Direct Primary Care (DPC) is a way of arranging primary care that many patients have never heard of. This article explains the basics so you can decide whether it is worth a conversation with a physician.
How Direct Primary Care works
In a DPC arrangement, a patient pays a fixed monthly membership fee directly to the practice. The fee covers a defined set of primary care services described in a written membership agreement. Because the practice is not billing insurance for those covered services, the schedule is often less constrained by payer rules.
How it differs from insurance-based care
In traditional insurance-based care, visits are billed to a health plan under that plan’s coverage rules, documentation requirements and reimbursement limits. Visit length and scheduling often reflect those constraints.
In a membership model, the agreement is directly between the patient and the practice. This can allow:
- Longer visits
- Scheduling that is more flexible, including same-day or within-hours access when available
- More time for the physician to review information before and after a visit
What Direct Primary Care does not replace
A DPC membership is not health insurance. Patients still need separate coverage for hospital care, specialist care and emergencies. Coverage and costs for those services depend on the individual’s plan.
Direct Primary Care at Celeste Clinica
Celeste Clinica in Scottsdale, Arizona also sees patients who have insurance, Medicare or Medicaid, so the right path is discussed during an initial consultation. You can read more on our Direct Primary Care membership page or see how it works.
Key takeaway
Direct Primary Care is one option among several. Whether it fits depends on your health needs, your insurance and how you prefer to access care.
This article is for educational purposes only. It is not medical advice and does not create a patient-physician relationship.
Reviewed by Dr. Ghadimi