Lost Your Health Insurance or Facing High Deductibles? Discover Direct Primary Care as an Affordable Alternative
TL;DR: Is Direct Primary Care Worth Considering?
Direct Primary Care (DPC) offers a more predictable way to access routine healthcare through a membership paid directly to your provider. It can be especially helpful for individuals with high-deductible insurance plans who want transparent pricing, personalized attention, and ongoing support.
At Stryker Optimal Health & Wellness in Spokane Valley, we offer direct-pay primary care with an integrative approach that considers your medical needs, nutrition, hormones, sleep, and lifestyle.
DPC does not replace health insurance, but it can complement your existing coverage. Membership benefits, included services, and additional costs vary.
Want to explore whether DPC is right for you? Contact our clinic to learn more about membership options and current pricing.
Every year, many individuals and families face the same question: Is my health insurance actually helping me afford healthcare?
Monthly premiums can be expensive. Deductibles may be several thousand dollars. And even with insurance, you may find yourself paying out of pocket for office visits, laboratory testing, and medications.
For some people, this creates a frustrating situation. They have health insurance, but hesitate to schedule an appointment because they are concerned about another medical bill.
As you review your healthcare options for the coming year, you may be wondering whether there is a different way to access routine medical care.
One option worth understanding is Direct Primary Care (DPC).
At Stryker Optimal Health & Wellness in Spokane Valley, Washington, we believe patients should understand their healthcare costs, have time to discuss their concerns, and be active participants in their care.
Let's explore how DPC works, how it compares with traditional high-deductible insurance, and what this approach can look like at our clinic.
What Is Direct Primary Care?
Direct Primary Care is a healthcare model in which patients pay their primary care practice directly, typically through a recurring membership fee.
Instead of billing insurance for each covered primary care visit, the practice provides a defined set of services through the membership.
Depending on the practice and membership agreement, these services may include:
Routine primary care appointments
Preventive health discussions and screenings
Management of common chronic conditions
Follow-up visits for ongoing concerns
Medication management
Care coordination and referrals
Greater continuity with a familiar healthcare provider
The exact services, visit limits, communication options, and additional charges vary by practice.
The goal is to make routine primary care more predictable, accessible, and focused on the relationship between the patient and provider.
Importantly, DPC is not health insurance.
Why Are People Looking for Alternatives to High-Deductible Health Plans?
High-deductible health insurance plans can provide important financial protection against expensive medical events, but they may also leave patients responsible for substantial costs before certain benefits apply.
For example, someone may pay a monthly insurance premium and still face out-of-pocket expenses for nonpreventive office visits, diagnostic testing, or treatment until their deductible is met.
This can be especially frustrating for people who want to address concerns before they become more serious.
You might recognize some of these situations:
You delay an appointment because you are unsure what it will cost.
You want to discuss several concerns, but feel rushed during your visit.
You need follow-up care for thyroid, metabolic, or other chronic health concerns.
You want a more proactive approach to your health.
You rarely meet your insurance deductible despite paying premiums throughout the year.
A high-deductible plan is not necessarily a poor choice. For some individuals and families, it can be financially appropriate.
However, the way you pay for health insurance and the way you access everyday primary care do not have to be the same.
That is where Direct Primary Care may fit.
Direct Primary Care vs. Traditional High-Deductible Insurance
The biggest difference is what you are paying for.
With traditional health insurance, you pay premiums for coverage under the terms of your plan.
Depending on your deductible, copays, coinsurance, and network, you may have additional costs when you receive care.
With Direct Primary Care, you pay the practice directly for a defined package of primary care services.
Feature | High-Deductible Insurance | Direct Primary Care |
Payment | Insurance premiums plus applicable out-of-pocket costs | Direct membership payment |
Primary care visits | Subject to plan coverage and cost-sharing rules | Defined by the membership agreement |
Appointment length | Varies by practice | Longer, more individualized visits |
Routine follow-up | Subject to practice availability and insurance rules | Based on membership services |
Labs and medications | Costs depend on coverage and deductible | May offer transparent cash-pay options; usually separate unless included with elected membership |
Hospital and emergency care | Covered according to the insurance policy | Not covered by DPC membership |
Specialist care | Covered according to the insurance policy | Generally outside the DPC membership |
Neither approach automatically costs less for every patient.
The best financial decision depends on your medical needs, insurance options, expected utilization, and the services included in a particular DPC membership.
Can You Have Direct Primary Care and Health Insurance Together?
Yes.
In fact, many people choose to combine DPC with health insurance.
Your DPC membership can provide access to everyday primary care, while your insurance plan remains available for covered hospital services, emergency care, specialist visits, surgeries, and other medical expenses.
Some patients pair DPC with a high-deductible health plan because they want more predictable access to routine care without giving up insurance protection against larger medical expenses.
However, there are important considerations.
A DPC membership generally does not count toward your health insurance deductible or out-of-pocket maximum. DPC also does not guarantee that your total healthcare spending will be lower.
If you are considering changing your insurance coverage, review the financial risks carefully before making that decision.
What Does Direct Primary Care Look Like at Stryker Optimal Health & Wellness?
At Stryker Optimal Health & Wellness, our approach to care is built around individualized attention, patient education, and a more complete understanding of your health.
We are a nurse practitioner-owned, direct-pay clinic serving Spokane Valley and surrounding communities.
Our care philosophy combines primary care with an integrative perspective. This means we consider conventional medical evaluation and treatment alongside factors such as nutrition, physical activity, sleep, stress, and preventive health.
Rather than focusing only on a single symptom or laboratory result, we want to understand the bigger picture.
1. Time to Discuss Your Health Concerns
Many patients have more than one concern when they schedule an appointment.
You may want to discuss fatigue, weight changes, blood pressure, medications, sleep, or preventive health during the same conversation.
Our approach emphasizes meaningful discussion, education, and shared decision-making.
2. Preventive and Ongoing Health Management
Primary care is not just about treating an illness when something goes wrong.
It also involves identifying risk factors, monitoring ongoing conditions, reviewing medications, and discussing appropriate preventive care.
Depending on your needs, this may include conversations about cardiovascular health, blood sugar, cholesterol, thyroid concerns, nutrition, and recommended screenings.
3. An Integrative Approach to Health
Your lifestyle and daily routines can influence your health.
We consider factors such as:
Nutrition and metabolic health
Physical activity and strength
Sleep quality
Stress management
Medication and supplement use
Hormonal changes when clinically relevant
Long-term health goals
These factors do not replace evidence-based medical care. They are part of understanding your health and creating a practical plan.
4. Transparent, Direct-Pay Healthcare
Our clinic operates outside traditional insurance billing.
We discuss service costs directly with patients and offer access to laboratory testing and other services with transparent pricing.
Some services, including laboratory testing, medications, procedures, and specialty programs, may involve additional charges.
Your DPC membership agreement will explain which services are included and which are billed separately.
5. Personalized Care and Follow-Up
Healthcare should not end when you leave the exam room.
We emphasize reviewing findings, discussing treatment options, and determining appropriate follow-up based on your health needs.
Our goal is to help you understand not only what your results show, but what those findings mean for your care.
Does Direct Primary Care Include Functional Medicine or Hormone Therapy?
This is an important question because DPC membership services and specialty wellness programs are not necessarily the same.
At Stryker Optimal Health & Wellness, we also provide services such as:
Comprehensive laboratory evaluation and interpretation
Women's hormone health consultations
Men's testosterone and hormone evaluation
Medical weight management
Thyroid and metabolic health evaluation
Nutrition and lifestyle education
These services may be available separately from a DPC membership, and additional charges may apply.
Patients should not assume that specialized laboratory panels, hormone medications, weight-loss medications, or aesthetic treatments are included in a primary care membership.
We can help explain which services fall within your membership and which are separate.
Who Might Benefit From Direct Primary Care?
DPC may be worth considering if you:
Have a high-deductible insurance plan and want predictable access to primary care.
Are self-employed or purchasing your own health insurance.
Want a more personalized relationship with your primary care provider.
Have ongoing health concerns that require regular follow-up.
Prefer transparent pricing and direct-pay services.
Want more emphasis on prevention and lifestyle education.
It may be less suitable as a stand-alone financial strategy for someone who needs extensive specialist services, expensive procedures, or hospital care and does not have appropriate insurance protection.
Is Direct Primary Care Worth the Cost?
The answer depends on how you use healthcare.
Consider what you currently spend on insurance premiums, primary care visits, routine laboratory testing, and other medical expenses.
Then compare those costs with the membership fee, the services included, and any additional charges.
But cost is not the only consideration.
For some patients, the value of DPC is having a consistent provider who knows their history, explains their options, and helps them navigate ongoing health concerns.
For others, their existing insurance-based primary care arrangement may already meet their needs.
The right choice is the one that supports your health needs while fitting your financial situation.
Frequently Asked Questions About Direct Primary Care
Is Direct Primary Care the same as concierge medicine?
Not necessarily. Both models may use membership fees, but their services, pricing, and insurance billing arrangements vary. Many DPC practices do not bill insurance for their membership-covered primary care services, while some concierge practices also bill insurance.
Does DPC replace my health insurance?
No. DPC is a way to pay for primary care services. It does not provide insurance coverage for hospitalizations, emergency care, or other major medical expenses.
Can I use an HSA to pay for Direct Primary Care?
Federal rules change beginning in 2026 for certain qualifying DPC arrangements. Under those rules, some membership fees may be eligible for HSA payment, subject to statutory conditions and monthly limits. Not every membership qualifies. Confirm eligibility for your specific arrangement and tax circumstances.
Are lab tests included in the membership?
That depends on the membership agreement. At our clinic, patients have access to direct-pay laboratory options, but not every test or panel is included in a DPC membership. We explain applicable charges before testing.
Can I still see specialists?
Yes. A DPC provider may help coordinate referrals when appropriate. Specialist services are generally not included in a DPC membership and may be billed through insurance or paid separately.
Can I join if I already have insurance?
Yes. Many people use DPC alongside existing insurance coverage.
Explore Direct Primary Care in Spokane Valley
If you are reviewing health insurance options for the coming year, now is a good time to consider how you want to access routine healthcare.
At Stryker Optimal Health & Wellness, we offer an individualized, direct-pay approach that emphasizes patient education, preventive care, and a strong provider-patient relationship.
We welcome conversations about whether our Direct Primary Care options are a good fit for your needs.
Interested in learning more about our DPC membership options?
Contact Stryker Optimal Health & Wellness to review current membership details, included services, and pricing.
Stryker Optimal Health & Wellness
12615 E Mission Ave, Suite 105
Spokane Valley, WA 99216
(509) 795-2642
This article is for educational purposes and does not constitute medical, insurance, financial, or tax advice. Coverage, membership eligibility, and applicable tax rules depend on individual circumstances.
Medical & Healthcare References
References
American Academy of Family Physicians (AAFP). Direct Primary Care.
Internal Revenue Service (IRS). Publication 969: Health Savings Accounts and Other Tax-Favored Health Plans.
HealthCare.gov. High Deductible Health Plan (HDHP).
Written by Sara Stryker, APRN | Family Nurse Practitioner
Owner, Stryker Optimal Health & Wellness
