Do I Still Need Health Insurance If I Have Direct Primary Care? | Englewood, Colorado
- David Battiste
- 24 minutes ago
- 3 min read
One of the most common questions people ask when learning about Direct Primary Care (DPC) is:
"If I join a Direct Primary Care practice, do I still need health insurance?"
The short answer is yes.
Direct Primary Care is not health insurance. Instead, it is a membership-based model that provides direct access to your primary care provider for a monthly fee. For many patients, Direct Primary Care works best alongside health insurance—especially high-deductible health plans.
What Direct Primary Care Covers
A Direct Primary Care membership typically includes many of the services people use most often, such as:
Same-day or next-day appointments
Preventive care visits
Sick visits
Chronic disease management
Direct communication with your provider
Telehealth visits
Many in-office procedures
At Avaly Direct Health, members have direct access to their provider without worrying about copays or surprise bills for routine primary care visits.
What Health Insurance Covers
Health insurance is designed to help protect against large and unexpected medical expenses.
Examples include:
Hospitalizations
Emergency room visits
Surgery
Specialist care
Advanced imaging (MRI, CT scans)
Cancer treatment
Major injuries
These are expenses that can quickly become financially overwhelming without insurance coverage.
Why Many Patients Choose Both
Many patients find that Direct Primary Care and health insurance complement each other well.
Insurance provides protection against major medical expenses, while Direct Primary Care improves access to everyday healthcare.
This combination often allows patients to:
See their primary care provider more easily
Avoid unnecessary urgent care visits
Receive more personalized care
Improve continuity of care
Better manage chronic conditions
What About High-Deductible Health Plans?
Direct Primary Care is especially popular among people with high-deductible health plans.
Many patients become frustrated paying high monthly premiums while still facing significant out-of-pocket costs before insurance begins covering routine care.
A Direct Primary Care membership can help fill that gap by providing predictable access to primary care services without additional visit fees.
Is Direct Primary Care Right for Everyone?
Every healthcare situation is different. Some people value having easier access to their provider, longer appointments, and direct communication when health concerns arise.
Others may be primarily focused on protecting against large medical expenses. For many families, combining Direct Primary Care with a health insurance plan offers a balance between accessibility and financial protection.
A Real-World Example for Families with High-Deductible Health Plans
Direct Primary Care is not designed to replace health insurance. Instead, many patients choose to pair Direct Primary Care with a high-deductible health plan. Consider a family of four:
Traditional PPO Plan
$900/month premium ($10,800/year)
Primary care copays
Urgent care copays
Deductible of several thousand dollars
High-Deductible Health Plan + Avaly Direct Health
$500/month HDHP premium ($6,000/year)
$250/month Avaly Direct Health family membership ($3,000/year)
Total annual cost: approximately $9,000/year
Higher deductible before insurance coverage begins
Same or next-day primary care access
Direct communication with your provider
No copays for routine primary care visits through Avaly
In this example, the family spends approximately $1,800 less per year in premiums and membership costs before considering copays, urgent care visits, or other healthcare expenses.
While a high-deductible health plan may require more out-of-pocket spending if a major medical event occurs, many families find that Direct Primary Care helps them access routine healthcare more easily while maintaining insurance protection for larger, unexpected medical expenses.
Every family's situation is different, and healthcare decisions should be based on individual needs. This example simply illustrates why some families choose to combine Direct Primary Care with a high-deductible health plan rather than relying solely on a traditional insurance model.
Final Thought
Direct Primary Care is not a replacement for health insurance. Instead, it is a different way to access primary care. For many patients in Englewood and the Denver area, Direct Primary Care works alongside insurance to provide easier access, more personalized care, and a stronger relationship with their healthcare provider.
Avaly Direct Health is based in Englewood, Colorado and serves patients throughout Denver, Littleton, and surrounding communities.
Learn more about Direct Primary Care: www.avalyhealth.com
Schedule a free Meet & Greet: www.avalyhealth.com/meet