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Direct primary care
Direct Primary Care in Texas: How It Works and What It Costs
A flat monthly fee for your own primary care team, with no copays. Here's how it works in Texas, the law behind it, and why it's never enough on its own.
- Free, no obligation
- Not an insurance agency
- Honest about the limits
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Prefer to talk now? Call (214) 307-8614The short answer
Direct primary care (DPC) is a membership with a primary care practice. You pay a flat monthly fee, and sick visits, checkups, questions and follow-ups are included, with no copay each time. It isn't insurance, and it doesn't pay for specialists, hospitals or emergencies. Most people pair it with something for big bills.
Texans search for "direct primary care" about 1,900 times a month, and for "concierge doctor" about 2,900 times. Many people know DPC by that second name, though the two aren't quite the same (see below).
What Texas law says
Texas recognized direct primary care in its Occupations Code in 2015. Section 162.253 says a physician providing direct primary care is not an insurer or HMO, that a direct primary care medical service agreement is not health or accident insurance, and that neither the doctor nor the agreement is regulated by the Texas Department of Insurance (source). The doctor doesn't need an insurance license to offer the membership.
In practice, that means a DPC membership is a contract with a medical practice, not a health plan. It doesn't count as minimum essential coverage under the ACA, and it won't pay for anything outside the practice.
What a DPC membership usually includes
- Sick visits and checkups, in person or by video, without a copay
- Direct contact with your doctor's team by phone, text or video
- Help managing common conditions such as high blood pressure or diabetes
- Often, low cash prices on basic labs and generic medications (varies by practice)
What it doesn't include
- Hospital stays, surgery and emergencies
- Specialists, imaging such as MRI, and most procedures
- Anything outside primary care
That gap is why a DPC membership is never enough by itself. For big bills, the options are a Marketplace plan or health care sharing.
Local practice or virtual membership?
| Local DPC practice | Virtual primary care membership (our pairing) | |
|---|---|---|
| Where | An office you can drive to | Phone and video, anywhere in Texas, and when you travel or work far from home |
| Hands-on care | Exams, stitches, in-office tests | You go in person elsewhere when needed |
| Best for | Families near a practice who want the same doctor in person | Busy schedules, rural and small-town households, crews who work away from home |
| Price | Set by each practice; ask for adult and child fees | Built into the combined monthly amount on our price table |
Practices set their own fees and services. Confirm them with the practice before you join. We don't rank practices.
Questions to ask any DPC practice
- What's the monthly fee for adults and for children, and is there a sign-up fee?
- How fast can I get a same-day or next-day visit?
- Which labs and medications do you offer at cost, and what do they cost?
- Can I reach the doctor after hours?
- How much notice do I need to cancel?
Where it fits
Most households we help pair three things: primary care membership for everyday care, health sharing for big unexpected bills, and a dental savings plan for teeth. See what the full combination costs.
Common questions
Is direct primary care legal in Texas?
Yes. Texas law (Occupations Code § 162.253) says a physician providing direct primary care isn't an insurer or HMO, and a direct primary care agreement isn't health insurance or regulated by the Texas Department of Insurance.
Is direct primary care the same as concierge medicine?
Not quite. Both charge a membership fee. Concierge practices often also bill your insurance and tend to charge more. Direct primary care usually doesn't bill insurance at all; the membership is the whole price for primary care.
Do I still need something for big bills?
Yes. Direct primary care doesn't pay for hospitals, surgery, specialists or emergencies. That's why we pair it with health sharing or point you to insurance.
Can I use a local DPC doctor instead of the virtual one?
Tell us. Our standard pairing includes a virtual membership that works statewide. If you already have, or want, a local DPC practice, we'll talk through how that fits with health sharing.
Sources
Want to see what this would cost your household?
Tell us who needs care and what you pay now. We'll walk you through the options, including when insurance is the better fit.
Free, no obligation. Texas households only.