Direct Primary Care (DPC) and Health Savings Accounts (HSA)

What is Direct Primary Care?

Direct Primary Care (DPC) is a membership model. You pay a fixed, recurring fee directly to your clinician’s practice for ongoing care—visits, messaging, telehealth, and care coordination—instead of the practice billing insurance visit by visit.

A DPC membership covers your clinician’s professional services. It is not health insurance, so you’ll still want coverage for emergencies, hospital care, imaging, and specialists.

What changed for HSAs in 2026

The One Big Beautiful Bill Act, signed July 4, 2025, created a specific category called a “direct primary care service arrangement.” Starting January 1, 2026, a qualifying arrangement affects your HSA in two separate ways:

• Paying with HSA funds: membership fees for a qualifying arrangement count as qualified medical expenses, so you can pay them from your HSA.
• Continuing to contribute to your HSA: being enrolled in a qualifying arrangement no longer blocks you from contributing—but only if your total membership fees are $150/month or less for an individual ($300/month for a family), adjusted for inflation after 2026.

What makes an arrangement qualify

Under IRS guidance (Notice 2026-5), in plain terms:

• Care consists only of primary care services from primary care practitioners (a definition that includes nurse practitioners and physician assistants, as well as certain physicians).
• The fixed periodic fee is the only payment for that care—no separate per-visit billing for covered services.
• The arrangement can’t include prescription drugs (other than vaccines), procedures requiring general anesthesia, or lab services not typically performed in a primary care office.

Whether a specific membership—including ours—meets every requirement depends on how it’s structured and on your plan’s rules. We can’t make that determination for you. Please confirm with your HSA administrator or tax professional, especially if you plan to keep contributing to your HSA.

Why menopause care is primary care

Louisiana law defines primary care as routine health care that includes screening, assessment, diagnosis, and treatment to promote health and to detect and manage disease. That’s the work we do every day:

• Screening: we assess your risk for conditions that change after menopause, like bone loss, and help you build a personalized screening plan.
• Assessment and diagnosis: we evaluate your symptoms and diagnose perimenopause and menopause—often by symptoms alone, when lab tests can’t give a clear answer.
• Treatment and management: hormone therapy when appropriate, non-hormonal options, and ongoing follow-up with adjustments as your body changes.
• Health promotion: education and prevention for the decades after menopause, not just symptom relief.

Menopause belongs in primary care, but most clinicians never received menopause training. Our clinicians hold the MSCP credential from The Menopause Society. We work alongside your PCP: cancer screenings stay with your PCP for continuity and monitoring.

What our membership includes

• Perimenopause and menopause evaluation and ongoing management
• Individualized hormone therapy planning, when appropriate
• Messaging and asynchronous check-ins for treatment adjustments
• Care coordination and education so you understand your options

What’s not included in our membership

• Medications — you pay the pharmacy directly
• Lab testing — you pay the lab directly
• Imaging and outside specialist care — billed by those providers

If you have an HSA

• Ask your HSA administrator two questions: Is this membership an eligible expense? And does enrolling affect my ability to contribute?
• If you add optional services to your membership, include them when comparing your total monthly fees to the $150 limit.
• Save your invoices and receipts for membership fees and any other out-of-pocket medical expenses.