Direct Primary Care vs Traditional Insurance
DIRECT PRIMARY CARE PUTS YOU FIRST WITH UNLIMITED ACCESS, NO INSURANCE HASSLES, AND A TRUSTED RELATIONSHIP WITH YOUR DOCTOR.
FEATURE
How You Pay
Network
& Choice of Doctor
Typical Panel Size
Appointment
Availability
Visit Length
Copays & Deductibles
After-hours Access
Virtual Care
Care Coordination
Continuity / Relationship
Specialist Referrals
Price Transparency / Predictability
Who It’s Best For
Direct Primary Care (DPC)
$225 Flat Month Membership that covers all visits. Never billed to insurance but referrals are coordinated with in-network providers if patient has insurance.
You choose your DPC doctor who has a small panel and not restricted by insurance networks
Small and exclusive. 100-300 Patients which enables access & continuity.
Same day or next day, in-person or telehealth. Scheduling via text and email with a quick turnaround.
30-60+ minutes common
No copays/coinsurance for covered primary care; wholesale pricing for meds/labs/imaging when arranged. Can use insurance for outside care like labs, imaging.
Exclusive access through Spruce Texting with a quick turnaround answered by Dr. Tsui or staff.
Telehealth appointments are available to meet you where you are.
Direct coordination with special- ists; navigates cash/insurance options as needed
High—small panel, direct access, ongoing messaging
Yes—DPC coordinates; insurance or cash options
Very clear—membership covers defined services; wholesale labs/meds/imaging often published
People/families/employers who want exclusive and personal access and continuity at an affordable price with no co-pays or surprise billing
Concierge Medicine
Annual retainer ($2k–$5k+ typical) in addition to insurance; office often still bills insurance for visits
You choose a concierge doctor (very small panel)
Estimated 200-600
Typically same-day / next-day
30–45 minutes (longer for physicals)
Yes for billed services (retainer plus insurance cost-sharing)
24/7 direct physician access common
Usually included with the concierge practice
High-touch coordination (often with insurance navigation)
Very high—tiny panel & longer visits
Yes, coordinated by concierge MD
Retainer is clear; billed services still subject to insurance complexities
Those wanting luxury-level access & time and willing to pay premium retainer plus insurance
Traditional In-Network (HMO/PPO/MA)
Insurance bills the plan; you pay premiums + copay/coinsurance; services apply to deductible
Must use in-network doctors; “narrow networks” limit choice in many plans
Often ~2,000–2,500+ patients per PCP
New-patient & routine waits often weeks (national averages ~31–38 days reported)
~15–20 minutes typical
Yes—copays/coinsurance; many services subject to deductible
Nurse line or on-call service varies by plan
Plan-provided telehealth or practice-specific
Within network; prior auths and referrals required by plan rules
Varies; churn when plans change networks
Usually required for HMOs/POS; PPOs may allow self-referral
Opaque; EOBs, prior auths, surprise bills still occur
Those tied to specific insurance benefits/networks or very low premium needs