“[Direct Primary Care] allows for deeper connections and a stronger therapeutic relationship. It gives me the opportunity to fully understand a patient’s history, lifestyle, and goals, which leads to more personalized and effective care. This model fosters trust and shared decision making, resulting in higher patient satisfaction and better health outcomes overall.”
The change stems from newly adopted provisions in H.R. 1 – One Big Beautiful Bill Act, a wide ranging legislative package passed earlier this year. Under current rules, a DPC membership, which typically involves paying a flat monthly fee to a physician or practice in exchange for access to primary care, disqualifies an individual from contributing to an HSA or using their HSA funds to pay that fee.
That barrier will be removed on January 1, 2026 thanks to the legislative update. According to policy analysts at the Paragon Health Institute, “Current rules prevent people from contributing to HSAs if they have DPC arrangements or using their HSAs to pay the monthly fees for DPC [memberships].”
Los statute sets specific dollar limits on how much of the DPC fee can be covered by HSA funds, which are up to $150 per individual per month, or up to $300 per family per month. These amounts will be adjusted annually for inflation. Healthcare advocates say this change represents a significant step toward expanding consumer choice and supporting new care models.
The update is particularly relevant for nonprofit health sharing communities and other organizations that promote alternatives to traditional health insurance. It allows individuals to combine a DPC membership, which emphasizes accessibility and strong physician patient relationships, with the tax advantages of an HSA.
Dr. Jayson Malufau, a DPC provider working with Primestin Care, states that “all patients can benefit from DPC. Our model brings value by returning to the heart of what primary care is meant to be, personalized, accessible, and relationship driven care. At Primestin Care, we serve adults, children, and women, addressing preventive, chronic, and urgent care needs covering an estimated 85–90% of what patients typically require.”
For many households, this update removes one of the biggest barriers to joining a DPC. Instead of paying membership fees entirely out of pocket, members can now use their HSA, reducing their overall healthcare expenses. This makes DPCs especially valuable when paired with a Healthshare, since DPC memberships handle routine and preventive services while the Healthshare supports members during larger, unexpected medical events.
When asked how having more time with each patient changes the quality of care, Dr. Malufau explained that it “…allows for deeper connections and a stronger therapeutic relationship. It gives me the opportunity to fully understand a patient’s history, lifestyle, and goals, which leads to more personalized and effective care. This model fosters trust and shared decision making, resulting in higher patient satisfaction and better health outcomes overall.” This extended time also enables providers to build meaningful relationships with their patients and identify potential health concerns early, before they become more serious.
What this means for Individuals:
- If you have or are considering opening an HSA with a high-deductible health plan, you may use HSA funds to pay your monthly DPC fee within the $150 or $300 cap. There are some benefits administrators who also offer HSA programs that can work alongside health sharing memberships.
- The policy takes effect on January 1, 2026 so individuals should take some time to evaluate whether a DPC membership is the right fit for their needs.
- As with all HSA and HDHP questions, eligibility rules and plan details matter and individuals should refer to their plan documents or consult a tax advisor.
Allowing HSA funds to be used for DPC memberships represents a notable policy change that could make these memberships more accessible to individuals seeking cost effective, relationship-based care. It is a meaningful step toward increasing accessibility and empowering families to choose healthcare options that truly work for them.
*Zion HealthShare does not endorse or recommend the direct primary care (DPC) providers that are listed on its website. DPC providers are listed merely as a reference to assist members and not as a guarantee of sharing. Additionally, any and all treatment received from a DPC is still subject to the Member Guidelines. Members should read and understand the Member Guidelines concerning what is considered shareable and not shareable with the community.