A $100 monthly doctor membership adds up to $1,200 a year. If you work for yourself, that is one line in a healthcare budget that also needs insurance, medications, tests and room for unexpected bills.
Direct primary care (DPC) lets you pay a practice directly for a defined set of primary care services. The membership agreement determines what you receive. Insurance remains a separate purchase for services outside the practice, including hospital and specialist care.[1]
For freelancers and business owners, the practical question is how that combination fits your income. Start with what you expect to spend, then calculate how much cash you need available if the year gets expensive.
Start With the Membership Agreement
Ask the practice for its full fee schedule and included services. Check:
Monthly fees for each person joining.
Enrollment fees, minimum commitments and cancellation terms.
Which visits and procedures the membership includes.
Separate charges for prescriptions, labs, imaging and outside care.
Appointment availability and how the office handles questions between visits.
For a concrete example, My Doctor Cares, in Diamond Bar, California, publishes a $109 monthly standard adult membership and a $100 one-time enrollment fee. That makes the first year $1,408 before outside services. Its website specifically excludes labs, imaging, medicines, specialists, hospital care and emergency care from the membership price.[2]
That level of detail helps you compare physician-led practices in California or your own state. Use each practice's actual terms when building your budget. Our guide to direct primary care explains the model in more detail.
Price Insurance Alongside DPC
Get insurance quotes before deciding what you can afford for a membership. Compare the monthly premium, deductible, covered medications, specialist network and annual out-of-pocket limit. HealthCare.gov recommends comparing total yearly costs rather than choosing on premium alone.[3]
A deductible is the amount you pay for certain covered services before the plan starts paying. You may still owe copayments or coinsurance afterward. Coinsurance is your percentage of a covered bill.[3]
Use the premium you would actually pay after any financial assistance. Marketplace savings depend on income and household size. Freelancers and solo business owners can shop through the individual Marketplace; owners with employees may need to evaluate small-business coverage separately.[4]
Choosing DPC does not automatically make a higher-deductible plan a better deal. Price the care you expect outside the practice, too.
Two Example Healthcare Budgets
These are hypothetical planning examples, not insurance quotes, market averages or promised savings. Both assume 12 months of coverage. Insurance premiums represent the household's payment after any assistance. Replace every figure with your own quotes and expected costs.
The second example covers two adults, with both joining DPC. Prescription, testing and other-care amounts are annual estimates divided by 12, so actual bills will arrive unevenly.
Budget item | Solo freelancer: monthly equivalent | Two-adult household: monthly equivalent |
|---|---|---|
DPC membership | $100 | $200 |
Health insurance premium | $350 | $850 |
Prescriptions paid out of pocket | $25 | $75 |
Labs and imaging paid out of pocket | $25 | $50 |
Specialist and other medical bills paid out of pocket | $50 | $125 |
Estimated monthly spending | $550 | $1,300 |
Additional transfer to medical savings | $150 | $300 |
Monthly cash to allocate | $700 | $1,600 |
Estimated annual spending | $6,600 | $15,600 |
Additional annual savings | $1,800 | $3,600 |
Annual cash to allocate | $8,400 | $19,200 |
Enrollment fees, dental care, vision care and lost income are outside these examples. Add them where applicable.
Money transferred to savings remains yours until you spend it. If you use that reserve to pay a bill already included in your spending estimate, record the bill once. Moving money between accounts creates no additional healthcare expense.
For a broader comparison of payment models, see our DPC versus traditional primary care cost guide.
Check Prescriptions and Tests Individually
Bring your medication list when comparing insurance plans. Check each drug's dose, coverage rules, pharmacy and expected patient price. A plan's formulary is its covered-drug list. HealthCare.gov recommends checking that list and confirming whether your pharmacy participates in the plan.[5]
For each planned test, ask what the membership includes, what the outside provider charges and what you would owe using insurance. Ask your insurer whether a cash payment would count toward your deductible or out-of-pocket limit.
If you choose self-pay for scheduled care, request a written good faith estimate. Federal rules generally require one when you request it or schedule care at least three business days ahead. Separate providers may require separate estimates.[6]
Calculate a High-Cost Year Separately
Your insurance plan's out-of-pocket maximum limits your spending on covered, in-network services. Premiums, uncovered services and out-of-network care generally sit outside that limit.[7]
Return to the solo example. Suppose the quoted plan has an $8,000 out-of-pocket maximum, and covered, in-network care reaches it. The calculation becomes:
Annual insurance premiums: $4,200.
Annual DPC membership: $1,200.
Covered, in-network patient spending: $8,000.
Total: $13,400, plus enrollment fees and expenses outside the plan's limit.
Replace the earlier covered-care estimates with the $8,000 figure. The deductible is already part of that maximum; adding it again would overstate the total.[7]
The example's $150 monthly savings transfer builds $1,800 over a full year, assuming no withdrawals. Compare your existing medical savings with the amount you might need early in the year. A January bill can arrive before you have built that reserve.
Check the 2026 HSA Rules
A Health Savings Account (HSA) can help eligible people save for medical expenses. Starting in 2026, a qualifying DPC arrangement can preserve HSA contribution eligibility when aggregate monthly fees stay within $150 for one person, or $300 for an arrangement covering more than one person. Other HSA eligibility requirements still apply.[8]
Qualifying arrangements charge a fixed periodic fee for primary care. The agreement's services and billing terms also matter. The federal definition excludes bundled prescription drugs other than vaccines and certain laboratory services. A membership's name or price alone cannot establish eligibility.[8]
HSA reimbursement and contribution eligibility have different rules: an otherwise qualifying arrangement above the fee limit may remain reimbursable from existing HSA funds while making you ineligible to contribute during enrollment. DPC fees also do not count toward an HSA-qualified health plan's deductible or out-of-pocket maximum.[8]
Confirm your agreement and coverage before treating membership payments or savings transfers as HSA transactions.
Make the Budget Work With Uneven Income
Set aside the monthly amount from each example using your own figures. During higher-income months, you can fund upcoming premiums and build the medical reserve in advance. Keep a separate allowance for income you would lose if you could not work.
Review the budget quarterly and when coverage or medications change. If your expected annual income changes, update your Marketplace application promptly. Report net self-employment income after business expenses, along with other required household income. Changes can affect financial assistance and what you owe when you file taxes.[9]
FAQ
Can DPC replace health insurance if I am self-employed?
DPC covers the primary care services specified in your agreement. You still need to arrange coverage or payment for outside services such as hospital and specialist care.[1]
Will joining DPC lower my total healthcare costs?
Savings depend on your membership, insurance and actual care. Compare annual costs with and without DPC using the same expected services, and evaluate appointment access separately.
How much should I save for unexpected medical bills?
Use your plan's out-of-pocket maximum, expenses outside that limit and existing savings to set a target. The example transfers above illustrate budgeting mechanics; they are not recommended reserve amounts for every household.[7]
You can compare concierge and DPC practices on NextMD, review physician credentials and ask each office for the details needed to build your budget.
Sources
American Academy of Family Physicians. (2024). Direct Primary Care. DPC policy and scope of membership services.
My Doctor Cares. (Accessed October 24, 2026). DPC Membership, PPO & Rates. Adult membership, enrollment fees and outside costs.
HealthCare.gov. (Accessed October 24, 2026). Your Total Costs for Health Care: Premium, Deductible & Out-of-Pocket Costs. Comparing annual insurance and care costs.
HealthCare.gov. (Accessed October 24, 2026). Health Coverage If You're Self-Employed. Marketplace options for self-employed people.
HealthCare.gov. (Accessed October 24, 2026). Getting Prescription Medications. Checking covered drugs and pharmacies.
Centers for Medicare & Medicaid Services. (Accessed October 24, 2026). What Is a Good Faith Health Insurance Estimate? Good faith estimates for uninsured and self-pay patients.
HealthCare.gov. (Accessed October 24, 2026). Out-of-Pocket Maximum/Limit. What counts toward the annual limit.
Internal Revenue Service. (2025). Notice 2026-5: Expanded Availability of Health Savings Accounts Under the One, Big, Beautiful Bill Act. Pages 5–6 and 11–15, particularly questions 11–14, 16 and 20. Federal DPC and HSA guidance.
HealthCare.gov. (Accessed October 24, 2026). Reporting Self-Employment Income to the Marketplace. Estimating income and reporting changes.