We are excited to announce that beginning January 1, 2026, patients will finally be able to use their Health Savings Accounts (HSAs) to pay for direct primary care (DPC) memberships. This long-awaited policy update recognizes DPC fees as qualified medical expenses, meaning they can be paid tax-free using HSA funds. 

In addition, DPC memberships no longer jeopardize a patient’s ability to contribute to an HSA, as long as fees remain under federally approved limits. Currently, that cap is $150 per month for individuals and $300 per month for families, indexed for inflation.

This marks a significant shift in how people can structure their health care. For the first time, the law fully supports pairing a high-deductible health plan (HDHP) with direct primary care and an HSA—an approach that gives patients more control, transparency, and long-term financial flexibility.

As Dr. Brown explains, “I’m happy that people now have more flexibility to use their income for the type of care they need and want. This change empowers patients to choose a healthcare model that truly serves them.”

What Is an HSA and How Does It Work?

A Health Savings Account is a tax-advantaged medical savings account available to people enrolled in a qualifying high-deductible health plan. HSAs are considered one of the most powerful financial tools in health care because of their triple tax advantage.

Key HSA features include the following:

• Pre-tax contributions. Money deposited into your HSA is not taxed.
• Tax-free growth. Funds can be invested, and earnings accumulate tax-free.
• Tax-free medical spending. Withdrawals used for qualified medical expenses—including DPC memberships starting January 2026—are tax-free.
• No expiration. Unused funds roll over every year and continue growing.

This structure helps people pay for health needs today while building long-term savings for future medical expenses.

How an HSA Differs From Traditional Insurance

An HSA is not insurance. It is a savings vehicle that works alongside a high-deductible health plan. Traditional insurance attempts to cover routine and unexpected care through copays, deductibles, and premiums. This often results in higher monthly costs and less flexibility for patients.

Using an HSA with an HDHP typically means the following:

• Lower monthly premiums
• More autonomy over how healthcare dollars are spent
• The ability to save and invest money tax-free
• Greater incentive to choose value-driven care models such as DPC

DPC, meanwhile, is not insurance either. It is a membership-based healthcare model where patients pay a simple monthly fee for comprehensive primary care services, including extended visits, direct communication with their physician, and improved access.

Why Policy Has Lagged Behind DPC’s Growth

Despite the rapid expansion of direct primary care nationwide, federal tax policy has been slow to adapt. Previously, DPC fees were often treated similarly to insurance premiums, which HSAs cannot pay. In some interpretations, being enrolled in direct primary care could even threaten HSA eligibility. This uncertainty created unnecessary barriers for patients who wanted both the financial advantages of an HSA and the relationship-driven care offered by direct primary care.

The new legislation resolves these issues by clearly defining DPC memberships as qualified healthcare expenses and removing conflicts with HSA eligibility. Starting in 2026, patients can confidently use pre-tax dollars to support the care model they prefer.

Six Benefits of Direct Primary Care

DPC has become increasingly popular because it delivers a more accessible, personalized, and cost-effective approach to health care. Here are six key benefits:

1. Predictable Monthly Costs

DPC replaces unpredictable copays and surprise bills with a clear monthly membership fee. Most primary care services are included, making budgeting simple—especially when using pre-tax HSA dollars.

2. Faster Appointments and Better Access

DPC physicians usually manage smaller patient panels, which allows same-day or next-day appointments for urgent needs. This ensures problems are addressed early, before they escalate.

3. Longer, More Personalized Visits

Appointments often last 30–60 minutes or more. That extra time leads to better understanding, more accurate diagnoses, and treatment plans that consider the whole person.

4. Prevention-Focused Health Care

Without pressure from insurance-driven visit quotas, DPC doctors can focus on prevention—sleep, stress management, nutrition, and lifestyle changes—which can reduce long-term healthcare costs.

5. Easy Virtual Communication

Many concerns can be handled through phone calls, messaging, or video visits included with membership. This convenient access reduces missed work and unnecessary trips to the clinic.

6. Fewer Urgent Care and Emergency Room Visits

Because you have direct access to your physician, you are less likely to rely on expensive urgent care or ER visits for non-emergencies. Over time, this can save thousands of dollars.

Why Now Is the Right Time to Plan for 2026 Healthcare Costs

With the new HSA rules beginning January 1, 2026, now is the ideal moment to reevaluate your healthcare strategy. Patients should consider whether switching to a high-deductible plan makes sense, how much they want to contribute to an HSA in 2025, and whether joining a direct primary care practice aligns with their goals.

For many, this change will offer a more affordable path to high-quality care while maximizing tax advantages.

Have Questions? Strive Direct Health Can Help.

This policy change is exciting, but it may also raise questions about how HSAs and direct primary care work together. If you want help understanding…

• How to set up or adjust your HSA strategy
• Whether your DPC membership qualifies under the new rules
• How to combine DPC, an HDHP, and an HSA for maximum benefit

…then Strive Direct Health is here to help. While we cannot provide tax advice, we can walk you through how membership works, what services are included, and how other patients are preparing to integrate HSAs and direct primary care starting January 2026.

Reach out anytime. We’re happy to help you create a smarter and more affordable healthcare plan.

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