Do You Still Need Insurance With DPC? A Simple Breakdown

Direct Primary Care (DPC) has changed the way families think about healthcare. With unlimited visits, direct access to your provider, and transparent pricing, DPC takes the stress and guesswork out of everyday medical care. But one question comes up over and over again:

“If I join a Direct Primary Care practice, do I still need health insurance?”

The short answer: Yes—but not for the reasons you think.

Here’s a simple, easy breakdown to help you understand what DPC covers, what insurance covers, and why most people benefit from having both.

What DPC Covers

DPC is designed to take care of the majority of your everyday healthcare needs—without the middleman.

At Manatee Direct Primary Care, your membership includes:

✔ Unlimited visits with your provider (no copays, deductibles, or surprise bills)

✔ Same-day or next-day appointments (because waiting weeks for care makes no sense)

✔ Direct access to your provider (call, text, or message when you need help)

✔ Discounted labs and imaging (cash-based pricing that’s often 80–90% lower than traditional billing)

✔ Acute + chronic care management (from strep tests and ear infections to thyroid, blood pressure, diabetes, and hormone care)

✔ Women’s health, annual exams, and preventative care (routine care without the extra cost)

✔ Personalized, unrushed visits (no 7-minute appointments)

For most people, DPC covers 80–90% of their healthcare needs.

What DPC Doesn’t Replace

DPC isn’t health insurance—and it’s not meant to be.

You still need insurance for:

✔ Hospitalizations or emergency care (ER visits, surgeries, and inpatient stays are not covered by DPC)

✔ Major imaging (such as CT scans, MRIs, or ultrasounds)

✔ Specialist visits (cardiology, orthopedics, dermatology, GI, etc.)

✔ Expensive prescriptions (DPC helps you find cost-effective options, but coverage matters)

✔ Catastrophic events (accidents, major illnesses, and unexpected emergencies still require insurance)

DPC + insurance work together, not against each other.

So What Kind of Insurance Do You Actually Need?

Most DPC patients save money by switching to a lower-cost plan because DPC covers their everyday care.

Here are the most common approaches:

1. High-Deductible / Catastrophic Plan

• • This keeps monthly premiums lower while still protecting you in emergencies.

2. Employer Plan + DPC

• • Many people choose to keep their employer insurance but use DPC for better access and personalized care.

3. Health Sharing Plans

• • A popular low-cost option for people who pay for their own insurance.

4. Medicare + DPC

• • Medicare covers emergencies and specialists; DPC provides more personal, accessible primary care.

There is no one-size-fits-all—but almost every patient needs some level of coverage outside of DPC.

Why You’ll Use Your Insurance Less (and Save More) With DPC

Because DPC handles the majority of your everyday needs, this often means:

✔ fewer urgent care visits

✔ fewer ER visits

✔ fewer specialist referrals

✔ fewer unnecessary tests

✔ fewer surprise bills

Most patients actually save money when they pair DPC with a simpler, lower-cost insurance plan.

The Bottom Line

Yes, you still need insurance—but you’ll use it very differently.

Think of it like this:

✔ DPC = everyday care

✔ Insurance = “big stuff” care

Together, they create a complete, affordable healthcare picture that actually works for real families.

If you’re unsure what type of insurance works best with DPC, we’re always happy to help you explore options and point you in the right direction.