Is the Cost of a DPC Membership Worth it?

Is a DPC Membership Worth it?

A direct primary care membership is an additional expense, for sure, however, I feel that the benefits you get from a DC membership is better than anything you can buy in a traditional insurance space practice, and most times is actually cheaper overall!

First, let's break down how insurance based practices actually work.

In a typical insurance-based primary care practice, the practice only makes money when people come in to see the physician or an assistant. This means that the practice needs to be big enough so that the small percentage of patients that are sick or want to come in for their annual physical on any one given day, actually fills up the available appointment slots for that day. Typically, this means that a physician must have approximately 5,000 to 6,000 patients that he or she cares for. With this many patients, that fills up the schedule pretty quick, and it's difficult to get people who really need to be seen in quickly because the schedule is already filled up for several weeks.

Insurance companies also places several requirement and stipulations on primary practices with regards to the type of documentation, type of visit, and diagnosis codes (of which there are over 70,000!). Most of this is well-intentioned to encourage better care, however, as with any complex system, this introduces significance inefficiencies when it comes to delivering care. It's not uncommon for an insurance company to deny using your benefits for services provided at a primary care office for a small error in one of those requirements or stipulations, and resolving those takes significant manpower. In this setting, one physician typically requires at least two other people to handle billing and administrative tasks, so as to keep the physician available to do what he or she does best—care for patients. This increases the practices overhead, and the cost of providing care, and doesn't even include scenarios where insurance refuses to reimburse the clinic for services rendered, in which case the practice has to absorb those costs or risk expensive legal costs without guarantee of prevailing against gigantic insurance corporations.

Doesn't sound very efficient does it? And the truth is—it's not. And it shows, for every hour we spend seeing patients, we spend 30 minutes on administrative tasks, mostly dictated by those insurance stipulations I mentioned above. Couldn't those 30 minutes be better used to care for patients?

They can!

Enter DPC! When we remove the insurance company from the relationship, we also free ourselves of all the requirements and stipulations that—while well intentioned—get in the way of providing excellent primary care. This also allows us to deliver care in the manner that is best for you as the patient. This includes digitally, via telephone, or in person at the office. The reduced complexity of billing also means we can keep monthly membership cost low making the practice is much simpler to operate and we can then pass those savings onto you as the patient.

If that wasn't enough already, pairing a DPC membership with a lesser insurance plan often results in significant overall savings as well. This frees the insurance plan to do what it does best: catastrophic event, hospitalizations, seeing specialists, surgeries, etc., and that gives you access to excellent primary care for way cheaper than what you can get by paying for primary care through your insurance. Below I've listed some example plans I was able to find off the health insurance marketplace this year (2025).

Age	Minimal Insurance Plan (/mo)	Insurance Plan with Primary Care Included (/mo)	Minimal Plan with DPC at InnoVie (/mo)	Savings (/year)
45	$391.03	$589.83	$520.03	$837.60
65	$812.37	$1,225.40	$941.37	$3,408.36

To be sure, there are other factors that go into this besides just cost, and it's worth it to do a more in-depth analysis for your particular medical situation. However, consider pairing a membership at a direct primary care practice, such as InnoVie, with your traditional insurance plan to give you the flexibility to focus on using your insurance for your particular needs and help you optimize your yearly medical expenses. Starting in 2026, you can even use your HSA funds to pay for your DPC membership.