Can a small business offer DPC without offering health insurance?

For many small-business owners, providing traditional group health insurance to employees can be difficult.

That raises an important question:

Can an employer offer direct primary care to employees even if the business does not offer traditional group health insurance?

Direct primary care can be offered as a primary care benefit, but it is important for both the employer and employees to understand exactly what that benefit does—and does not—provide.

What does direct primary care provide?

Direct primary care, commonly called DPC, is a membership-based approach to primary care.

Instead of billing health insurance for routine primary care services, a DPC practice receives a recurring membership fee directly from the patient or another payer, such as an employer.

The membership provides access to the primary care services included by the practice.

At Firebird Direct Primary Care, employees may use their membership for many everyday healthcare needs, including:

Members also have access to the practice through phone, text, secure messaging, and telehealth when clinically appropriate.

Learn more about services available at Firebird DPC.

DPC is not health insurance

This is the most important distinction for an employer considering DPC.

Direct primary care is not comprehensive health insurance.

The membership is designed around primary care.

Employees can still have medical expenses outside the practice, including:

An employee who has DPC but no health insurance can therefore still face significant medical expenses if a major illness or injury occurs.

Employers should communicate that distinction clearly.

Why offer DPC if it isn't insurance?

Because primary care itself can still be a useful employee benefit.

An employer may want employees to have an established physician they can contact for everyday medical concerns even if the business is not providing a comprehensive group health plan.

DPC separates that primary care relationship from traditional insurance billing.

Instead of wondering what a routine physician visit will cost or whether a deductible applies, participating employees have access to the primary care services included in their membership.

That can make the benefit relatively easy for employees to understand:

The employer is providing access to primary care—not comprehensive medical insurance.

What might an employer-sponsored DPC arrangement look like?

There is not one arrangement that works for every business.

Depending on the employer, possible approaches may include:

The appropriate arrangement can depend on the employer's broader benefit structure.

Businesses should review tax, benefits, and regulatory questions with their benefits, accounting, or legal advisers.

Firebird DPC can explain the membership itself, what services are included, and practical options for enrolling participating employees.

Explore Firebird DPC options for small businesses.

What if an employee already has health insurance?

DPC can also be used by employees who already have health insurance.

The two serve different purposes.

Health insurance can provide financial protection for medical expenses outside the primary care practice, while the DPC membership provides access to the primary care services included by the practice.

Some employees may therefore use DPC for routine and ongoing primary care while retaining insurance for services outside the DPC practice.

Learn more about how direct primary care works.

What if an employee is uninsured?

An uninsured employee can still participate in a DPC practice.

The membership can provide access to primary care, but it does not eliminate the financial risk associated with medical care outside the practice.

For example, a DPC physician may evaluate a patient with abdominal pain and determine that emergency imaging or hospital evaluation is necessary. Those outside services would not become part of the DPC membership simply because the initial evaluation occurred in the primary care office.

That distinction should be understood before enrollment.

What about HSA eligibility?

Federal law affecting direct primary care and Health Savings Accounts changed beginning in 2026.

Under federal rules, an otherwise eligible individual participating in certain qualifying direct primary care arrangements may remain eligible to contribute to an HSA, subject to applicable requirements and DPC fee limits.

However, HSA eligibility depends on more than DPC membership alone.

Employees and employers should confirm how the rules apply to their particular health coverage and benefit arrangement with an appropriate tax or benefits adviser.

Questions a small-business owner should ask

Before offering DPC, consider asking:

A short conversation with the DPC practice can answer many of these questions before an employer makes a decision.

Direct primary care for small businesses in Central Ohio

Firebird Direct Primary Care is located in Worthington, Ohio, and works with individuals, families, and small businesses in Worthington, Columbus, and surrounding Central Ohio communities.

For an employer, the purpose of DPC is straightforward: provide participating employees with an established relationship and easier access to a local primary care physician.

It does not need to be confused with health insurance or presented as something it isn't.

Learn more about Firebird DPC for small businesses or schedule an employer Meet & Greet.