How Does Direct Primary Care Work With HealthShare? A Member's Guide

If you’re considering a HealthShare plan alongside a Direct Primary Care membership, you’re probably wondering how the two work together day to day—and how to avoid paying twice for the same visit. Understanding how billing works, which expenses are shared, and what benefits are included can help you make an informed decision. At Rural Authentic Wellness, we offer something even more: RAW Healthcare, an exclusive program that combines our primary and urgent care membership with a HealthShare plan and additional reimbursable benefits designed to help you save on eligible healthcare expenses. Unlike pairing a RAW membership with just any HealthShare, RAW Healthcare brings these benefits together in one exclusive program. Explore our RAW Healthcare guide to see how it works and how it may fit your healthcare needs. 

What Is a HealthShare Plan?

A HealthShare plan, also called a health care sharing ministry, isn't insurance. According to the National Association of Insurance Commissioners, members pay a monthly amount into a shared pool, and that pool is used to help cover other members' qualifying medical expenses. Instead of a premium, this monthly payment is usually called a “share.”

Most HealthShare plans also have an amount you're responsible for before sharing kicks in, similar to a deductible. And unlike many traditional insurance plans, routine and preventive care, like an annual physical or a same-day sick visit, often isn't something the HealthShare pool covers at all. That gap is exactly where a DPC membership fits in.

How DPC Membership Fees and HealthShare Contributions Work Together

Your DPC membership fee and your HealthShare contribution are two separate, ongoing payments. Your primary care membership covers your everyday care: sick visits, annual wellness exams, chronic disease management, and direct access to your provider. Your HealthShare contribution stays in place to help with larger, unpredictable medical costs, like a hospital stay or a specialist procedure.

Neither payment replaces the other. You're not choosing between DPC and HealthShare. You're using DPC to handle the primary care your HealthShare likely wouldn't cover anyway, while keeping your HealthShare in place for bigger, less predictable expenses.

What a HealthShare Typically Reimburses vs. What Your DPC Membership Covers

This is where the two plans actually divide the work:

• HealthShares typically reimburse: hospitalizations, surgeries, specialist care, and other larger, unpredictable medical events, once you've met your responsibility amount
• HealthShares typically do not reimburse: routine primary care, annual physicals, and preventive visits
• Your DPC membership covers: unlimited primary care visits, same or next-day appointments, direct provider access, and preventive care, for one flat monthly fee

Because these two categories rarely overlap, most members aren't submitting the same visit to both. The DPC membership handles the everyday care before it would ever reach your HealthShare's responsibility amount.



Avoiding Double-Paying: A Step-by-Step Example

Say you wake up with a sore throat. Here's how that visit typically plays out for a member with both a DPC membership and a HealthShare plan:

• You message or call your DPC provider and get a same-day appointment
• The visit and exam are already covered by your flat monthly membership fee
• If your provider orders a throat swab, that’s billed as an additional charge, significantly discounted because you’re a member at our lab
• There’s no separate bill to submit to your HealthShare, because routine visits like this typically fall outside what it shares in the first place
• If that visit had led to something bigger, like a hospital admission, that’s when you’d submit the bill to your HealthShare for reimbursement

The membership fee and the HealthShare contribution both keep running in the background. You're not paying twice for the sore throat visit; you're paying for two different layers of care.

Is This Combination Right for You?

This setup tends to work well for people who want predictable, unlimited access to primary care without waiting on approvals, while still having a plan in place for larger medical events. Our membership pricing page breaks down what's included at each membership level.

If you want the broader picture of how DPC and insurance or HealthShare plans generally compare, our Insurance vs. HealthShare page covers that overview. This guide is meant to go a layer deeper into how the two actually operate together month to month.

Ready to see exactly how the two would work together for you?

Book a FREE Meet and Greet and we'll walk through it together.

Frequently Asked Questions

1. What is the difference between DPC and concierge medicine?

DPC typically charges a lower flat monthly fee and focuses on primary care access, while concierge medicine often charges a higher annual fee on top of your existing insurance and can include a broader range of services.

2. How does direct primary care work?

You pay a flat monthly membership fee for direct access to your provider, including office visits, same-day or next-day appointments, and ongoing care, with no phone trees, no hold music, and no insurance paperwork.

3. How much would I pay each month with both a DPC membership and a HealthShare plan?

You'd pay your DPC membership fee and your HealthShare's monthly share amount separately. The exact combined cost depends on your household composition and which HealthShare program you choose. Our individual rates start at a flat $80 per month.

4. Does my HealthShare need to know I also have a DPC membership?

Requirements vary by HealthShare program, so it's worth checking your plan's guidelines directly. A DPC membership generally isn't classified as insurance, so it typically doesn't conflict with HealthShare eligibility, but confirm this with your specific program rather than assuming it applies to yours.

Key Takeaways

• A DPC membership and a HealthShare plan are two separate, ongoing payments that cover different things.
• HealthShares typically don't reimburse routine primary care, which is exactly what a DPC membership is built to cover.
• Most day-to-day visits are handled entirely through your DPC membership, with no bill going to your HealthShare at all.
• Your HealthShare contribution stays in place for larger, less predictable medical events.
• Checking your specific HealthShare program's guidelines is worth doing before combining the two.