Informed Choices: How DPC Compares to Insurance in Open Enrollment Season

Traditional health insurance programs currently offer open enrollment for patients. During this special enrollment period, you can enroll for 2024 health coverage without a qualifying life event, such as loss of coverage or marriage. Many people believe that they can only receive affordable healthcare services with insurance coverage, however, direct primary care serves as a fantastic alternative.

This guide explains what direct primary care is, how it compares to traditional insurance, and everything you should consider before making a decision.

What Is Direct Primary Care?

Direct primary care, or DPC, eliminates the need for third-party insurance companies. Patients will instead pay a premium, either as a monthly or annual fee, directly to the healthcare provider. In exchange, they can receive the following services:

• Urgent care services
• Physical wellness exams
• Chronic disease management
• Allergy testing
• Women's health services
• Nutrition counseling for weight loss

Patients can receive treatment for a majority of common ailments through a DPC provider. Unfortunately it excludes any emergency medical care or surgery.

DPC vs. Insurance

If you're reluctant to renew your insurance coverage or change plans during open enrollment, you could find that switching to DPC better suits your needs. The key differences come down to the total cost but also the coverage. You need to determine which program checks off all the boxes for you.

Pros and Cons of Insurance 

When you carry health insurance, you hold a contractor with a provider. In exchange for a monthly premium, your policy covers everything from preventative care and prescription drugs to hospitalizations and surgeries. 

However, the structure of modern health insurance comes with several drawbacks. The monthly payments might not fit your budget, and you'll have to either wait for the next open enrollment or endure a qualifying life event to change your policy.

Pros and Cons of DPC

With direct primary care, you can receive coverage on a contract basis. Your membership fee tends to be more predictable than insurance and since payment goes directly to healthcare providers, there are less administrative hassles. There are no surprise bills and you get personalized care.

Another pro to DPC is that it is accessible and you can have direct access to your provider and cut out the middle man hassles of insurance. You don’t need to wait for answers or worry about not feeling heard.

One notable drawback is that DPC doesn't usually include coverage for hospital stays or surgeries.

How to Make the Right Decision for You

Choosing direct primary care over traditional insurance appeals to a growing number of Americans. However, the decision ultimately comes down to your needs.

Do you have a serious medical condition that frequently puts you in the hospital? Insurance supplemented with DPC that includes this type of care might be a better option. On the other hand if you benefit from preventative care and routine care, DPC is a great option.

Direct Primary Care of Burleson – Providing Superior Care to Texas Residents

If you don't have insurance coverage, there's no need to wait for open enrollment to see a provider. Direct Primary Care of Burleson treats a range of common conditions and can keep you healthy with affordable, personalized services. Contact our clinic in Burleson, TX at (817) 968-5756 to learn more about becoming a member or to schedule an appointment.