What is Direct Pay Healthcare?

Direct Pay Healthcare is a healthcare practice model where the patient directly pays the physician or medical practice a very reasonable membership fee for ongoing care, and some practices accept payment for a single visit. Membership fees are usually a monthly payment; however, some membership fees, depending on the practice, are quarterly or annual. These membership fees cover your medical services so that you have access to that medical practice at any time during their open operating hours. Each practice lists what services are included along with their individual practice’s membership fee, or pricing list.

This healthcare practice model allows for complete price transparency and no surprise bills for the patient. The patient knows what services are included in their monthly membership fee. If the patient is recieving a single procedure, such as a surgergy, where a membership may not be applicable, these direct pay healthcare practices will still disclose what services are provided and the cost of services before recieving the service.

Direct Pay Healthcare is not specific to any medical specialty, but an umbrella term for all medical specialties who offer direct pay services. Direct Pay Healthcare offers a directory of medical practices who have a direct pay model and the practices do not accept health insurance. To read in greater detail about what Direct Pay Healthcare is, click here to go to our page that is solely dedicated to answering questions on what Direct Pay Healthcare is.

How does Direct Pay Healthcare improve the patient and doctor relationship?

Direct Pay Healthcare (DPH) doctors are able to spend quality time with their patients in an environment that promotes trust and honesty. DPH providers do not report your information to the insurance companies, so you can be 100% honest with your provider without fear of your out-of-pocket monthly premium being increased. This promotes trust, honesty, and privacy within the patient doctor relationship. DPH providers do not have contracts with insurance companies or pharmaceutical companies, meaning if your doctor prescribes you a medication, it is more likely to be in your best interest rather than a medication that a pharmaceutical company is trying to promote for any given condition. Knowing that your doctor is prescribing medication specifically for you, and not because of pharmaceutical contracts can largely impact and increase the trust between the patient and doctor.

What is Direct Primary Care?

According to the American Academy of Family Physicians (AAFP), Direct Primary Care is a healthcare model that gives family medicine doctors a worthwhile alternative to fee-for-service insurance billing. Direct Primary Care (DPC) offered by board-certified family physicians, and others, provides the patient with significant financial savings as well as more time with their doctor.

Direct Primary Care (DPC) providers are usually, but not limited to, family medicine and internal medicine doctors who do not accept insurance, and instead do a membership fee for their services. Depending on the cost of operating in any specific area, an average membership fee may fall between $70-$150 a month for an individual and around $250 a month for a family. We encourage you to look at the individual medical practice you are interested in for their specific pricing as these numbers are averages across many private practices but offer you a rough estimate of the cost of having a Direct Primary Care (DPC) provider.

Most of the individual Direct Primary Care (DPC) medical practice websites provide a price list, including their membership fee, as well as what services are included in that membership fee. Like the membership fee, services may vary. Many DPC providers include services in their membership fee that include but are not limited to wellness visits, same day illness visits, women’s health, minor surgeries or procedures, chronic disease management, and the regular vaccination schedule, among others. Often, they will also include discounts on laboratory work as well as prescription medication discounts.

Overall, we are seeing many patients that are very happy with the quality of care received when they choose Direct Primary Care (DPC) providers.

How much does it cost to have a Direct Primary Care provider?

Direct Primary Care (DPC) doctors run private practices and there is no standardized cost. Depending on your location and the operating costs of the area, the DPC practice will charge an annual, quarterly, or monthly membership fee. Each practice’s website will have a pricing list, with what is included in that price. While each practice is different, it is common for most primary care services, laboratory services, and comprehensive care management to be included in their fee. Keeping in mind that every practice is different, the cost most commonly seems to range between $70-$150 a month for an individual and around $250 a month for a family. Please verify on your individual DPC doctor’s website the specific cost for their services; however, this should give you an approximate cost for Direct Primary Care.

Can employers set up Direct Primary Care memberships for their employees?

Yes! There are many Direct Primary Care (DPC) Providers that provide memberships to businesses as a means of providing access to healthcare for their employees. Talk with a DPC doctor near you to converse over options for your business. Look through our Direct Pay Healthcare Directory to find a DPC doctor near you.

What is Direct Pay Psychiatry?

This is often referred to as self-pay psychiatry, where the psychiatrist does not process insurance claims. Similar to the Direct Primary Care model of family practice physicians, psychiatrists offer a direct pay model where they cut the insurance middleman out and the patient is afforded the savings and increased time with the doctor. These doctors are not reporting to insurance companies and are not associated with your work, so if you need or want mental healthcare, with the added benefit of trust and privacy, search our [Direct Mental Healthcare Directory]5 today.

What are Direct Pay Pharmacies?

The pharmacy is where medications are distributed to the patient. Often patients have found themselves overwhelmed by the cost of the prescriptions they need to stay alive, or maintain good health. Typically, the pharmacy benefit manager negotiates costs between drug manufacturers and insurance companies. When patients don’t use insurance for their medications, there is no need for a pharmacy benefits manager or negotiation of drug costs as these Direct Pay Pharmacies deliver your medications at an almost at-cost price, saving families significant amounts of money on their medication expenses. One of the most well-renowned Direct Pay Pharmacies is Mark Cuban’s Cost Plus Drug Company.

What are Health Savings Accounts (HSAs)?

A Health Savings Account (HSA) is a tax-exempt trust account where you save pre-tax dollars to pay for qualified medical expenses and can also provide valuable benefits for retirement. Contributions made to your HSA are tax deductible. If you do not spend the money in the account within the year, it rolls over into the following year and when you reach 65 years of age, there is no penalty for using the money in the account for non-qualified medical expenses. To read about Health Savings Accounts (HSAs) in greater detail, click here to read our page dedicated to HSAs.

Do I need Health Insurance paired with Direct Primary Care?

Healthshare plans paired with Direct Pay Healthcare can achieve a very similar result as having a 'full coverage' traditional health insurance plan. An HSA can simultaneously allow you to save for any up front medical costs. To read more about Healthshare Plans, click here. To read more about Health Savings Accounts (HSAs), click here.