For the first time, your Direct Primary Care (DPC) membership fees can be paid with tax-free Health Savings Account (HSA) funds, which changes the math for many small businesses and individuals considering this model.
Starting January 1, 2026, the One Big Beautiful Bill Act (signed into law in late 2025) made DPC arrangements fully compatible with Health Savings Accounts. You can now contribute to an HSA while enrolled in a DPC plan and use those funds to pay your membership fees. For small businesses already pairing HDHPs with HSAs, this is a meaningful change worth understanding.
Here's what DPC is, how it works, and whether it makes sense for you or your team.
What is Direct Primary Care?
Direct Primary Care is a membership-based healthcare model where patients pay a flat monthly fee directly to a primary care physician or practice—no insurance claims, no copays, and no surprise bills for routine visits.
The membership typically runs $50–$150/month for adults and covers the full range of primary care: annual physicals, chronic disease management, same-day sick visits, and direct access to your doctor via phone, text, or email.
What makes DPC different isn't just the pricing model, but the relationship. DPC physicians typically cap themselves at 600–800 patients (versus 2,000+ in traditional practices), which means longer appointments (30–60 minutes versus the standard 7–15), less waiting, and a doctor who actually knows you.
What's Included—and What's Not
Most DPC memberships cover:
- Unlimited office visits for acute and chronic care
- Preventive care and annual physicals
- Basic in-office procedures
- Chronic disease management (diabetes, hypertension, asthma, etc.)
- Care coordination and specialist referrals
- Direct access to your physician via phone, email, or text
- Wholesale-priced labs and medications at many practices
What DPC doesn't cover is equally important to understand: DPC is not health insurance. It typically won't cover hospitalizations, ER visits, specialist care, surgeries, or major diagnostic tests like MRIs. Most DPC patients pair their membership with a high-deductible health plan (HDHP) for that protection.
The Financial Case: DPC + HDHP + HSA
Here's the setup that's become increasingly popular, especially for small business owners and employees:
- DPC membership covers routine and preventive primary care at a flat monthly rate
- HDHP provides protection against major medical events, with lower premiums than traditional plans
- HSA lets you save pre-tax dollars for healthcare costs, and as of 2026, that now includes your DPC membership fee
The savings can be substantial. Lower HDHP premiums often offset or exceed the DPC membership cost, and the HSA tax advantage adds another layer. For small businesses that offer benefits, this combination can reduce total healthcare spend while improving employees’ access to care.
Is DPC Right for You?
DPC tends to be a strong fit if you:
- Want more time with your primary care physician and are tired of rushed 10-minute appointments
- Have ongoing primary care needs like chronic conditions, a family with kids, or regular preventive care visits
- Want predictable, transparent primary care costs
It's probably not the right move if you rarely visit the doctor and would rather minimize monthly fixed costs, or if you already have comprehensive insurance with low primary care copays.
Availability is also a factor. DPC practices are growing, but aren't everywhere yet.
For Small Businesses: A Simpler, Smarter Benefits Strategy
DPC has gained real traction as an employer benefit, particularly among small businesses that want to offer meaningful healthcare support without the complexity and cost of traditional group insurance.
When paired with an HDHP and HSA contribution strategy, DPC can:
- Lower total benefits spend
- Give employees better day-to-day access to care
- Reduce sick days through more proactive, preventive relationships with primary care physicians
- Simplify benefits administration
It's not a fit for every workforce, but for healthcare-adjacent businesses, startups, and lean teams, it's worth a serious look.
The Bottom Line
Direct Primary Care has always offered a compelling alternative to the traditional insurance-driven primary care experience. The 2026 HSA compatibility change makes HSAs more financially attractive than ever, especially for individuals and small businesses already using HDHPs.
If you're evaluating whether DPC makes sense for your team's benefits strategy, we're happy to help you run the numbers. Talk to a LegUp advisor →
