Direct Primary Care (DPC) is a growing alternative to the traditional, insurance-based healthcare system. DPC is designed to make everyday healthcare more accessible and affordable for both individuals and employers. To understand why DPC matters, it helps to start with the basics: primary care.
Primary care is where most people turn first when they’re sick, need a prescription, or want to manage ongoing conditions. It’s also where preventive care happens—checkups, screenings, and early interventions that help people stay healthy and avoid unnecessary emergencies or hospital visits.
But in the U.S., access to primary care is increasingly out of reach. According to the National Association of Community Health Centers (NACHC), one-third of Americans lacked access to a primary care provider in 2023. That’s more than 100 million people—including one in four children. For many, the high cost of traditional insurance plans makes it difficult to get consistent primary care. As a result, people delay treatment, avoid routine care, or rely on urgent care centers and emergency rooms for issues that could have been prevented. When minor health concerns go unchecked, they often escalate into more serious problems, forcing employees to miss work, incur additional expenses, and leaving employers to manage the costs of lost productivity and unplanned coverage gaps.
That’s why more people—and the employers who support them—are turning to Direct Primary Care (DPC) memberships. DPC memberships offer a simpler and more affordable healthcare experience. It’s more personalized care delivered for a flat monthly fee. No insurance required, no surprise bills, and no red tape.
In this article, we’ll break down what Direct Primary Care is, how it works, and how you can give employees access to quality primary care while keeping costs low for your budget.
Understanding Direct Primary Care (DPC)
Direct Primary Care (DPC) is a subscription-based healthcare model that provides direct access to essential primary care services, including routine visits, preventive screenings, and more, without going through traditional insurance. It also gives employers a more predictable, manageable way to offer health benefits to their employees.
How do you pay for DPC?
With Direct Primary Care, individuals, or employers on behalf of their employees, pay a flat monthly fee directly to a medical professional or institution, such as a physician or nurse practitioner. Traditional health insurance is not required to participate in a DPC membership. In fact, most DPC practices do not accept payments from group health plans, Medicare, or Medicaid. Instead, DPC memberships operate entirely outside of the insurance system, which allows providers to focus on care—not claims.
With DPC, there are no copays, no deductibles, and no surprise bills for the employer or the individual. The consistent, subscription-style payment model makes healthcare costs more predictable and removes the financial barriers that can prevent people from seeking primary care when they need it.
What is the Goal of DPC?
The goal of DPC is to improve access to consistent, high-quality primary care by removing the complexities and limitations of traditional insurance-based healthcare. By focusing on the patient-provider relationship rather than billing codes and paperwork, DPC memberships allow providers to spend more time with each patient and deliver more personalized, proactive care.
This model helps patients stay healthier and reduces the need for emergency care or costly specialist visits down the road.
What does DPC cover?
While offerings vary by DPC provider, most DPC memberships include:
- Routine checkups and sick visits
- Care for minor injuries or illnesses
- Chronic condition management (e.g., diabetes, asthma, high blood pressure)
- Basic lab work and screenings
- Care coordination and referrals to specialists
- Generic prescription access
- Direct communication with a provider
- Vaccinations
How DPC solves common healthcare challenges
DPC is designed to solve many of the issues that have made traditional healthcare frustrating and expensive. Here are just a few of the healthcare challenges DPC helps eliminate:
- Long wait times for appointments
- High out-of-pocket costs for primary care
- Confusing insurance networks
- Delays in care due to cost or access
- Burnout among primary care providers
- Administrative burdens for both providers and employers
- Not enough time spent with patients
- Unnecessary in-person visits
- A disconnect between physician and patient
By addressing these core issues, DPC not only improves the individual’s experience but also helps employers reduce healthcare-related costs, absenteeism, and turnover. It’s a benefit that works better, because it’s built for how people actually use healthcare.
Pros and Cons of Direct Primary Care
Like any healthcare model, DPC has its strengths and limitations. Understanding the pros and cons can help both individuals and employers decide whether it's the right fit for their needs.
Pros of DPC:
- Predictable costs: The subscription-style payment model allows individuals and employers to budget more effectively. There are no surprise bills, copays, or deductibles—just a single, consistent monthly or annual fee.
- More time with providers: DPC practices typically serve a smaller patient panel than traditional clinics, which allows providers to spend more time with each patient. This leads to longer visits, deeper relationships, and a better understanding of each patient’s health.
- Faster appointments and shorter wait times: Many DPC providers offer same- or next-day availability, often with more flexible scheduling. This means patients can get the care they need quickly, without waiting weeks for an opening.
- Improved doctor-patient relationships: Without the pressure of insurance-driven visit quotas, providers can build meaningful, ongoing relationships with their patients. Many DPC models allow patients to contact their provider via phone or secure messaging, so they don’t need to come into the office for every minor question or concern. This makes care more convenient and responsive.
- Prevention-focused care: DPC prioritizes preventive care, such as physicals, screenings, immunizations, and health coaching. This proactive approach helps catch potential issues early and improves long-term health outcomes.
- Fewer insurance hassles: Because DPC operates outside of traditional insurance, there are no claims to file or billing codes to manage. This eliminates paperwork for both employers and providers, reduces administrative overhead, and eliminates much of the friction from the healthcare experience.
- Reduced burden on employers: For businesses, offering DPC can help reduce claims usage, lower overall healthcare costs, and simplify administrative processes. It’s also a strong recruiting and retention tool for companies looking to offer more meaningful benefits.
Cons of DPC:
- Doesn't cover major medical events: DPC typically covers everyday care, but it usually excludes hospitalizations, emergency services, and specialty procedures. Patients typically still need a separate insurance plan for major medical events.
- Out-of-pocket costs for specialists and hospitals: While DPC providers can coordinate referrals, any outside care, such as specialist visits or surgeries, typically falls outside the membership fee and requires separate payment or insurance coverage.
- Not ideal for high-need or complex health situations: Individuals with frequent specialist visits, surgeries, or terminal illnesses may require broader coverage and more extensive services than DPC can provide alone.
- Not ACA-compliant on its own: For employers, offering DPC by itself does not satisfy the Affordable Care Act’s requirement to offer Minimum Essential Coverage (MEC). However, it can be paired with other solutions to create a compliant benefits package.
How Direct Primary Care Works Alongside Insurance
While DPC can be used as a standalone healthcare service, it’s not intended to replace insurance entirely, as it does not cover more serious medical events, such as emergency surgeries, hospital stays, or care related to major accidents or terminal illnesses.
When it comes to employer-sponsored health benefits, there are also legal requirements to consider. Under the Affordable Care Act (ACA), employers with 50 or more full-time equivalent employees are classified as Applicable Large Employers (ALEs) and must offer health coverage that meets specific minimum standards. DPC alone does not meet the ACA requirements. That’s why many employers choose to pair DPC with other insurance options to create a more complete and compliant benefits package that is affordable for the employer and the employee. Because DPC focuses on everyday, routine care, it works especially well as the foundation of a broader benefits strategy.
Here are three common ways employers combine DPC with other health benefit offerings:
- Minimum Essential Coverage (MEC) Plans: For ACA compliance, ALEs are required to offer a plan that meets minimum essential coverage (MEC) and minimum value (MV) standards. MEC plans typically cover preventive services and emergency care, but they fall short on everyday access to primary care. When paired with DPC, employers can offer a fully compliant package that also delivers real, practical value to employees, improving employee retention and recruitment efforts.
- Health Reimbursement Arrangements (HRAs): HRAs are employer-funded arrangements that reimburse employees for qualified medical expenses. Depending on the HRA type, employees may purchase their own health coverage through the Marketplace and receive reimbursement for premiums and eligible out-of-pocket costs, up to a specified monthly or annual amount. By offering DPC alongside an HRA, employers can give their team a low-cost way to access everyday care, allowing employees to use their reimbursement toward premiums or more expensive medical services. This combination provides employees with more flexibility and helps them stretch their healthcare dollars further.
- Traditional Group Plans: Employers offering a group health plan can include DPC as an added benefit. While group plans are typically ACA-compliant, they still require employees to pay deductibles, copays, and often wait days or weeks for a primary care appointment. As a result, many employees avoid using their plan for routine care altogether. By offering DPC alongside a group plan, employers provide their team with a faster and more affordable way to access primary care when needed. Employees stay healthier, take fewer sick days, and return to work more quickly. It also improves employee satisfaction by reducing stress around accessing care, without increasing the employer’s insurance premium burden.
For many businesses, this layered approach allows them to offer more value without adding unnecessary complexity or expense. It ensures employees have consistent access to care for day-to-day health needs, while still being covered for emergencies or more serious medical events.
Primary Care: The Way It Always Should Have Been
For too long, traditional healthcare has been expensive, confusing, and hard to access, especially for hourly, part-time, and uninsured workers. That’s why more employers are turning to DPC memberships to provide their teams with better health benefits.
Vitable is the health benefits platform built to make that possible. We deliver healthcare the way it should be—accessible, affordable, and designed around the everyday needs of working people. By partnering directly with employers, we make it easy to offer real care that employees actually use, trust, and value.
At Vitable, primary care is at the core of our offerings. We believe it’s the most effective, people-first way to deliver everyday healthcare. Our enhanced Primary Care membership is the foundation of every Vitable plan. Employers can offer it as a stand-alone service alongside their existing coverage or combine it with one of our flexible MEC or HRA plans to create a benefits package that meets compliance requirements and fits their workforce.
We offer nationwide care through a virtual-first model, making it easy for employees to get help when and where they need it. From scheduling to follow-up, our digital platform simplifies the experience for employees and employers. Below, we’ll dive deeper into the benefits employers and their employees receive with Vitable’s Primary Care membership.
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Benefits of Vitable’s Direct Primary Care Membership
Vitable goes beyond the typical DPC membership. While many DPC memberships have caps on primary care visits, Vitable delivers a more robust, people-first experience. Our enhanced Primary Care membership includes unlimited primary care visits, convenience with virtual visits, and access to a broad suite of integrated services—all designed to improve employee health outcomes and reduce the cost burden on employers. From mental health support and urgent care to lab work and chronic condition management, we make everyday healthcare simple and affordable.
What Employees Get
With Vitable, employees get more than just coverage—they get continuity of care, faster access to providers, and a better overall experience that leads to improved health and fewer missed workdays.
- Access to a dedicated team of providers
- $0 copays and no deductibles
- Unlimited primary care visits (routine care, sick visits, checkups, etc.)
- Same day appointments (no need to wait a week for an appointment!)
- Access to 1,000+ prescriptions at no cost
- Chronic disease management
- Urgent care services
- Unlimited mental health coaching
- Mental health therapy
- Free dependent coverage (family coverage at no additional cost)
- Labs, screenings, and vaccinations
- Episodic care
- Ongoing care navigation and follow-up support
What Employers Gain
Vitable gives employers a smarter, more affordable way to offer health benefits. Whether your organization is fully insured, self-funded, or looking for a new approach altogether, our Primary Care membership can integrate seamlessly into your existing benefits structure or serve as the foundation of a fully customized Vitable solution.
With Vitable, employers benefit from:
- Predictable, monthly flat-rate pricing model
- Flexible benefit package options
- Simplified benefits administration
- Fewer high-cost claims by reducing urgent care and ER visits
- Easy-to-use digital employer dashboard
- Open enrollment support, managed by Vitable’s dedicated team
- Streamlined employee onboarding
- Increased employee retention and productivity
- ACA-compliant plan options to help avoid costly IRS penalties
- Stronger recruitment, especially for hard-to-staff roles
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Making the Switch to DPC with Vitable Health
Whether you’re a small business wanting to provide meaningful health coverage or a larger organization looking to supplement existing benefits, DPC offers a more sustainable path to delivering real healthcare, without the high cost or administrative burden of traditional plans.
Ready to start offering better benefits? Get a free quote today!
Frequently Asked Questions
What is the difference between Direct Primary Care and traditional health insurance?
Direct Primary Care is not insurance. It’s a flat-rate, subscription-based model that provides employees with unlimited access to everyday care, including sick visits, checkups, chronic condition management, and prescriptions. Traditional insurance, on the other hand, is typically used for major medical expenses, emergencies, and hospitalizations, and often comes with high deductibles, copays, and confusing networks.
Does Direct Primary Care meet ACA requirements on its own?
No. While DPC provides valuable access to everyday care, it does not meet the Affordable Care Act (ACA) requirements on its own. However, when paired with a Minimum Essential Coverage (MEC) plan, it becomes part of a compliant and comprehensive healthcare solution for your workforce.
Can Direct Primary Care be used with other insurance plans?
Yes. DPC pairs well with Minimum Essential Coverage (MEC) plans, Health Reimbursement Arrangements (HRAs), or traditional group plans to provide a complete, flexible benefits package.
Who benefits from Direct Primary Care?
Both employees and employers. Employees get fast, easy, and affordable access to care they’ll actually use. Employers reduce healthcare costs, boost retention, and offer a competitive benefit without the high cost of traditional group insurance.
What makes Vitable’s DPC membership different?
Vitable offers unlimited virtual-first visits, nationwide access, mental health services, care navigation, free prescriptions, and dependent coverage—all included in one flat-rate plan. We go beyond the basics to deliver care that employees use and value.
