What is Direct Primary Care (DPC)?
It is a membership fee paid directly to the business in exchange for pre-approved services or care, sometimes at a discounted rate. Direct primary care memberships have become much more common for doctors and dentists to provide, but it is not insurance. It does not cover emergencies or significant medical problems. They do not go through insurance, and the charges do not change despite the approved services used—no co-payments, deductibles, or coinsurance.
Can I get my DPC membership reimbursed?
No, unfortunately, you can’t. The IRS considers DPCs to be “membership plans” because you may be paying for services that have not been rendered yet. Also, they are not considered minimum essential coverage (MEC).
How to identify a DPC
Not all DPCs will directly say that they are direct primary care, and they might be labeled as discount programs, memberships, concierge fees, or financial plans. If you pay a monthly fee directly to the practice instead of having the service charges go through insurance, then it's a DPC. The best way to figure out if your payment is for a DPC is to simply ask your provider.