Texas Direct Primary Care Guide [2024 Update]

Texas Direct Primary Care, usually abbreviated as TX DPC, is an alternative to the traditional insurance model that offers affordability, a direct connection with your doctor, and other benefits. However, most people find that they need to combine their DPC agreement with a high deductible health plan (HDHP) or a healthshare plan, like DPC Direct.

Not entirely sure how direct primary care in Texas works? I created this blog post to help explore this option and ensure that you’re able to make the most informed decision possible when it comes to your health and finances.

What Is Texas Direct Primary Care?

Direct primary care in Texas is pretty much what it sounds like. It’s an agreement between you and a medical practice/physician in TX that takes the place of a conventional health insurance policy. Instead of paying monthly premiums to an insurance carrier, you’ll pay a monthly fee to the practice, that covers all of your family’s visits.

How Does TX DPC Differ from Conventional Health Insurance?

When you are a member of a DPC practice, you pay one monthly fee for direct access to your doctor, whenever you need care. There is no insurance involved, and no networks to navigate.

• Be able to build a strong relationship with your doctor
• Spend more time with your doctor
• Benefit from more personalized care
• Pay less for your care (in most instances)
• Avoid costly insurance premiums and deductibles
• Get the treatments you need, rather than what the insurer thinks you should have

In addition to those differences, you’ll also find that direct primary care in Texas allows you to do other things that were difficult or impossible with conventional health insurance. For instance, with traditional insurance, you’re usually limited to when you can make appointments. Physician offices are so busy with insurance patients that appointments often have to be set weeks out. With a DPC practice, that’s not the case and you can often make an appointment for the next day or even the same day!

DPC Doctors are also freed from the time-intensive process of preparing, completing, and filing insurance-related paperwork. That alone frees up an immense amount of time for physicians to focus on you and your family, instead of on dotting I’s and crossing T’s. So, a DPC agreement allows physicians to create patient and family-focused practices.

Yet another difference is that with a DPC in Texas, you’re often able to take advantage of additional programs offered by your DPC, including annual wellness and prevention planning, weight loss management help, chronic disease management, weight loss management, and so much more.

When Did Texas Direct Primary Care Agreements Become Possible?

Will a Texas Direct Primary Care Agreement Cover All My Healthcare Needs?

A DPC membership will not likely cover all of your healthcare-related needs. That’s because it only covers the services available from that specific practice, which means that you likely won’t have access to specialized care and treatment, nor will you have access to emergency treatment or hospitalization.

Where does that leave you, then? Actually, there are two possible choices. First, you can purchase a high deductible health plan. These are health insurance plans with very high deductibles and most people use them in case of catastrophic situations – a cancer diagnosis, for instance.

With a high deductible health plan, your monthly premiums are more affordable, and even when combined with the monthly cost of your DPC agreement, you still might not be shelling out as much as you would for a conventional health insurance plan.

If you want to make things even more affordable, you could consider skipping the high deductible health plan and going with a healthshare, instead. These are becoming more and more popular every year. What are healthshare plans?

Healthshare plans offer a way to share the costs of healthcare with a group of other families. They’re often faith-based, but not always. For instance, DPC Direct is a rapidly growing healthshare serving Texas families, but it does not limit enrollment based on faith or religious affiliation. That means:

• You don’t have to worry about the costs of medical care being denied because a treatment or situation does not line up with the group’s religious beliefs.
• Pregnancy/birth-related costs can be covered even for those who are not married.

With a healthshare, you’re able to reduce the costs of emergency care, specialist care, drug coverage, and other costs that aren’t covered by your DPC agreement.

Compare Pricing on the Best HealthShare Plans Available

Where Can I Find A DPC Practice?

Use the map below to find a DPC practice in your area. Note that some may not be accepting new patients at this time.

The drop pins that are Blue are DPC offices with whom we have a personal relationship, and that are currently accepting new patients. You can also see past issues of our DPC Newsletter that we mail out to our DPC Partners. (Attention doctors and patients: if you do not see your DPC clinic on the map, please click here to add your clinic.)

How Does DPC Direct Work?

DPC Direct is a unique healthshare plan designed specifically for Texans who want to take part in direct primary care agreements and who want to avoid the hassles and costs of a high deductible health plan. First, you must enroll in a Texas DPC plan. Once you’ve enrolled, you simply need to make an appointment with your Personal Benefits Manager to discuss your needs and how DPC Direct can help.

You’ll need to complete a few additional steps, too. For instance, you will need to determine what initial unshared amount (IUA) you prefer. This is similar to a deductible and represents the amount you must pay before you can begin sharing costs for eligible medical needs. Once you have met your IUA, you can submit your cost-sharing request, and, once approved, the community will cover the remainder of the bill.

Here are some additional articles on Direct Primary Care programs: Direct Primary Care Directory – 2024 Patients’ Guide | Best Health Plan to Pair with Your DPC Membership [Direct Primary Care Explained]

Here are some additional pages related to this article: DPC Direct Healthshare: Designed To Work With Your Direct Primary Care (DPC) Membership | Direct primary care – Wikipedia