Concierge Medicine vs. Direct Primary Care: What's the Difference?
Updated: Oct 15
If you're tired of 10-minute appointments & weeks-long waits, you've probably run into two terms: concierge medicine & direct primary care (DPC). Both put you in a direct relationship with your doctor. Both mean longer visits & easier access. But they aren't the same thing, & the differences matter when you're deciding where to spend your healthcare dollars.
Here's a plain comparison so you can figure out which one fits you.
What Is Direct Primary Care?
Direct primary care is a membership model where you pay your doctor a monthly, quarterly or annual fee that covers most of your primary care. According to the American Academy of Family Physicians (AAFP), DPC practices don't accept or bill insurance at all. The fee is the whole relationship.
The AAFP puts typical DPC fees in the range of $50 to $100 a month. Because there's no insurance billing, DPC doctors can keep smaller patient panels than a traditional practice & spend more time with each person.
What Is Concierge Medicine?
Concierge medicine is also a membership model, but it's broader & more varied. You pay a recurring fee for enhanced access to your doctor, longer visits & more personalized care. Some concierge practices still bill insurance for visits on top of the membership. Others, like PICM, don't bill insurance at all.
The AAFP notes that concierge fees tend to run higher than DPC. That usually reflects smaller patient panels, more time per patient & a wider range of services.
Want the longer version? Read What Is Concierge Medicine, and Is It Worth It?
Concierge Medicine vs. DPC at a Glance
Direct primary care | Concierge medicine | |
Payment | Monthly, quarterly or annual fee | Monthly or annual fee |
Insurance billing | Never | Varies by practice |
Typical fee | About $50 to $100/month (AAFP) | Generally higher than DPC |
Patient panel | Smaller than traditional practices | Often smaller still |
Visit length | Longer than traditional | Longer than traditional |
HSA (2026) | Can qualify, up to $150/month individual | Generally doesn't qualify |
Every practice sets its own model, so treat this table as a starting point & ask each practice exactly what's included.
Cost & Insurance: The Real Difference
The biggest practical difference is money. DPC is built to be affordable primary care, often paired with a high-deductible or catastrophic insurance plan for everything outside the clinic.
Concierge medicine costs more, & what you get for that extra cost depends on the practice. At its best, the higher fee buys a doctor with fewer patients, more time per visit & the room to dig into complex health questions instead of just triaging them.
Either way, a membership isn't health insurance. You'll still want coverage for hospital stays, specialists, imaging, emergencies & prescriptions.
The 2026 HSA Change
Starting January 1, 2026, federal tax law changed how DPC works with health savings accounts. A qualifying DPC arrangement no longer disqualifies you from contributing to an HSA, & you can use HSA funds to pay the membership, as long as the fee stays at or below $150 a month for an individual or $300 a month for a family.
That change applies to DPC arrangements that meet the rules. Traditional concierge memberships, including those above the fee cap, generally fall outside it. Tax rules have fine print, so check with a tax professional before you plan around HSA dollars.
How to Choose Between Them
You're generally healthy & want affordable, accessible primary care
You want to pair a membership with a high-deductible plan & use HSA funds
Your needs are mostly routine: checkups, sick visits, basic labs
Concierge medicine may be a better fit if:
You're managing complex or chronic conditions that need real time to sort out
You see multiple specialists & want one doctor coordinating the big picture
You've felt dismissed or rushed in traditional care & want a doctor who has the bandwidth to listen
That second list is a big part of why PICM exists.
Where PICM Fits
PICM is a concierge practice. Membership is $450 a month with a 6-month minimum. We don't bill insurance, & we can provide superbills you may be able to submit to your insurance for possible out-of-network reimbursement.
Our physicians are board-certified family physicians who provide full primary care for patients 10 & up. We also have a particular focus on patients living with Ehlers-Danlos syndrome, POTS & MCAS. These conditions often overlap, involve several specialists & take time to manage well. A rushed visit model works against that. A smaller panel works for it.
See what's included on our Membership page, or check our FAQ for answers about billing & enrollment.
Frequently Asked Questions
Is concierge medicine the same as direct primary care?
No. Both are membership models, but DPC never bills insurance & usually costs less. Concierge practices vary more, often cost more & may or may not bill insurance.
Do I still need health insurance?
Yes. Neither model covers hospital care, specialists, emergencies or most prescriptions. A membership covers your relationship with your primary care doctor.
Can I use my HSA for a concierge membership?
Generally no. As of 2026, the HSA rule covers qualifying DPC arrangements up to $150 a month for an individual. Talk to a tax professional about your situation.
Does PICM bill insurance?
No. PICM doesn't bill insurance, but we can provide superbills for possible out-of-network reimbursement.
Find the Right Fit for Your Care
The right model depends on your health, your budget & how much time you need with your doctor. If you're managing EDS, POTS, MCAS or another complex condition & want a primary care home that has the time to get it right, let's talk.
Sources
American Academy of Family Physicians. Direct Primary Care
LegalClarity. Are Concierge Doctor Fees HSA Eligible? What the IRS Says
This article is for general information only & isn't medical, legal or tax advice. Membership details vary by practice. Talk to a tax professional about HSA eligibility for your situation.
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