No — self-employed people can use Direct Primary Care for everyday doctor visits, but DPC is not health insurance and doesn’t cover specialists, hospital stays, surgery, ER visits, or advanced imaging. The smart approach is pairing a DPC membership with an ACA-compliant plan, often a high-deductible plan, so you’re protected against major medical bills.
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 now have a number of DPC practices, and many offer discounts for children and family memberships.
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. (See what happens if you get sick without insurance as self-employed.)
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). For reference, HSA limits are $4,400 self-only / $8,750 family for 2026 and $4,500 / $9,000 for 2027. Learn more in how 1099 contractors save with HDHPs.
Why This Combination Makes Sense Financially
Here’s a simplified, hypothetical comparison using round numbers for illustration only. Say a DPC membership runs $100/month ($1,200/year) and you pair it with an HDHP costing $400/month ($4,800/year). Total: $6,000/year, with strong primary care access and protection against a catastrophic event. Compare that to a richer plan with a lower deductible at $600/month ($7,200/year) with copays for routine visits. Keep in mind that since enhanced subsidies expired after 2025, anyone above 400% of the poverty level (about $63,840 for a single person for 2027 coverage) pays full price, which can make the HDHP side of this math more attractive. 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. That plan’s out-of-pocket maximum — capped at $10,600 for an individual in 2026 and $12,000 in 2027 — is what actually limits your worst-case exposure. Our major medical coverage page explains the options.
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
If you’re exploring other lower-cost structures, compare them with the cheapest health insurance options for self-employed people before deciding.
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.
Frequently Asked Questions
Is Direct Primary Care the same as health insurance?
No. Direct Primary Care is a membership with a primary care practice, not insurance. It doesn’t cover specialists, hospitalization, surgery, emergency care, or advanced imaging, and it doesn’t count as minimum essential coverage. You still need an ACA-compliant plan for protection against major medical costs.
How much does Direct Primary Care cost?
DPC memberships are usually a flat monthly fee that varies by practice and age, commonly around $50 to $150 per month for adults, with discounts for children or families at many practices. The fee typically covers unlimited primary care visits, direct communication with your doctor, and basic in-office services.
Can I pair Direct Primary Care with an HSA-eligible plan?
Many self-employed people pair DPC with a high-deductible plan and HSA. IRS treatment of DPC fees and HSA eligibility has changed over time, so confirm current rules with a tax advisor before paying DPC fees from your HSA. HSA limits for 2027 are $4,500 self-only and $9,000 family.
What is the best insurance to pair with Direct Primary Care?
An ACA-compliant high-deductible or Bronze plan often pairs well, since DPC handles routine care and the insurance covers hospital, specialist, and emergency costs. Compare out-of-pocket maximums — up to $12,000 for an individual in 2027 — and confirm the plan’s network includes the hospitals and specialists you’d want.
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 budget, let’s talk it through — we help self-employed Floridians in DeLand, Orlando, Tampa, and beyond build coverage that doesn’t leave them exposed. Call or text Michael McAllister at 321-230-9536 — he is the owner of Choice Health Insurance Brokers in DeLand, a licensed broker appointed with 200 carriers (NPN 18229135) — or visit choice.healthcare to get started. There is no cost to work with us.