It's open enrollment season, and if your health insurance premiums are going up again (like mine are!), here’s something most people don’t know: you can pick almost any insurance plan and still have a great primary care doctor.
With Direct Primary Care (DPC), your primary care comes through a simple monthly membership, not your insurance. That means you can choose the plan that saves you the most money, and still get longer appointments, direct access to a doctor who knows you and actually has time for you.
As a Direct Primary Care doctor in Walnut Creek, California, I can offer my patients better care, and help them spend less on healthcare overall.
You may be able to save money, and have a primary care doctor who knows you and has time for you. The right combination depends on your health needs, budget, and the coverage you want for everything outside your DPC membership.
Here's what to consider during open enrollment.
Why your primary care doctor doesn't have to be in-network
At Tarantino Medical Group, I don't bill insurance. Your membership gives you concierge-level care, with longer appointments, direct access to me, even after hours, and more time to address your health concerns.
That means you can explore insurance plans based on what you need for specialist visits, hospital care, emergencies, and other medical expenses outside your membership.
You still need to consider provider networks for specialists, prescription coverage, deductibles, and your maximum out-of-pocket costs. But you have more flexibility when choosing how to cover your healthcare.
If you choose a high-deductible plan, an HSA-qualified plan, a catastrophic plan, or a health-sharing arrangement, the discounted rates on labs, imaging, and medications available through my practice may help you spend less throughout the year.
If your insurance doesn't cover a test, or your deductible has you paying out of pocket anyway, cash pricing might save you money.
An MRI can cost thousands of dollars depending on the facility and how it's billed. If you choose to pay out of pocket at a local imaging center, you may find self-pay pricing for less than $1,000 for the same test.
A vitamin D test alone could cost $350 if your insurance doesn't cover it. Through my discounted lab pricing, an entire panel that includes blood counts, blood sugar, cholesterol, liver and kidney function, thyroid, vitamin B12, folate, hemoglobin A1c, and vitamin D right now costs less than $60.
Certain medications may also be available at significantly lower cash prices when dispensed directly from my office. That's potentially a significant savings, and it's convenient, too.
Actual prices vary by test, medication, and facility. Always confirm the price and whether a medication is appropriate for you, but the savings can be significant.
Insurance options worth comparing
Depending on your circumstances, there are several options worth exploring. Different plans work better for different people, so it's worth comparing the numbers before automatically renewing your current plan.
Bronze or high-deductible health plans
These plans often have lower monthly premiums and higher deductibles. Since your routine primary care is already covered by your DPC membership, a lower-premium plan may be worth considering, provided you're comfortable with the deductible and potential out-of-pocket costs.
Depending on your plan, you may also be able to use FSA funds for your membership, so check with your FSA administrator.
HSA-qualified plans
A Health Savings Account (HSA) lets eligible individuals set aside money for qualified medical expenses with tax advantages. Beginning in 2026, federal rules expanded HSA eligibility to include Bronze and catastrophic plans, subject to applicable requirements.
Before making a decision, confirm how your specific plan and DPC membership are treated under current IRS rules with a qualified tax professional or HSA administrator.
Catastrophic plans
These plans generally have low premiums and very high deductibles. Eligibility rules apply, although certain people beyond age 30 may qualify under specific exemptions or other eligibility provisions. They may be worth comparing if you qualify, but make sure you understand how much you could pay if you need significant medical care.
Health-sharing arrangements
Some people explore health shares as an alternative to traditional insurance. These arrangements generally have lower monthly costs than traditional insurance, but they are not health insurance and do not guarantee that your medical expenses will be paid. Coverage limitations, including those involving pre-existing conditions, can be significant.
Research the specific arrangement carefully and understand the financial risks before enrolling.
If you have a chronic condition, anticipate surgery, are planning a pregnancy, or expect significant medical expenses, a plan with higher premiums but better coverage may make more financial sense.
The goal isn't to find the cheapest plan. It's to find the right combination of primary care and coverage for your circumstances.
If you have Medicare, this is a little different. Medicare has its own rules for doctors who work outside of it, and you can’t contribute to an HSA once you’re enrolled, so ask me how membership works with your Medicare coverage.
What you get with Direct Primary Care
At Tarantino Medical Group in Walnut Creek, you get longer appointments, direct access to me, and personalized, holistic care focused on your health.
Whatever insurance you choose, it never changes the care you get from me, because I don’t bill insurance. Read more about my practice.
Your membership includes:
Longer appointments and direct access to me, even after hours.
Time to address prevention and the bigger picture of your health.
Discounted cash prices for labs and imaging.
Access to lower-cost medications I can now dispense directly from the office, when possible.
Discounted supplements through Fullscript.
In-office ultrasound when appropriate for your care.
One complimentary OMT session per year, plus discounted rates on future visits.
One complimentary medical-grade red light therapy session per year, plus discounted rates on future visits or a monthly red light therapy add-on membership.
These benefits can help you manage healthcare expenses beyond your monthly insurance premium. Actual prices vary by service, medication, and other factors.
Not sure which option makes sense for you?
You don't have to figure everything out alone.
I met Christine Corsini of HSA for America at a Direct Primary Care conference. She helps individuals, families, and small business owners explore insurance options that may work alongside Direct Primary Care, at no cost to you for her assistance. I don't receive anything for this referral.
Book a call: https://hsaforamerica.com/ChristineCorsini/calendar
Email: christinecorsini@hsaforamerica.com
I'm not an insurance broker, and I don't claim to be an expert in insurance plans. But I want you to know that you may have options worth exploring. I encourage you to compare your choices and consider your total costs, including premiums, deductibles, your DPC membership, prescriptions, and potential medical expenses.
Open enrollment is a chance to see whether you can spend less on healthcare while still getting personalized, concierge-level care, without an insurance company dictating your primary care.
If you're already a member of Tarantino Medical Group, you can continue seeing me while exploring which insurance arrangement works best for you.
And if you're looking for a primary care physician in Walnut Creek, I'm accepting new members, including individuals, families, and business teams.
Learn more about membership: https://www.taratarantino.com
Schedule a free meet and greet: https://calendly.com/tara-taratarantino/meet
Frequently asked questions
Do I still need insurance if I have a DPC membership?
Yes. DPC isn’t insurance. You’ll still want coverage for specialists, hospital stays, and emergencies.
Is direct primary care the same as a concierge doctor?
You get the same perks: longer visits and direct access to your doctor. The difference is that concierge practices usually still bill insurance. I don’t bill insurance at all.
Can I change my insurance and keep seeing you?
Yes. Your plan doesn’t affect your membership with me.
Will DPC save me money?
It depends on your premiums, deductible, and health needs. Compare your total costs, not just the monthly premium.
Do you accept new patients?
Yes. I’m accepting individuals, families, and business teams in Walnut Creek, serving the entire East Bay area. Schedule a free meet and greet.