They're not the same product, and the comparison is cost per useful visit. Group insurance costs about $657 a month per employee in employer share and covers everything, in theory, after a $2,631 deductible. Direct primary care costs $135 a month, covers primary care only, and has no deductible. For an employee who sees a doctor three times a year for ordinary things, insurance paid nothing toward those visits; the membership paid for all of them. The question is whether you also need hospital coverage, and at what price.
| Group health insurance | Direct primary care | |
|---|---|---|
| Employer cost per employee | ~$657/mo single | $135/mo |
| Deductible | $2,631 at small firms | None |
| Doctor visits | Copay, after deductible on many plans | Unlimited, included |
| Wait for a new-patient appointment | Weeks | Same or next day |
| Reach the doctor | Portal, days | Text or call |
| Hospital, surgery, specialists | Covered after deductible | Not covered; pair with a plan or self-pay |
| Minimum participation | Usually | None |
| Contract | Annual | Month to month |
Pick a max per employee for a doctor and a dentist. The page shows which local practices fit.
They choose their own doctor and dentist from that list. No network cards, no claims.
Itemized per person. You pay what each person actually picked. Start or stop any month.
If you can afford both, an HDHP for the hospital and DPC for everything else is the combination most benefits people recommend now. If you can afford one, DPC is the one your employees will actually use.
No. It's not insurance. Companies under 50 have no mandate; companies over 50 need a plan alongside it.
Yes, and that's common. DPC for day-to-day care, insurance for the rest.
Under current federal rules, DPC arrangements at or under $150 a month per person are. Several practices on our panel fit. Confirm with your plan advisor.