Key takeaways
- Families on job-based insurance now pay an average of $7,471 a year toward premiums, up 9% in one year, and employers expect even bigger increases in 2027.1
- Direct primary care (DPC) is a flat monthly membership with your own doctor, and it works alongside insurance rather than replacing it.
- Under a federal law that took effect in 2026, people with a qualifying high-deductible plan can generally pay DPC fees of up to $150 a month ($300 for a family) from an HSA.34
- The best savings come from catching problems early, which is exactly what easy access to your doctor makes possible.
If your open enrollment packet made you wince this year, you are not imagining things. Health insurance is getting more expensive, and the people paying the bill are workers and families. At DocTalker we spend our days talking with patients about how to stay healthy and how to afford it, so let us walk through what is happening and where direct primary care fits.
How much are insurance costs rising in 2027?
The 2026 KFF Employer Health Benefits Survey, reported October 22, found that the average employer premium for family coverage rose 5% to $28,303. Workers' own share climbed 9% to $7,471 a year, and 44% of large employers raised what workers pay. The average individual deductible was $1,772 at large companies and $2,624 at small ones.1
Looking ahead, benefits consultants project employer costs to rise roughly 8% to 9.5% in 2027, with Marsh calling its estimate the highest jump since 2003. Meanwhile, workers' earnings rose an average of 3.7% in 2026.1 Costs are growing faster than paychecks, and that gap lands on your family budget.
Why does a higher deductible change how people use care?
When the deductible goes up, so does the temptation to wait. A cough becomes pneumonia, a creeping blood pressure number becomes an emergency room visit, and a skipped checkup hides a problem that was easy to fix six months earlier. Waiting feels like saving money, but it is often the most expensive choice.
That is the heart of the problem: insurance is designed to protect you from big, unexpected bills, but it is not built for the everyday, relationship-based care that keeps you out of the hospital in the first place.
What is direct primary care?
Direct primary care is a simple idea. You pay a flat monthly membership fee to your doctor's practice, and in return you get ongoing primary care with real access: calls and texts with your physician, same-week visits, and unhurried time to make decisions together. There are no per-visit copays for the services the membership covers, and no billing codes standing between you and your doctor.
DPC is not insurance, and it does not replace insurance. Think of it as the everyday care layer that sits next to the coverage you keep for hospital stays, specialists and emergencies.
Can I pay for direct primary care with my HSA?
In many cases, yes, and this is new. A law signed in July 2025 (Public Law 119-21, Section 71308) changed the rules starting in 2026. A qualifying DPC arrangement no longer disqualifies you from contributing to a Health Savings Account, and its fees can be paid from your HSA, up to $150 a month for one person or $300 a month for an arrangement covering more than one person. Those caps are adjusted for inflation.34
A few fine-print points are worth knowing. You still need a qualifying high-deductible health plan to contribute to an HSA, and the 2027 HSA contribution limits rise to $4,500 for self-only coverage and $9,000 for family coverage.2 A qualifying DPC arrangement must charge a fixed periodic fee, and it generally cannot include prescription drugs (other than vaccines), services that require general anesthesia, or lab services not typically done in a primary care office. DPC fees also do not count toward your plan's deductible.4 Because rules like these can change and depend on your situation, please confirm details with a tax professional or your plan administrator.
How can DPC help me spend less on health care overall?
We cannot promise any particular dollar figure, but the logic is straightforward. When you can text your doctor about a worrying symptom and be seen the same week, small problems get handled before they become big, costly ones. When your doctor knows your history, you avoid duplicate tests and unnecessary urgent care visits. And when you are choosing a plan, a physician who knows you can help you estimate your likely visits, medications and screenings so you can pick coverage that fits.
Call or text DocTalker to talk through how direct primary care can fit alongside your insurance, and get same-week access to a doctor who knows you. Contact DocTalker today.
Frequently asked questions
Is direct primary care a replacement for health insurance?
No. Direct primary care covers everyday primary care for a flat monthly fee, while insurance protects you from larger costs such as hospital stays, surgery and specialist care. Most people keep both.
Can I use my HSA to pay for direct primary care?
Often, yes. Since 2026, a qualifying DPC arrangement can be paid for with HSA funds up to $150 a month for an individual or $300 a month for more than one person, if you are otherwise HSA-eligible with a qualifying high-deductible health plan. Check with a tax professional for your situation.
How much are employer health insurance costs expected to rise in 2027?
Industry projections range from about 8% to 9.5% for employer costs in 2027, following a 9% rise in workers' family premium contributions in 2026, according to the KFF survey and consultant estimates.
Do DPC fees count toward my insurance deductible?
No. Membership fees paid to a DPC practice do not count toward your health plan's deductible or out-of-pocket maximum, so it is worth planning your budget with that in mind.
References
- KFF Health News. Job-Based Health Plan Costs Rise, With Little Relief in Sight. Oct 22, 2026.
- CPA Practice Advisor. IRS Increases Health Savings Account Limits for 2027 (summarizing IRS Rev. Proc. 2026-24). May 29, 2026.
- DPC America. Can You Pay for Direct Primary Care With an HSA in 2026?
- BenefitsPro. How Will HSA-Compatible Direct Primary Care Work? The IRS Explains. Dec 10, 2025.
This article is general education, not medical, tax or financial advice. Please confirm HSA and insurance details with a qualified professional.