DPC data brief applies that range to adults 65 or younger, puts typical child fees at $20 to $49 a month and family memberships at $100 or more. Age is the main driver within a practice, and children are often cheap when a parent is enrolled. Check one-time costs as well: Florida Direct Primary Care lists a $0 enrollment fee, while Winter Pine Direct Primary Care in Brunswick, Maine, lists $100.

DPC vs Concierge Medicine vs App Memberships

"Membership primary care" covers several different products. The key questions are whether the practice also bills your insurance, and whether visits are included in the fee or charged on top.

Concierge medicine: MDVIP

MDVIP says individual memberships generally run $2,500 to $5,000 a year depending on location, payable quarterly, semi-annually or annually (MDVIP membership overview; MDVIP employers FAQ). Individual doctor pages can differ: one Milford, Michigan, practice page lists $1,980 a year, so check the fee for the specific doctor. The fee pays for a personalized annual wellness program and preventive services not typically reimbursed by insurance, and is not itself reimbursable by insurance. Your MDVIP-affiliated doctor continues to bill your in-network insurance for routine care, including copays, coinsurance and deductibles for services like sick visits (MDVIP on insurance). At $2,500 a year, the low end works out to about $208 a month, above the $150 IRS limit for a qualifying DPC arrangement described below. MDVIP says its fee may be reimbursable through an HSA or FSA; check with your plan administrator or tax adviser.

Amazon One Medical membership

Amazon lists One Medical at $9 a month or $99 a year for Prime members and $199 a year for everyone else, and Prime members can add up to five family members at $6 a month or $66 a year each (Amazon One Medical). The membership pays for the app, on-demand virtual care and services such as referral management. According to One Medical's FAQ, in-office appointments and scheduled remote visits are billed to your insurance, with your usual copay, deductible or coinsurance, and drop-in lab services are not covered by the fee (One Medical FAQ). Without a membership, pay-per-visit care is $29 for a message visit or $49 for video. That makes it a different product from DPC, where the fee is meant to be the practice's payment for the primary care it covers.

Telehealth primary care memberships

Lemonaid's online primary care is the closest app-based match to DPC pricing: $99 a month for one person or from $178 a month for a family plan, with unlimited virtual care, no additional fees or co-pays, and a first appointment of about an hour. Medications are billed separately (Lemonaid). It is virtual only, so it cannot replace a hands-on exam. PlushCare and Sesame sell discount memberships instead: PlushCare's $19.99 a month or $149 a year sits on top of a flat $129 visit fee if you have no insurance (PlushCare), and Sesame Plus at $10.99 a month or $99 a year takes $10 off each visit (Sesame terms). For posted per-visit prices across services, see our cash-pay telehealth visits guide and the Sesame vs MDLive vs Teladoc comparison.

What DPC Does Not Cover, and Why You Still Need Insurance

DPC is primary care only. The fee does not pay for emergency room visits, hospital stays, specialist care, surgery or anything else outside the practice. The AAFP notes that some services are not covered by a retainer and that DPC practices often suggest a high-deductible, wrap-around policy to cover emergencies (AAFP advocacy). Imaging and labs beyond what the practice includes are usually billed separately or through your insurance, so ask which tests the practice covers.

Two Marketplace options are worth knowing as the wrap-around layer:

• Catastrophic plans. If you are under 30, you do not need an exemption to enroll. People 30 and older need a hardship or affordability exemption; for plan year 2026, CMS guidance says the hardship route includes people who expect to be ineligible for premium tax credits or cost-sharing reductions based on projected household income (CMS guidance; HealthCare.gov).
• Bronze and catastrophic plans are now HSA-compatible. As of January 1, 2026, bronze and catastrophic plans available through an Exchange count as HSA-compatible even if they do not meet the usual high-deductible plan definition (IRS; HealthCare.gov).

If you need urgent care that your DPC practice cannot provide, our urgent care cost without insurance guide covers self-pay visit prices. For an emergency, call 911.

HSA Rules for Direct Primary Care in 2026

The 2025 budget reconciliation law, H.R. 1, became Public Law 119-21 on July 4, 2025 (Congress.gov). It changed how DPC works with health savings accounts. According to the IRS, beginning January 1, 2026, an otherwise eligible person enrolled in certain DPC service arrangements may contribute to an HSA and use HSA funds tax-free to pay the periodic DPC fees (IRS announcement). IRS Notice 2026-5 sets the conditions (Notice 2026-5):

• Monthly cap: fees can total no more than $150 a month for one person, or $300 a month if the arrangement covers more than one person.
• Fixed fee only: the fixed periodic fee must be the only payment for care under the arrangement. Practices may still bill separately for services outside the arrangement that they offer to members and non-members alike.
• Primary care only: for this rule, primary care excludes procedures that need general anesthesia, prescription drugs other than vaccines, and lab services not typically done in an ambulatory primary care setting.
• Longer billing periods are allowed if they stay within the monthly limit on an annualized basis. The IRS example for one person in 2026 is $1,800 for a year, $900 for six months or $450 for three months.
• Over the cap: fees above the limit can still be reimbursed from an HSA as medical expenses, but you cannot contribute to an HSA while you are enrolled.
• 2027: Rev. Proc. 2026-24 keeps the limits at $150 and $300 for 2027 (Rev. Proc. 2026-24).

Employer-Sponsored DPC

The AAFP definition includes fees paid by employers, so a DPC membership can be offered as a workplace benefit; if you are an employer, ask practices whether they offer group rates. Benefits advisers summarizing Notice 2026-5 note that, starting in 2026, employees enrolled in qualifying DPC arrangements can stay eligible to contribute to an HSA, and that plan sponsors should confirm their plans follow the notice (WTW; Sequoia). If your employer offers DPC, ask HR who pays the fee, whether the arrangement is designed to meet the IRS conditions if you also use an HSA, and what happens to your membership if you leave the job.

How to Find and Vet a DPC Practice

Start with the DPC Frontier mapper, then read the practice's own fee page and membership agreement. State rules vary. A McDermott Will & Emery 50-state survey says roughly half of states have laws that explicitly exempt DPC arrangements from insurance regulation, and that most of those laws include consumer protections, such as barring practices from charging an annual fee up front (McDermott survey). Before you sign, get written answers to these questions:

1. Fees: the monthly fee for each household member by age, any enrollment fee (listings we checked ranged from $0 to $100), and any family cap.
2. Commitment and cancellation: any minimum term (one listing requires 3 months), how much notice cancellation needs, and whether prepaid fees are refunded pro rata.
3. Labs: which tests are included, which are sold at member prices, and where samples are drawn.
4. Medications: whether the practice dispenses medications, at what prices, and whether it bills them separately from the membership.
5. Access: how quickly you can get an appointment, how after-hours calls and messages are handled, and who covers when your doctor is away.
6. Outside care: how referrals to specialists, imaging and hospitals work, and whether the practice can help you find cash prices.
7. HSA: whether the total fee stays within the $150 or $300 IRS limit and whether anything is billed outside the fixed fee.

How to Save on Direct Primary Care

• Price your household, not just yourself. Child fees such as $10 at Atlas MD or $15 at Plum Health (its 2022 pricing), with an enrolled parent, can make family memberships cheaper than they first look.
• Compare the full year. A $50 tier is $600 a year; a $200 practice is $2,400. Five $129 cash telehealth visits cost $645, so count how often you actually see a doctor.
• Ask about annual billing, carefully. The San Francisco practice above lists $2,200 a year against $200 a month ($2,400). Prepay only if the contract states how unused fees are refunded, and note that some state DPC laws bar charging an annual fee up front.
• Use member pricing for labs and medications. If a practice sells labs near cost, routine tests can cost a fraction of retail direct-access prices. Ask for the list.
• Pair DPC with cheaper wrap-around coverage. A catastrophic or bronze plan covers emergencies and hospital care; since 2026, Exchange bronze and catastrophic plans are HSA-compatible.
• Pay with HSA dollars if you qualify. A qualifying DPC fee within the IRS limits can be paid from an HSA tax-free.
• Ask your employer. Some employers pay for DPC as a benefit, and practices may offer group rates.

If your DPC practice does not include a lab test you want, our guide to ordering a blood test without a doctor explains self-pay lab options. The primary care hub compares cash-pay primary and urgent care services.

Red Flags and When to See a Clinician

• A practice or salesperson suggests a DPC membership replaces health insurance. It covers primary care only.
• The contract has no clear cancellation terms, auto-renews without notice, or requires a large prepayment with no refund policy.
• The practice cannot tell you which labs and medications are included or what they cost.
• You are told the fee is HSA-eligible, but it exceeds $150 a month per person or the practice also bills insurance for the same care.
• You cannot find the doctor's license; check it with your state medical board before joining.