DPC Value Calculator
See what Direct Primary Care (DPC) would actually cost — or save — in your situation. Every number this calculator uses is either typed in by you or shown to you in “Numbers we assumed for you,” where you can change it. Sometimes the answer will be that DPC doesn’t save you money; when that’s true, we’ll say so. Curious what membership actually includes? Read about direct primary care in Gainesville — the membership works the same whether you’re local for house calls or join by telehealth from any state we serve.
Your Information
DPC works alongside all of these — the question this page answers is what it adds and what it costs in each case.
Your age determines the individual membership rate.
Every tier is at or below the federal $150/$300 monthly limit for Health Savings Account (HSA) compatibility in 2026.
Estimated total cost of a potential surgery, emergency room visit, or hospitalization. This is where the options below really separate — try $50,000 and watch.
From your plan documents. The 2026 base beneficiary premium is about $39/month; many plans differ.
Many Medicare Advantage plans are $0/month — enter yours if it isn’t.
Numbers we assumed for you — check and change them
Every calculator makes assumptions. Most hide them; here are ours, editable. For family plans, deductibles and out-of-pocket maximums are doubled. The “cash price elsewhere” visit figures are not AMH prices — AMH doesn’t bill per visit; primary care is included in the membership. They’re national estimates of what cash-paying patients face at other practices (a 2024 national survey put the average uninsured primary-care visit at $171, range $40–$300; self-pay specialist consults commonly run $200–$500) — replace them with real local quotes if you have them. The insurance negotiated rate defaults to 58% of billed charges, the average commercial rate in a 2022 Health Affairs study of hospital price-transparency data — it varies enormously by plan and service, so replace it with yours too. The plan designs (deductibles, coinsurance, maximums) are illustrative estimates, not any specific plan.
Your Personalized Results
Healthcare Acronyms: A Quick Guide
Definitions for the abbreviations used in the DPC guide and calculator. Understanding these terms is key to making an informed decision about your healthcare coverage.
DPC
A healthcare model where patients pay a flat, recurring monthly fee directly to their primary care physician. In exchange, they receive a comprehensive package of primary care services without per-visit fees or copays. Since January 1, 2026, federal law formally recognizes DPC arrangements (Public Law 119-21 §71308), and fees up to $150/month for one person ($300/month for more than one) are compatible with Health Savings Accounts.
A subscription or membership for your healthcare (like Netflix for your doctor).
HSA
A personal, tax-advantaged savings account for medical expenses. To contribute, you must be enrolled in a High-Deductible Health Plan (HDHP) and have no disqualifying other coverage. For 2026 you can contribute up to $4,400 (self-only) or $8,750 (family), plus $1,000 more at age 55+. The money is yours forever — it rolls over, moves with you between jobs, and can be invested. New for 2026: DPC membership fees are a qualified expense, and being a DPC member no longer blocks contributions. One hard stop: enrolling in any part of Medicare ends new contributions (you can still spend the balance).
A 401(k) for healthcare. Pre-tax going in, tax-free growth, tax-free coming out for qualified expenses.
FSA
An employer-sponsored account funded from your paycheck before taxes, used for medical expenses during the plan year. The 2026 limit is $3,400, and it is largely use-it-or-lose-it — at most $680 can carry over. Two things DPC patients should know: (1) whether an FSA can reimburse a DPC membership fee is unsettled — administrators disagree, so ask yours in writing; and (2) a general-purpose FSA counts as “other coverage” that blocks HSA contributions. A limited-purpose FSA (dental and vision only) does not block an HSA — that’s the version to pair with one.
A pre-tax debit card for this year’s predictable medical costs — powerful, but it expires.
MSA
Two distinct things share this name. A Medicare MSA is a special Medicare Advantage plan: no plan premium, Medicare itself deposits money into a savings account for you each year, and the plan pays 100% of Medicare-covered services after a high deductible. You cannot add your own money, the plans include no drug coverage (you’d buy Part D separately), and — the honest catch — for 2026 they are offered only in Wisconsin, so no Florida resident can enroll in one today. The older Archer MSA for the self-employed has been closed to new enrollment since 2007. Whether MSA dollars can pay a DPC fee is less settled than for HSAs — ask a tax professional.
Medicare’s version of the HSA-plus-high-deductible idea — interesting on paper, currently almost impossible to buy.
HRA
An employer-funded account that reimburses employees tax-free for qualified medical expenses, up to an amount the employer sets. The employer owns and funds it — you can’t contribute. Many HRAs can reimburse DPC fees, but there’s a trade-off: an HRA that reimburses more than insurance premiums generally makes you ineligible to contribute to an HSA (IRS Notice 2026-5). Small employers can offer a QSEHRA, capped at $6,450 single / $13,100 family for 2026.
A healthcare allowance from your employer — their money, their rules, real value.
HDHP
A health insurance plan with a higher deductible and lower premiums, and the only kind of plan that unlocks HSA contributions. For 2026 an HDHP must have a deductible of at least $1,700 (self-only) / $3,400 (family), with out-of-pocket maximums no higher than $8,500 / $17,000. New for 2026: any Bronze or Catastrophic plan bought through the ACA Marketplace is treated as an HDHP even if it doesn’t meet those tests (Public Law 119-21 §71307).
“Major medical” or catastrophic insurance — protection from very large bills, paired naturally with DPC for the everyday care.
PPO
A traditional health insurance plan with a network of “preferred” doctors and hospitals. You pay less in network, can go out of network at higher cost, and usually don’t need referrals to see specialists. Premiums are typically the highest of the common plan types.
The flexible, full-service — and usually most expensive — way to buy insurance.
AHP
A term used by some Health Sharing Ministries (Medi-Share, for example). It’s the amount a household must pay out of pocket for eligible medical expenses each year before other members’ contributions begin to share the costs. Larger AHPs mean lower monthly shares — and more risk kept on your side of the table.
The health-sharing world’s version of a deductible — except no regulator guarantees what happens after you meet it.
IUA
Another health-sharing term for the same idea as the AHP, used by organizations like Sedera and Zion: the amount you pay yourself, per medical need, before the community shares the rest. Note it’s often per incident rather than per year — three separate medical events can mean paying the IUA three times. Read your plan’s guidelines for which way yours works.
A per-event deductible in health-sharing clothing.