I get this question a lot from self-employed clients across Central Florida who are tired of high premiums: “What if I just skip insurance and pay a doctor directly?” Direct Primary Care has become genuinely popular in Florida over the last few years, and it’s easy to see why — flat monthly fees, no copays, real access to your doctor. But I want to walk through exactly what DPC is, what it isn’t, and why it should be a piece of your coverage strategy rather than your entire strategy.
What Direct Primary Care Actually Is
Direct Primary Care is a membership model where you pay a flat monthly fee — typically somewhere between $50 and $150 depending on your age and the practice — directly to a primary care doctor. In exchange, you generally get unlimited office visits, same- or next-day appointments, longer visit times, direct texting or calling access to your doctor, and no copays or insurance billing for anything within the scope of primary care. There’s no claim to file and no surprise bill after the visit; the membership fee is the whole transaction.
Florida has seen real growth in this model. Central Florida and Volusia County in particular now have a number of established DPC practices, including several around Orlando, Ormond Beach, and Port Orange, offering monthly memberships generally in the $80–$130 range for adults, often with discounts for children and family plans.
What DPC Covers Well
- Routine primary care visits and annual physicals
- Preventive care and chronic disease management (diabetes, high blood pressure, cholesterol)
- Same-day or next-day sick visits
- Basic in-office labs and minor procedures, depending on the practice
- Direct communication with your doctor via text, phone, or email
What DPC Does Not Cover — And This Is the Important Part
Here’s where I stop clients before they make a costly mistake. Direct Primary Care does not cover:
- Specialist visits — cardiologists, dermatologists, orthopedists, and so on
- Hospitalizations of any kind
- Surgeries
- Emergency room visits
- Advanced imaging like MRIs or CT scans
- Most labs beyond basic panels done in-office
If you break a leg, get diagnosed with something that needs a specialist, or end up in the ER after a car accident, your DPC membership does nothing for those bills. This is the single biggest misunderstanding I run into, and it’s the reason DPC on its own leaves people badly exposed.
The Smart Strategy: DPC Paired With a High-Deductible Plan
The way I usually see this work well for self-employed clients is pairing a DPC membership with a high-deductible health plan (HDHP) or catastrophic-style ACA plan. You use your DPC membership for everyday care — sick visits, physicals, chronic condition management, quick access when something feels off — and you rely on your HDHP to protect you against the big-ticket stuff: a hospital stay, surgery, a cancer diagnosis, a serious accident. Many people pair this setup with a Health Savings Account, since HDHPs are typically HSA-eligible, which lets you save pre-tax dollars toward both your deductible and DPC membership costs (note: DPC membership fees are HSA-eligible in some cases but not always — check with a tax advisor, since IRS guidance on this has shifted).
Why This Combination Makes Sense Financially
Here’s a simplified comparison. Say a DPC membership runs $100/month ($1,200/year) and you pair it with an ACA HDHP running roughly $350–$450/month after subsidy for a mid-40s individual in Florida — call it $4,800/year in premium. Total: roughly $6,000/year, but with excellent primary care access and real protection against a catastrophic event. Compare that to a richer ACA plan with a lower deductible running $550–$650/month ($7,200–$7,800/year) with more built-in copays for routine visits. Depending on how much care you actually use and your specific subsidy eligibility, the DPC + HDHP combination can come out ahead — but the math depends entirely on your individual numbers, income-based subsidy, and health needs, which is exactly why running the actual comparison matters more than a rule of thumb.
The Critical Caveat: DPC Is Not Health Insurance
I want to be very direct about this because I’ve seen people get burned by not understanding it: Direct Primary Care is not insurance, and a DPC membership alone does not satisfy the requirement for minimum essential coverage. If your only “coverage” is a DPC membership, you have no protection against a major medical event, no coverage for specialists, no coverage for hospitalization, and no coverage for prescriptions beyond what your DPC doctor can provide in-house. You need a genuine ACA-compliant health plan — whether through healthcare.gov or off-exchange — sitting alongside your DPC membership, not instead of it.
What This Looks Like in Real Life
A self-employed client of mine in DeLand runs a landscaping business. He joined a local DPC practice for quick access when he strains his back or needs antibiotics for a sinus infection, and he pairs it with an ACA-compliant HDHP through the marketplace for anything serious. It works well for him because he’s generally healthy and values fast access over comprehensive routine coverage — but he knows that if he ever needs a specialist referral or ends up in the hospital, his ACA plan is what’s actually protecting him financially.
Bottom Line
Direct Primary Care can be a genuinely smart piece of a self-employed health coverage strategy in Florida — better access, more time with your doctor, and predictable costs for everyday care. But it works best as a supplement to real insurance, not a replacement for it. If you skip real coverage entirely to save money on premiums, you’re one bad diagnosis or one ER visit away from a financial disaster that a DPC membership simply can’t touch.
If you’re weighing a DPC membership against your health insurance options, or trying to figure out whether an HDHP paired with DPC makes sense for your specific situation and budget, let’s talk it through. Contact Michael McAllister at Choice Health Insurance Brokers — we help self-employed Floridians in DeLand, Orlando, Tampa, and beyond build coverage strategies that combine the best of both worlds without leaving you exposed.