What Is Direct Primary Care? A Clear Guide to How It Works and What It Costs

If you’ve heard the term “direct primary care” and weren’t sure what it actually meant, you’re in good company. The model has been growing steadily across the country, but most people still encounter it for the first time when someone they know leaves a traditional practice and can’t stop talking about how much easier their healthcare has become.

Here’s a clear, honest explanation of what direct primary care is, how it differs from what you’ve likely experienced, and whether it might be a better fit for how you want to manage your health.

What Is Direct Primary Care?

Direct primary care, usually called DPC, is a membership-based model of primary care. Instead of billing insurance for each visit, the practice charges a flat monthly fee. That fee covers your primary care: office visits, chronic disease management, preventive care, routine screenings, and direct access to your physician by phone, text, or email.

No copays. No explanation-of-benefits paperwork. No surprise bills for a conversation that took twelve minutes.

The relationship is between you and your doctor, without an insurer sitting in the middle of every interaction.

How Does Direct Primary Care Work?

You pay a monthly membership fee, your physician keeps their patient panel small, and the result is a fundamentally different kind of practice.

In a traditional insurance-based primary care office, a physician may manage 2,000 to 3,000 patients. Appointments are often scheduled weeks out, and visits can feel rushed because the model is built around volume. DPC practices deliberately limit their panels, typically to a few hundred patients per physician, so each person actually gets time and attention.

At Agora Health, a direct primary care practice in Micanopy, FL, Dr. Jason Pfaffly and Dr. Mallory Pfaffly run the practice on this model:

• Members get same-day and next-day appointments
• You can reach your physician by phone, text, or email during clinic hours
• Visits aren’t timed or rushed
• Members have access to in-office procedures, labs, and tests at significantly reduced prices as a benefit of membership
• Prescriptions and outside services are available at negotiated cash pricing

The physician spends more time with you because they have fewer patients. That’s the structural difference, and it changes how care actually gets delivered.

What Does a DPC Membership Cost?

DPC membership costs vary by practice and by patient age. At Agora Health, the monthly rates for the Agora Essentials plan are:

Age Group	Monthly Rate
0–17 years	$30/mo
18–44 years	$80/mo
45–64 years	$95/mo
65+ years	$120/mo

*Kids’ memberships are $30/mo when enrolled alongside a parent or guardian.

For those who want more comprehensive care, the Agora Well Plan, which covers functional and longevity medicine, is $185 per month. There’s no enrollment fee, and new members pay their first three months upfront before switching to standard monthly billing.

For context, many people spend more than this on copays, specialist referrals, and urgent care visits in a single year, for conditions a DPC physician could manage proactively as part of the membership.

Does DPC Replace Health Insurance?

No, and this is one of the most common misconceptions about the model.

Direct primary care covers primary care, which handles the majority of everyday health needs: infections, chronic conditions like diabetes or hypertension, preventive visits, minor procedures, and care coordination. It does not cover hospitalizations, surgeries, or major specialist care.

Most DPC members pair their membership with a high-deductible health plan (HDHP), a health-sharing arrangement, or a traditional insurance plan with a higher deductible than they’d otherwise carry. Because DPC absorbs routine and preventive care, the insurance plan is used less often, which can help keep premiums more manageable.

Some members also use DPC alongside an HSA. IRS rules around HSA-eligible plans have specific requirements, so it’s worth confirming compatibility with a benefits advisor.

Who Is Direct Primary Care For?

DPC works for a wide range of patients, but there are a few situations where it tends to make the most sense.

People managing chronic conditions. If you have diabetes, high blood pressure, thyroid disease, or another ongoing condition, DPC gives you consistent access to a primary care doctor who knows your history. You’re not re-explaining your situation at every visit.

People who want preventive, proactive care. DPC practices are built for prevention, not just reaction. Your physician has time to review your labs in depth, discuss lifestyle factors, and help you identify problems before they become serious.

Individuals and families without employer coverage. If you’re self-employed, between jobs, or your employer doesn’t offer benefits, DPC combined with a lower-cost insurance plan can be more affordable than a full premium on its own.

Employers. Agora Health offers employer-sponsored DPC plans, which businesses can use to give their teams direct access to primary care. These plans can help reduce ER and urgent care use and support more proactive management of employee health.

What’s Included in a DPC Membership?

The specific inclusions vary by practice. At Agora Health, membership covers:

• Unlimited visits with no copays
• Same-day and next-day appointments
• Direct communication with your physician by text, phone, or email
• Telehealth and in-person visits
• Annual wellness visits and preventive screenings
• Chronic and acute condition management
• In-office lab draws, on-site ultrasound, and EKGs
• Prescription management with discounted cash pricing
• Coordinated referrals to specialists when needed

The practice also includes a range of in-office procedures at low, transparent pricing as part of the membership: skin biopsies and excisions, joint injections, spirometry, wound care, and more.

Why Some Patients Leave Traditional Practices for DPC

There’s a pattern you hear from DPC members that comes up consistently. They didn’t always leave their old doctor because of a bad experience. They left because the system made it too difficult to actually see anyone.

Waiting three weeks for an appointment when you’re sick. Eight minutes with your doctor before the visit is over. Receiving a bill for a phone call you had no idea would be billed. Being told to come in for something that could have been resolved with a five-minute conversation.

DPC removes most of that friction. You text your physician. You get an answer. You come in the next morning if you need to. For people actively managing their health, or for those who simply want access to a doctor they can build a real relationship with, the difference is significant.

Key Takeaways

• Direct primary care is a membership model: you pay a flat monthly fee for unlimited primary care, with no copays or per-visit billing.
• DPC does not replace insurance. It covers primary care; you still need coverage for hospitalizations and major procedures.
• DPC physicians keep smaller patient panels, which is what makes same-day access, longer visits, and direct communication possible.
• Monthly costs in a DPC practice typically range from $30 to $120 depending on age, making it accessible for individuals, families, and employer groups.
• DPC pairs well with high-deductible insurance plans, HSAs, and health-sharing arrangements.
• Agora Health, founded by Dr. Jason Pfaffly and Dr. Mallory Pfaffly, offers DPC memberships in Micanopy, FL, serving patients across Alachua and Marion County with plans starting at $30 per month.

Is Direct Primary Care Right for You?

Direct primary care removes much of the friction most people have come to accept as normal in healthcare: a flat monthly fee, a physician who knows you, and appointments when you actually need them.

Whether you’re managing a chronic condition, trying to stay ahead of health risks, or simply want a primary care experience that doesn’t feel like a transaction, DPC is worth understanding on its own terms. Agora Health offers a practical entry point into this model, with transparent pricing, no enrollment fees, and care built around the patient rather than the claim.

Frequently Asked Questions