Insurance
Do I still need health insurance with direct primary care?
Yes. Here is why, and how the two work together.
Key takeaways
- Keep your insurance. DPC covers everyday primary care, not emergencies, hospital stays, surgery or specialists.
- Many members pair DPC with a high-deductible plan, a health-sharing plan, a plan through work, Medicare or TRICARE.
- When you need a specialist or imaging, I coordinate it and help you compare cash prices with your insurance.
Direct primary care is not health insurance. Your membership covers your relationship with your primary care doctor: visits, calls, texts, check-ups and the everyday care most people need in a year. It does not cover the big, expensive, unpredictable things.
What DPC covers and what insurance covers
| Need | Covered by |
|---|---|
| Primary care visits, calls and texts | DPC membership |
| Annual exams and chronic disease care | DPC membership |
| Many in-office procedures | DPC membership |
| Labs and generic medications | Member prices through DPC, or your insurance |
| Specialists and imaging | Insurance, or cash prices I help you find |
| Emergency room, hospital stays and surgery | Insurance |
Why the pairing works
Think of it like a car. You don't file an insurance claim for an oil change. You pay for routine maintenance yourself and keep insurance for accidents. DPC is the routine care. Insurance is there for the accident.
Many DPC members pair their membership with a high-deductible plan, which usually has a lower monthly premium. Others use a health-sharing plan, a plan through work, or Medicare or TRICARE. Starting in 2026, people with a health savings account can also pay their DPC membership from their HSA within federal limits. I explain those limits in How much does DPC cost?
What I do to help
When you need a specialist, imaging or a hospital, I coordinate it. I send the specialist what they need, and I help you compare cash prices with what your insurance would cost, so you can choose what is cheaper for you.
Questions about DPC and insurance
Is this health insurance?
No. Direct primary care is a membership with your doctor. It does not cover hospital stays, surgery, specialists or emergencies, and it is not a substitute for insurance.
Can I keep my insurance?
Yes, and most members should. You can use insurance for specialists, imaging, hospital care and prescriptions alongside your membership. Many members pair DPC with a high-deductible health plan.
Can I use my HSA or FSA?
Starting in 2026, federal law lets you pay a direct primary care membership from a health savings account if the fee is no more than $150 a month for an individual or $300 for a family (2026 limits, adjusted yearly). Check with your HSA administrator or tax advisor about your own account.
What happens in an emergency?
Call 911 or go to the nearest emergency room. Direct primary care does not replace emergency care.
Join the waitlist
Peak Health is not open yet. It opens for direct primary care in Colorado Springs after Dr. Bennett's Army service ends. People on the waitlist hear first and are offered membership first.
No payment and no commitment.