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Direct Primary Care

Can You Have Direct Primary Care and Health Insurance at the Same Time?

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Absolutely. In fact, for many people, Direct Primary Care and health insurance can work very well together.

One of the most common questions we hear when someone first learns about Direct Primary Care (DPC) is:

“If I already have health insurance, why would I also need a DPC membership?”

It’s a fair question.

The answer starts with understanding that DPC and health insurance are designed to serve different purposes.

Direct Primary Care focuses on your ongoing primary care relationship—the everyday healthcare needs that often include preventive care, sick visits, chronic condition management, medication discussions, follow-up care, and having a physician who knows your medical history.

Health insurance, on the other hand, is designed to help cover the cost of healthcare services that go beyond routine primary care, such as hospitalizations, emergency care, specialists, surgeries, advanced imaging, and other major medical expenses, depending on your particular plan.

DPC Doesn’t Replace Your Health Insurance

A DPC membership is not health insurance.

Instead, it is a direct relationship between you and your primary care practice. Rather than submitting claims to an insurance company for covered primary care services, you pay the practice a predictable monthly membership fee.

At Balanced Physician Care, that membership gives our patients access to a broad range of primary care services without the traditional fee-for-service approach.

That means you aren’t paying a copay every time you need to see us for an included service, and you’re not dealing with insurance claims for those services.

The goal is simple:

Make primary care more accessible, more personal, and easier to navigate.

So What Is the Insurance For?

Think of your DPC membership as taking care of your primary care relationship, while your health insurance provides financial protection for healthcare needs that may be much more expensive.

Depending on your insurance plan, that may include:

  • Specialist visits
  • Hospitalization
  • Emergency room care
  • Surgery
  • Advanced diagnostic imaging
  • Cancer treatment
  • Other major medical expenses

Your specific coverage, deductible, copays, coinsurance, and network requirements will depend on your insurance policy.

That’s why DPC should not be viewed as a replacement for comprehensive health insurance.

Instead, the two can complement one another.

What Happens When You Need a Specialist?

Being part of a DPC practice doesn’t mean your primary care physician has to handle everything.

Sometimes a medical concern can be evaluated and treated within primary care. Other times, seeing a specialist is the appropriate next step.

When that happens, your DPC physician can help determine whether a referral or specialist consultation is appropriate and help coordinate your care.

And when you come back from the specialist, you still have someone who understands your overall health picture and can help you make sense of what comes next.

That continuity is one of the important differences between simply having access to healthcare and having an ongoing relationship with your primary care physician.

But Isn’t DPC Just Another Monthly Healthcare Expense?

This is where many people initially get hung up.

Yes, a DPC membership is an additional monthly expense if you already have insurance.

But it’s worth looking at what you’re actually paying for.

Traditional insurance-based primary care generally involves billing insurance for individual services. DPC operates differently: you pay a predictable membership fee directly to the practice for the primary care services included in your membership.

At Balanced Physician Care, our goal is to eliminate much of the uncertainty and frustration surrounding routine primary care.

Instead of:

“How much is this visit going to cost me?”

the question becomes:

“How can we take care of this?”

That difference can be particularly valuable when you have questions, need to be seen for an acute illness, need follow-up care, or simply want more time with your healthcare provider.

What About HSAs and DPC in 2026?

There is another important consideration in 2026.

Federal law changed the rules surrounding Health Savings Accounts and qualifying Direct Primary Care arrangements. Beginning in 2026, certain individuals participating in qualifying DPC arrangements can remain eligible to contribute to an HSA, and HSA funds may be used tax-free for qualifying DPC fees subject to applicable requirements and limits.

Because HSA eligibility depends on the individual’s circumstances and health plan, it’s important to review your particular situation and the current IRS requirements rather than assuming every DPC arrangement is treated exactly the same.

This is especially important if you have a high-deductible health plan and are considering pairing it with a DPC membership.

Why Would Someone Have Both?

For some people, the combination makes a lot of sense:

DPC for primary care.
Health insurance for major medical expenses.

Your DPC membership can provide a direct relationship with your primary care practice, while your insurance remains available for healthcare expenses outside the scope of the DPC membership.

This can give you two things that are often difficult to get from a traditional healthcare arrangement:

Predictable primary care costs and protection from large medical expenses.

The Question Isn’t Really “DPC or Insurance?”

A better question might be:

“What do I want from my primary care physician?”

Do you want to be able to reach your primary care practice when you have a question?

Do you want longer appointments instead of feeling rushed through your visit?

Do you want same-day or next-day care when you’re sick, when available?

Do you want a physician who has the time to understand your medical history and your health goals?

Do you want to spend less time dealing with insurance-related hassles for your routine primary care?

These are some of the reasons people choose Direct Primary Care.

DPC and Insurance Can Work Together

Direct Primary Care isn’t about eliminating health insurance.

It’s about changing the way you access primary care.

You can maintain your health insurance for the medical expenses that fall outside your DPC membership while having a direct relationship with your primary care practice for your everyday healthcare needs.

At Balanced Physician Care, we believe primary care should be personal, accessible, and centered around the relationship between the patient and the physician—not the insurance company.

If you’re curious about whether Direct Primary Care makes sense for you, we’re happy to explain how the membership works and answer your questions before you make a decision.

Give us a call at Balanced Physician Care to schedule your no obligation, Meet & Greet – 904-930-4774.

The Three Biggest Misconceptions About Direct Primary Care—and Why Patient Education Matters

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After answering the question “What is Direct Primary Care?” countless times, I’ve noticed that three misconceptions come up again and again.

Understanding and addressing these misconceptions is one of the most important opportunities for DPC practices today—not simply as a marketing strategy, but as a way to help patients understand how healthcare can work differently.

1. The “Double Payment” Problem

“Why should I pay a monthly health insurance premium and a monthly DPC membership?”

It’s a fair question.

The challenge is that healthcare has conditioned us to think about routine medical care differently than we think about almost every other routine service in our lives.

We don’t ask, “Why should I pay for auto insurance and an oil change?” We understand that auto insurance protects us from major, unexpected expenses, while we pay directly for routine maintenance.

Likewise, we don’t ask, “Why should I have homeowners insurance and pay a plumber to fix a leak?” We understand the difference between insurance protection and the cost of maintaining our home.

In these situations, we understand what we are paying for, who we are paying, and why. We expect transparency, compare value, and often willingly pay more for quality or convenience.

Insurance serves as a financial safety net for large, unpredictable events.

Healthcare evolved differently.

We have been taught to expect health insurance to function as both a payment system and a safety net—covering everything from routine primary care visits to catastrophic illness. As a result, the relationship between price, value, and decision-making has become much less visible to the patient.

Patients often don’t know the true cost of their care. Providers and insurance companies negotiate prices behind the scenes. And premiums and out-of-pocket costs continue to rise.

DPC offers an opportunity to rethink this relationship.

Instead of asking insurance to pay for every healthcare interaction, we can use insurance for what it does best: protecting us financially from large and unexpected medical expenses.

Then, patients can directly invest in accessible, relationship-based primary care.

That creates something healthcare desperately needs: transparency, simplicity, and greater patient control.

2. The Retainer Stigma

Another common reaction is:

“Isn’t a membership doctor just something wealthy people have?”

It shouldn’t be.

This is where it is important to understand the difference between concierge medicine and Direct Primary Care.

Direct access to your physician should not be viewed as a luxury. It should be considered a fundamental part of high-quality primary care.

DPC challenges the idea that exceptional access to a physician has to be exclusive or reserved for the wealthy.

The model is built around something remarkably simple: creating an ongoing relationship between a patient and their primary care physician, with fewer barriers between them.

Patients shouldn’t have to wait weeks for an appointment, spend hours in a waiting room, or feel like they are bothering their doctor when they have a question.

Access is not a luxury. Relationship is not a luxury. Continuity is not a luxury.

These are essential components of good primary care.

DPC simply changes the way those services are delivered and paid for.

3. The Value Disconnect

Perhaps the biggest challenge is helping people recognize the value of a relationship with a physician before they actually need one.

Most people already understand the membership model.

We pay monthly for gyms, streaming services, entertainment, software, meal kits, and countless other subscriptions. The concept itself isn’t difficult.

The challenge is connecting the idea of a membership with the value of primary care.

DPC isn’t simply about unlimited office visits or being able to text your doctor.

It is about having a trusted physician in your corner when questions arise, symptoms begin, medications need adjusting, test results need to be explained, or life circumstances change.

That relationship has value—even when you’re healthy.

And this is where DPC practices have an enormous opportunity.

We need to clearly demonstrate how DPC is different—not only from traditional primary care and urgent care, but also from telehealth companies and other convenient healthcare options.

The value isn’t simply convenience.

It is continuity. Trust. Access. Familiarity. Partnership.

A telehealth service may be able to treat today’s sore throat.

A DPC physician knows the person who has the sore throat.

That distinction matters.

And explaining that distinction requires a tremendous amount of patient education.

But I believe it is also one of the greatest opportunities in healthcare today.

The Solution: Make Patient Education Part of the DPC Culture

So where does DPC begin solving this problem?

Educate. Educate. Educate.

Some people might call this marketing.

I believe it is something much deeper.

DPC isn’t simply a product to sell. It is a different healthcare model—one that patients need to understand.

Our job isn’t just to convince people to join.

Our job is to help them understand why this model exists, what problems it solves, and why it may be a better fit for their healthcare needs.

Education is the foundation of DPC growth.

And the good news is that primary care physicians are uniquely qualified to do this.

We aren’t salespeople. We’re educators.

Teaching patients is what primary care physicians have always done.

Every day, we explain diagnoses, discuss treatment options, interpret laboratory results, review medications, answer questions, and help patients make informed decisions about their health.

Teaching is already one of the most important parts of primary care.

Now we simply need to extend that same mindset to the healthcare system itself.

We need to help patients understand:

  • Why primary care is different from emergency and specialty care.
  • Why insurance is valuable, but isn’t necessarily designed to pay for every healthcare need.
  • Why an ongoing relationship with a physician matters.
  • Why access matters.
  • Why continuity matters.
  • Why knowing your physician—and having your physician know you—has value.
  • Why investing in primary care can be one of the most valuable investments a person makes in their health.

And this education doesn’t begin and end in the exam room.

It happens in conversations with friends and family.

It happens on social media.

It happens through websites, newsletters, community events, and employer partnerships.

It happens every time a potential patient interacts with a DPC practice.

Every one of those interactions is an opportunity to explain not just what DPC is, but why it matters.

Direct Primary Care Isn’t Just a Different Way to Pay for Healthcare

At its core, Direct Primary Care represents a different way of thinking about the doctor-patient relationship.

It puts primary care back at the center of healthcare.

It gives patients a clearer understanding of what they are paying for.

It gives physicians the opportunity to focus on relationships rather than volume.

And it gives patients something increasingly difficult to find in modern healthcare:

A doctor who knows them, is accessible to them, and is there when they need help.

That is the story Direct Primary Care needs to tell.

And the best way to tell it isn’t through better sales pitches.

It’s through better education.

Schedule your no obligation, Meet & Greet with Balanced Physician Care

NBC News Story: Explosive growth of Direct Primary Care Doctors

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What was a niche aspect of medical care just a few years ago has exploded to thousands of practices across the country. In direct primary care, medical providers don’t take insurance. Instead, their patients pay a monthly subscription fee. In exchange they get easier access, longer appointments, and continuity of care from the same provider. NBC News’ Anne Thompson reports on the doctor, and his patients, who says it’s a better way to practice medicine.

If you are interested in Direct Primary Care in Jacksonville Beach, Florida, visit the Balanced Physician Care membership page – www.balancedphysiciancare.com/membership

How Small Businesses Can Cut Healthcare Costs & Improve Employee Care

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If you’re a small business owner tired of sky-high premiums—or an employee who wants better care without the runaround—this Video episode below is your roadmap.

Please visit the Balanced Physician Care Small Business page for Membership Options at https://balancedphysiciancare.com/business-direct-primary-care/

Health Insurance for Direct Primary Care – Atlas Direct

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Finally a supplemental health insurance plan built specifically for Direct Primary Care practices like Balanced Physician Care

I’m happy to report that there is now a new insurance program called Atlas Direct that’s specifically designed to work with DPC.

It’s a fixed indemnity plan that offers coverage for hospitalization, emergency-room care, ambulance transportation and several other medical services as well as fixed payment amounts for over 400 surgeries and diagnostic procedures.

  • There are no deductibles or copays
  • Payments go directly to you, not providers
  • Cash benefits can be used for any expense, not just medical bills
  • There are no open enrollment periods, so you can enroll at any time
  • There are no network restrictions

It is also important to understand that Atlas Direct does not include Direct Primary Care itself, which you have to obtain from a Direct Primary Care provider (like Balanced Physician Care) who will charge you separately for their services (our membership). 

Finally, please understand that Atlas Direct is not a comprehensive major medical plan and that if you are looking for comprehensive health insurance you should consult with a licensed insurance agent or visit your state’s health insurance marketplace.

For additional details about Atlas Direct’s benefits, eligibility, limitations, and exclusions, please see their brochure. For a list of the 439 surgeries and medical procedures covered by Atlas Direct, click here. 

There are no deductibles or copays with Atlas Direct’s plan.

We are exciting about the possibilities with this new insurance option. It is worth taking a look at.

Yours Truly,

Sharyl Truty MD

Proactive Medicine, Metabolic Health & Treating the Whole Person

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Dr Delilah Beall DPT of Samson Strength & Performance Physical Therapy and Adrienne Denenberg PA-C spend some time talking about direct primary care and why it is better than traditional insurance-based primary care, functional medicine, and how to focus on long term health. In This episode you’ll hear about:

  • What a direct primary care model is and how it differs from traditional insurance-based care
  • How Adrienne combines traditional and functional medicine to treat the whole person
  • Why metabolic health is a key focus — and what it actually means
  • How lifestyle factors like sleep, stress, nutrition, and exercise play into long-term wellness
  • Common internal and external barriers that keep people from making healthy choices

Check out the podcast episode below (use the arrows to navigate):

Solving Common Direct Primary Care Issues

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When taking care of your health, choosing the right approach is essential. One option that’s growing in popularity is Direct Primary Care (DPC). This model focuses on bringing a fresh perspective to healthcare by forming a direct relationship between doctors and patients. It works on a membership basis, so patients pay a set fee to access various medical services without worrying about extra charges. With more people exploring this option, knowing the ins and outs of DPC can help you decide if it’s right for you.

Living in Jacksonville offers unique health challenges, and DPC practices like Balanced Physician Care are working to address these with personalized care. Services such as primary care, holistic medicine, sports medicine, and acupuncture form the foundation of their offerings. This setup allows patients to keep their health in check while exploring ways to stay well. Let’s look more closely at some common issues folks encounter with DPC and how solutions can improve the experience for everyone involved.

Common Issues with Direct Primary Care

One of the first things patients wonder about with Direct Primary Care is the membership-based model. It’s a shift from the usual fee-per-visit setup and involves paying a monthly or yearly fee to cover all primary care services. For some, paying upfront can make them uneasy, as they’re used to paying for each appointment separately. Some worry about whether the cost is worth it or if they’ll need more specialized care not covered by the plan.

Access to specialized services is another area where questions arise. While DPC offers valuable primary care, its integration with specialties like holistic medicine, hormone therapy, weight loss, sports medicine, and acupuncture makes it appealing to many. However, patients often wonder if these services are readily available or if they’ll need to seek out other providers. This concern leads many to ask how these specialized treatments affect their health plan.

Communication between patients and doctors is key. In a typical healthcare setting, patients might feel rushed during visits or unable to get answers to their questions. DPC aims to change that by ensuring that communication channels are open and active. Still, some patients wonder if their concerns will be fully heard and addressed in this model. Effective communication is crucial to ensure all health matters are discussed openly.

Lastly, managing health over time presents its own set of challenges. Regular follow-ups and personalized medical care plans are the cornerstone of DPC, yet staying consistent with appointments can be tough for some people. The busy schedules many have often mean that routine checks get pushed aside, which can hinder long-term health management. Patients need to understand the importance of regular visits in keeping track of their health journey.

Solutions to These Common Issues

A little clarity goes a long way for those concerned about membership-based models. Paying a set fee might seem unusual, but it simplifies expenses and covers a range of services without the surprise of extra charges. This model allows patients to focus on their health without financial worries, knowing precisely what they’re getting each month. Reassurances about cost transparency remind people of the predictability that DPC provides.

Meanwhile, access to specialized services might raise eyebrows, but it’s a key feature of DPC that enhances care. Patients have access to a blend of primary care, holistic medicine, sports medicine, hormone therapy, weight loss, and acupuncture without having to jump through hoops. This approach integrates different therapies, working together to address various health needs. It’s not about choosing one type of care but having a holistic plan that includes multiple healing practices.

Communication is another area that shines in the DPC model. The goal is to create an environment where patients feel heard and understood. Direct Primary Care facilitates open dialogue between patients and doctors, providing seamless communication tools. It’s not just about medical jargon; it’s about having a conversation where concerns are addressed, and patients feel part of the discussion.

Lastly, when considering health management and regular check-ups, DPC helps prioritize these through tailored care plans. By focusing on individual needs, patients can adhere to a proactive approach that keeps them on track. Consistent care helps monitor progress and adjust plans as needed, ensuring their health remains a top priority without constant reminders.

Why Choose Direct Primary Care in Jacksonville

Jacksonville residents have unique healthcare needs, and Direct Primary Care offers a solution tailored to those requirements. Through its comprehensive model, DPC provides an accessible and personal healthcare experience. The combination of various services under one roof appeals to those seeking traditional and alternative medicine approaches.

DPC’s convenience lies in its structured membership, which provides peace of mind and eliminates unexpected costs. Patients find comfort in knowing they have a dedicated team supporting their wellness journey. With the potential for personalized care plans, DPC stands out as a viable choice for maintaining health without the complexities of traditional healthcare settings.

Investing in one’s health through Direct Primary Care offers more than routine visits. It opens doors to engaging various healthcare methods, ensuring a well-rounded approach to well-being that resonates with the lifestyle and preferences of Jacksonville’s community.

Ready to take charge of your health with personalized care options? Explore how direct primary care in Jacksonville can support your wellness journey. Balanced Physician Care offers a membership-driven approach that includes primary care, holistic medicine, weigh loss plans, hormone therapy, sports medicine, and acupuncture. With these integrated services, you can enjoy a seamless healthcare experience tailored to your needs. Discover how this innovative model fits your lifestyle and start reaping the benefits today. Call the Balanced Physician Care office at 904.930.4774 for more information.

5 Ways Direct Primary Care Can Benefit You

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Our memberships at Balanced Physician Care incorporate the benefits of direct primary care. To learn more about both our membership plans visit www.balancedphysiciancare.com/membership or call the office at 904.930.4774

3 Common Misconceptions About Direct Primary Care

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Direct Primary Care (DPC) is a healthcare model that offers a refreshing alternative to the traditional insurance-based system. By paying a monthly or annual fee, patients get access to comprehensive primary care services without the need for copays or dealing with insurance claims. Despite the benefits, there are still myths surrounding DPC that can lead to misunderstandings. Let’s debunk three of the most common myths to clear up any misconceptions and shed light on why DPC is an excellent choice for many individuals and families.

For more information about how Direct Primary Care works or to learn about our membership plans, visit www.balancedphysiciancare.com/membership or give the Balanced Physician Care office a call at 904-930-4774.

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