Direct Primary Care
Primary care you pay for directly, with no insurance in the middle
One flat monthly fee, unlimited visits with the same provider, and laboratory testing at close to what it actually costs. Here is exactly how it works, what it includes, what it does not, and where the savings come from.
What it is
A membership for your primary care, not an insurance plan
Direct primary care, usually shortened to DPC, is a membership. You pay The Florida NP a flat monthly fee, and that fee covers your primary care. Nothing is billed to a health plan, so there is no copay when you are seen and no bill in the mail afterward. Because no insurer sits in the middle, the practice can also hand you laboratory testing at the price it is billed, which is often a tenth of the list price.
Membership is $79 a month for ages 18 to 44, $99 for ages 45 and older, and $35 for children 17 and under, and a family plan covering two adults and two children is $219 a month. See every fee. Direct primary care is not health insurance and is not a replacement for it.
The fifteen-minute visit is a billing problem, not a medical one
Almost everything patients dislike about primary care traces back to how it gets paid for.
In insurance-based primary care, the practice is paid per visit, and each visit has to be documented in a way the insurer will accept. To stay solvent at those rates, a practice needs a large panel of patients and short appointments. That is where the familiar experience comes from: the three-week wait, the fifteen minutes, the feeling that you got through two of your four questions, the follow-up visit booked mostly so something else can be billed.
Direct primary care changes the payment, and the rest follows. A membership practice is paid the same whether you come in once a year or once a month, so there is no reason to ration your time and no reason to turn a message into an appointment. Panels are small on purpose. A visit lasts as long as the problem takes.
It is not a new idea, and it is not a loophole. Florida recognizes these arrangements explicitly in statute, as direct health care agreements under Florida Statute 624.27, which is also what confirms that a membership of this kind is not insurance and is not regulated as insurance.
Side by side
How it compares to insurance-based primary care
| Direct primary care | Insurance-based primary care | |
|---|---|---|
| What you pay | One flat monthly fee | Premium, plus a copay or deductible at each visit |
| Cost of a visit | Included, however many you need | Charged each time, amount often unclear until the bill arrives |
| Visit length | As long as the problem takes | Typically ten to fifteen minutes |
| Messages and refills | Included | Increasingly billed as a visit |
| Laboratory testing | Passed through at the practice's cost | Billed at list price, applied to your deductible |
| Who you see | The same provider every time | Whoever is available |
| Prior authorization | Not applicable, nothing is billed to a plan | Common, and a frequent source of delay |
| Covers hospital and specialists | No, you still need insurance | Yes, subject to the plan |
Insurance-based figures describe the model generally and are not a statement about any particular plan or practice.
What you get
What a membership includes
Everything in this list is covered by the monthly fee. There is no charge at the time of a visit and nothing gets billed afterward.
Unlimited video visits
As many as you need, with no per-visit charge and no cap. If something comes up two days after your last visit, you are seen again. Nobody is counting.
Same-day or next-day appointments for urgent things
Small panels mean there is room in the schedule. The sinus infection that starts on a Tuesday gets looked at that week, not in three.
Longer appointments
Thirty to forty-five minutes for a new visit, and as long as it takes for a complicated one, because the practice is not paid by the visit.
Direct messaging between visits
Secure messaging for the questions that do not need a full appointment. A photo of a rash, a question about a side effect, a reading from your home blood pressure cuff. Answered by Kirsis Perez, ARNP, FNP rather than routed through a call center.
Chronic condition management
Diabetes, blood pressure, cholesterol, thyroid, asthma, reflux. Followed over time with the check-ins the condition actually calls for, rather than the number of visits a plan will reimburse.
Annual wellness and preventive care
A full yearly review of your history, screenings, medications and risk factors, with labs ordered and referrals arranged.
Prescriptions and refills
Written and sent to your pharmacy, with monitoring labs kept current. No appointment invented just to renew something you have taken for six years.
Lab ordering, pass-through pricing, and a real explanation
Orders sent to a Quest draw site near you at the practice's own cost, then results gone through with you in plain language instead of landing in a portal with no context.
Referrals and care coordination
When something needs a specialist, imaging, or hands-on examination, you leave with a referral, your records, and a clear next step.
Forms and paperwork
Work and school notes, prior authorization support for your pharmacy, and the routine paperwork that other practices charge a fee to complete.
Just as important
What a membership does not include
Being clear about this up front matters more than being persuasive. A membership is primary care, and primary care has edges.
A membership is not health insurance
It does not meet any insurance requirement and does not protect you from the cost of a hospital stay. Almost every member should carry a health plan, a health share, or another form of catastrophic coverage alongside it. The Florida NP LLC is not an insurer.
Hospital care, surgery, and emergencies
Admissions, operations, ambulance transport and emergency department visits are billed by whoever provides them. For an emergency, call 911.
Specialist care
Cardiology, dermatology, orthopedics and the rest. You are referred, and the specialist bills you or your plan directly.
Imaging and procedures
X-rays, ultrasound, CT, MRI, biopsies, and anything requiring hands-on examination or a procedure room. Ordered by the practice, performed and billed elsewhere.
The cost of the labs themselves
Pass-through means the markup is removed, not the cost. A panel that lists at $120 may be a few dollars, but it is still a few dollars, billed separately from your membership.
The cost of medications
Prescribing is included. The medication is filled and paid for at your pharmacy. Most primary care generics cost very little in cash, but that is between you and the pharmacy.
Psychiatric and mental health care
The Florida NP is a primary care practice. Psychiatric and mental health services are not offered and specialised psychiatric medications are not managed or prescribed, for members or for anyone else. If you are in crisis, call or text 988.
Anything needing an in-person examination
The practice is telehealth only, with no physical office. Some problems genuinely need hands on them, and when that is the case you will be told so and pointed to the right place rather than managed at a distance.
Care outside Florida
You must be physically located in Florida at the time of each appointment. Membership does not change the licensure rule.
Emergency and after-hours crisis coverage
This is not a twenty-four hour service and messages are not monitored around the clock. It is a primary care practice, not an emergency room.
The money
How direct primary care saves people money
Not by being cheaper at everything, but by removing the layer that makes ordinary care expensive.
1. The monthly fee replaces per-visit charges entirely
In an insurance-based practice, every visit has a price attached, and often you do not learn it until weeks later. Under a membership the marginal cost of being seen is zero. That changes behaviour in a way that saves real money: people come in while a problem is small and cheap instead of waiting until it is large and expensive, and nobody skips a visit because they are not sure what it will cost.
2. Laboratory testing is passed through at cost
This is the single largest and most visible saving, and it is worth understanding why it exists. The practice holds an account with Quest Diagnostics and is billed a set rate for each test. Nothing is submitted to a health plan, so there is no list price, no negotiated rate, and no deductible to apply it to. The practice hands that rate to you unchanged. See member lab prices.
3. Fewer urgent care visits, which are the expensive ones
A large share of urgent care and emergency visits happen because nobody could get in to see their own provider. When same-week access is included in a fee you have already paid, those trips mostly stop happening. An urgent care visit commonly runs $150 to $250 self-pay, and an emergency department visit for something that was never an emergency runs into the thousands.
4. Prescriptions get looked at as a whole
With time to review the entire medication list rather than one drug at a time, it is common to find a brand-name medication with an equivalent generic, a duplicate from two different prescribers, or something that stopped being necessary years ago. Most maintenance generics in primary care cost a few dollars a month in cash, which is frequently less than a copay.
5. No surprise bills, because there is nothing to be surprised by
There is no claim, no coding dispute, no explanation of benefits, no out-of-network charge, and no bill arriving six weeks after a visit for an amount you did not expect. You know the monthly figure in advance and it does not move.
6. It pairs with a lower-cost health plan
Many members carry a high-deductible plan for the catastrophic side, which typically costs considerably less in premium than a low-deductible plan, and let the membership handle everything routine. Whether that arithmetic works depends on your own health, your family, and what coverage is available to you, so it is worth pricing out rather than assuming.
7. As of 2026, the fee can come out of an HSA
Federal law changed effective January 1, 2026. A direct primary care arrangement no longer disqualifies you from contributing to a health savings account, and the membership fee itself can be paid from an HSA up to $150 a month for an individual and $300 a month for a family, with both caps indexed for inflation. That is a meaningful change, because it means the fee can be paid with pre-tax dollars. This is general information rather than tax advice, so confirm the specifics with your own tax advisor or plan administrator.
Membership
What it costs to join
One price per person by age, or a family plan for two adults and two children. Cancel with thirty days' notice.
Ages 18 to 44
$79per month
Adult membership
Ages 45 and older
$99per month
Adult membership
Ages 17 and under
$35per month
Child membership, with an enrolled adult
Family plan
$219per month
2 adults and 2 children. Each extra child $35.
One-time enrollment fee of $99 per adult, children free. No charge at any visit. Month to month, cancel with thirty days' notice. Labs are billed separately at the practice's cost.
An honest fit check
Who this suits, and who it does not
Likely a good fit
Membership probably makes sense if
- You have an ongoing condition that needs regular follow-up and labs
- You are self-employed, uninsured, or carry a high-deductible plan
- You are tired of waiting weeks and then being rushed
- You want one provider who knows your history
- You want to know the price before anything happens
Probably not a fit
Membership probably does not make sense if
- You are looking for something to replace health insurance
- Your care is mostly with specialists rather than primary care
- You need psychiatric or mental health treatment
- You need hands-on examinations or procedures regularly
- You see a provider once a year and are happy with that, in which case a membership may cost more than it saves
- You are enrolled in Medicare, including a Medicare Advantage plan, which the membership is not currently available with
Getting started
How joining works
Book a free membership call
Fifteen minutes with our membership team about how it works, what it costs for your household, and whether it fits. It is not a medical visit, there is no charge, and there is nothing to sign.
Read and sign the agreement
Membership is a written direct health care agreement under Florida Statute 624.27. It states what is included, what the fee is, how to cancel, and in plain terms that it is not health insurance. Nothing is charged until it is signed.
Complete intake
Secure forms covering your history, medications and pharmacy, filled out before the visit instead of during it.
Meet by video and go from there
A real evaluation, a plan, labs ordered near you if they are needed, and prescriptions sent to your pharmacy. Then you have somewhere to go the next time something comes up.
Questions people ask about direct primary care
If yours is not here, ask before you join rather than after.
What is direct primary care in plain language?
Direct primary care is a membership. You pay the practice a flat monthly fee, and that fee covers your primary care. Nothing is billed to a health plan, so there is no copay when you are seen and no bill afterward for a visit, a message, or a refill. It is the same arrangement as a gym membership or a phone plan, applied to your day-to-day medical care.
Is direct primary care health insurance?
No. A direct primary care membership is not health insurance, is not a substitute for health insurance, and does not meet any insurance requirement. It covers primary care only. You still need a health plan, a health share, or another way to pay for hospital stays, surgery, emergency care, imaging, and specialists.
Do I still need insurance if I join?
Yes, in almost every case. Direct primary care handles the ordinary eighty to ninety percent of medical care, the part you actually use most years. Insurance is there for the expensive ten percent nobody plans for. Many members pair a membership with a high-deductible plan, which is usually cheaper than a low-deductible plan and covers the catastrophic side.
Why are the lab prices so much lower than what I am used to?
Because nothing is routed through a health plan. The practice holds an account with Quest Diagnostics and is billed a set rate for each test. That rate is passed through to you at cost. The higher numbers people are used to seeing are list prices built for insurance negotiation, not the actual cost of running the test.
Can I use an HSA or FSA to pay the membership fee?
As of January 1, 2026, federal law treats a direct primary care arrangement as HSA-compatible, and the fee itself can be paid from an HSA up to $150 a month for an individual and $300 a month for a family, with those caps indexed for inflation. Before 2026 a membership could disqualify HSA contributions, so this is a recent change. Confirm the details with your own tax advisor or plan administrator, because this is general information rather than tax advice.
What happens if I need a specialist, imaging, or surgery?
You are referred, exactly as you would be from any primary care practice, and that care is billed by whoever provides it. Your membership does not pay for it. What the membership does is make sure the referral is the right one, that the records go with you, and that someone reviews the result with you afterward.
Is there a contract or a cancellation penalty?
Membership runs month to month. Either side can end it with thirty days' written notice, and any fee you have prepaid past the end date is refunded. There is no penalty for leaving and no minimum term. If you cancel and later come back, rejoining carries a $99 fee per adult.
Do I have to be a member to be seen?
Yes. Care at The Florida NP is provided through membership only, which is what keeps the schedule open and the visits unhurried. Before joining you can book a free membership call to learn how it works and whether it fits, with no charge and nothing to sign.
Does membership include prescriptions?
The membership covers prescribing and the monitoring that goes with it. It does not pay for the medication itself, which you pick up at your pharmacy. Most maintenance medications in primary care are generics that cost a few dollars a month in cash at a discount pharmacy, often less than a copay.
Do I need to be in Florida?
You need to be physically located in Florida at the time of each appointment. That is a licensure rule, and a membership does not change it. Florida residents travelling out of state cannot be seen until they are back.
Required notice
A direct primary care membership with The Florida NP LLC is a direct health care agreement under section 624.27, Florida Statutes. It is not health insurance, it is not a substitute for health insurance, and it does not satisfy any requirement to maintain health coverage. It covers primary care services only, as described in the written agreement.
Start with a free membership call
Fifteen minutes to learn how the membership works and whether it fits. No charge and nothing to sign.