DPC & Insurance
Understanding how DPC can save you money
Direct Primary Care (DPC) as well as our other direct care services offer a simple, transparent approach to healthcare that can save you money while delivering far more value. By cutting out insurance middlemen, you eliminate surprise bills, co-pays, and inflated costs, giving you access to comprehensive care without financial stress. Plus, your doctor can focus entirely on your care—free from the burden of paperwork and insurance claims—so you get more personalized attention and time during each visit. With DPC and our other direct care memberships, you get all-inclusive services, longer visits, and direct access to your doctor, all at an affordable, predictable monthly rate. Explore how our memberships can fit favorably into your budget while providing you with far greater value than using insurance in the traditional healthcare system.
How can our Memberships
save You Money? See for Yourself
Maximum Value for Your Dollar
At PridePoint Health, we focus on delivering exceptional value through our direct primary care (DPC) and direct care memberships. You could spend more money on premium insurance plans, but all that gets you is better insurance—not better healthcare! That’s because insurance companies don’t deliver care—we do! Therefore, carrying a more expensive premium insurance plan doesn’t improve the quality of care you receive.
With our DPC model, you’re cutting out the middleman and investing directly in personalized, high-quality care that the traditional healthcare system can’t match. Insurance-driven healthcare is based on volume and quantity. We’re about delivering value and quality. Every dollar you spend with us goes toward your well-being. It’s healthcare with real value—because your health deserves more than just an insurance policy. It deserves better care, tailored to you.
While the real value is in the enhanced level of care you receive, our membership can also save you money. Read on to learn how!
Crunching the numbers:
Direct Primary Care
vs the Traditional, Insurance-driven Model
Here’s how our Direct Primary Care (DPC) membership can provide an elevated healthcare experience while still costing* less than traditional, insurance-based models.
* Using data from healthcare.gov insurance marketplace from 2024
Example: The average 28 year old who visits the doctor about 3 times per year with a routine medical workup, purchasing their own insurance on the marketplace over the course of one year:
Traditional Gold PPO Health Plan (low deductible)
and Traditional Healthcare System
-
Annual baseline cost: $7,200
$600/month x 12 months for insurance premiums
Annual visit co-pay costs: $60
$20/visit x 3 visits
Annual lab/imaging co-pay costs: $70
$20/draw x 2 lab draws
$30 co-pay for Chest Xray
High Deductible Health Plan (HDHP)
and Traditional Healthcare System
-
Annual baseline cost: $4,200
$350/ month x 12 months for insurance premiums
Annual visit costs: $1,050
$350 x 3 visits (until $8,000 deductible met)
Annual lab/imaging costs: $700
$150 x 2 lab draws (until $8,000 deductible met)
$400 for chest Xray
* This would be in an average year; if an injury happens, the total annual cost can easily skyrocket up to the average $8,000 deductible
High Deductible Health Plan (HDHP)
and Direct Primary Care Membership
-
Annual baseline cost: $5,388
$99/month x 12 months for DPC
$350/month x 12 months for insurance premiums
Annual visit costs: $0
$0/visit x 3 visits
Annual lab/imaging costs: $140
$25/lab draw x 2 lab draws (our discounted wholesale pricing)
$90 for chest Xray. (our discounted wholesale pricing)
Summary
In an average year, pairing our Direct Primary Care (DPC) membership with your HDHP can save you $300 compared to using your HDHP alone in the traditional healthcare system. Scenarios where you will save even more money are when you’re on multiple medications, you get injured (unnecessary ER visits can cost multiple times the amount of an annual membership), and those that are overpaying for insurance. For example, you could save nearly $2,000 per year by choosing a HDHP and pairing with DPC, when compared to a traditional low-deductible plan with co-pays! Even if your employer covers your HDHP, the savings on visits and labs typically still work in your favor.
But it’s not just about cost savings—it’s about the value you receive for your dollar. This is where DPC is unmatched. With your DPC membership, you get so much more, including enhanced access to a doctor who truly knows you, minimal to no wait times for in-person care at our welcoming clinic, unrushed visits, and easy access to lab testing. You’re not just saving money—you’re investing in better, more personalized care. Plus, you can use HSA or FSA funds to cover your membership costs.
These are cost estimates based on the best available data—your specific savings may vary.
Crunching the Numbers:
PrEP and STI Care Membership
vs the Traditional, Insurance-driven Model
Here’s how our PrEP and STI Care membership can provide an elevated healthcare experience while still costing* less than traditional, insurance-based models.
* Using data from healthcare.gov insurance marketplace from 2024
Example: The average 30-year-old who is taking PrEP, needing regular STI testing, follow up appointments, and is purchasing their own insurance on the marketplace over the course of one year:
Traditional Gold PPO Health Plan (low deductible)
and Traditional Healthcare System
-
Annual baseline cost: $7,200
$600/month x 12 months for insurance premiums
Annual visit co-pay costs: $60
$20/visit x 3 visits
Annual lab co-pay costs: $40
$20/draw x 2 lab draws
High Deductible Health Plan (HDHP)
and PrEP and STI Care Membership
-
Annual baseline cost: $5,028
$69/month x 12 months for PrEP and STI Care Membership
$350/month x 12 months for insurance premiums
Annual visit costs: $0
$0/visit x 4 visits
Annual lab/imaging costs: $600
$150/lab draw x 4 lab draws (our discounted wholesale pricing)
Summary
Pairing our PrEP & STI Care membership with your HDHP can save you nearly $2,000 per year when compared to a traditional low-deductible plan with co-pays!
But it’s not just about cost savings—it’s about the value you receive for your dollar. This is where a direct care membership is unmatched. With your PrEP and STI Care membership, you get so much more, including enhanced access to a doctor who truly knows you, minimal to no wait times for in-person care at our welcoming clinic, unrushed visits, and easy access to lab testing. You’re not just saving money—you’re investing in better, more personalized care. Plus, you can use HSA or FSA funds to cover your membership costs.
These are cost estimates based on the best available data—your specific savings may vary.
Cost of PrEP is typically completely covered for all insurance plans, so this was omitted for simplicity.
Crunching the Numbers:
Gender Affirming Care Membership
vs the Traditional, Insurance-driven Model
Here’s how our Gender Affirming Care membership can provide an elevated healthcare experience while still costing* less than traditional, insurance-based models.
* Using data from healthcare.gov insurance marketplace from 2024
Example: The average 35-year-old who is on hormones, needing regular lab monitoring, and is purchasing their own insurance on the marketplace over the course of one year:
Traditional Gold PPO Health Plan (low deductible)
and Traditional Healthcare System
-
Annual baseline cost: $7,200
$600/month x 12 months for insurance premiums
Annual visit co-pay costs: $80
$20/visit x 4 visits
Annual lab co-pay costs: $80
$20/draw x 4 lab draws
High Deductible Health Plan (HDHP)
and Traditional Healthcare System
-
Annual baseline cost: $4,200
$350/ month x 12 months for insurance premiums
Annual visit costs: $1,400
$350 x 4 visits (until $8,000 deductible met)
Annual lab/imaging costs: $320
$80 x 4 lab draws (until $8,000 deductible met)
* This would be in an average year; if an injury happens, the total annual cost can easily skyrocket up to the average $8,000 deductible. Consider our DPC membership to avoid surprise costs and receive all-inclusive care without hitting your deductible
High Deductible Health Plan (HDHP)
and Gender Affirming Care membership
-
Annual baseline cost: $5,148
$79/month x 12 months for Gender Affirming Care Membership
$350/month x 12 months for insurance premiums
Annual visit costs: $0
$0/visit x 4 visits
Annual lab/imaging costs: $100
$25/lab draw x 4 lab draws (our discounted wholesale pricing)
Summary
Pairing our Gender Affirming Care membership with your HDHP can save you nearly $700 per year compared to using your HDHP alone in the traditional healthcare system. You could save nearly $2,000 per year by choosing a HDHP and pairing with our PrEP and STI Care membership, when compared to a traditional low-deductible plan with co-pays! Even if your employer covers your HDHP, the savings on visits and labs typically still work in your favor.
But it’s not just about cost savings—it’s about the value you receive for your dollar. This is where a direct care membership is unmatched. With your Gender Affirming Care membership, you get so much more, including enhanced access to a doctor who truly knows you, minimal to no wait times for in-person care at our welcoming clinic, unrushed visits, and easy access to lab testing. You’re not just saving money—you’re investing in better, more personalized care. Plus, you can use HSA or FSA funds to cover your membership costs.
These are cost estimates based on the best available data—your specific savings may vary.