Presence Answers
Primary care & direct primary care
Direct primary care means you pay the practice directly for primary care instead of routing every visit through a payer. These answers explain how that changes access, cost and who provides your care.
Written by the Presence care team · No visit guarantees a prescription or a note · Membership is not insurance
Full answers in this category
What is direct primary care?
Direct primary care is primary care paid for by a flat monthly membership instead of insurance billing. Here is what that changes, what it does not cover, and who it suits.
How does direct primary care work day to day?
From joining to your first visit, refills, labs and referrals: how a direct primary care membership works in practice, and what happens when you need care outside it.
How is direct primary care different from traditional insurance-based primary care?
A side-by-side comparison of membership-based direct primary care and insurance-billed primary care: access, visit length, cost, coverage and the trade-offs of each.
What is the difference between direct primary care and concierge medicine?
Concierge medicine and direct primary care both charge a membership fee. They differ in price, in whether insurance is still billed, and in who the model is built for.
Can you use direct primary care if you already have insurance?
Yes, and many members do. Here is how a direct primary care membership works alongside a health plan, what insurance still covers, and how HSA and FSA funds fit in.
How much does direct primary care cost?
What direct primary care memberships typically cost, what drives the price up or down, what is never included, and how Presence plans are priced from $19.99/month.
Can a nurse practitioner be your primary care provider in Texas?
What a nurse practitioner is, what an Adult-Gerontology Primary Care Nurse Practitioner does in Texas, how prescriptive authority works, and what to ask before choosing one.
Ready to act on this? Direct Primary Care
Quick answers
Short answers to the questions people ask before booking. Each links to the page that owns the full detail.
Will my family see the same clinician every time?
Not necessarily on a network visit — we will not promise that. What the membership does give is one household account, year-round access, and history available to the next clinician.
If a named provider who knows your history is what you want, that is Presence membership primary care rather than the national network, and it is available where our provider is licensed.
Limits: Continuity of records depends on what the platform supports; we describe it no further than that.
What is direct primary care?
A monthly membership paid directly to the practice for primary care, instead of the practice being paid per visit by an insurer.
Removing insurance billing from everyday primary care removes the reason visits are seven minutes long. It buys time, direct access and continuity. It is not insurance, and you should keep coverage for hospital and specialist care.
Limits: Not insurance; does not cover hospital, surgical, specialist or emergency care.
How is this different from concierge medicine?
Concierge practices typically charge a retainer on top of billing your insurance. Direct primary care replaces that billing for everyday care with one transparent membership.
The practical differences are price and honesty about what you get: concierge retainers are usually multiples of a DPC membership, and DPC pricing is published rather than quoted privately.
Limits: Descriptions of other models are general; individual practices vary.
How is membership care different from a traditional insurance-based practice?
Longer visits, direct access to your provider, published pricing, and member pricing on labs and imaging — because the practice is paid by you rather than per billable encounter.
You can keep your existing practice and use membership for the everyday layer. Nothing requires you to leave a clinician you like.
Limits: Membership does not replace insurance, and specialists and hospitals bill separately.
Will I actually get more than ten minutes?
Yes — longer visits are the structure of membership care rather than an upgrade you buy on top of it.
Time is what makes the difference for multiple problems, a complicated medication list, or a story nobody has taken properly. That is the whole reason the model exists.
Limits: Visit length is clinical judgement, not a contractual minute count.
Can I message or call my provider directly?
Direct access between visits is part of membership care, within reasonable hours and clinical judgement.
Most between-visit questions do not need an appointment; they need an answer. What direct access is not is an emergency line or a guarantee of an immediate reply at any hour.
Limits: Not for emergencies. Urgent symptoms go to 911 or an emergency department.
Can I cancel a membership?
Presence membership terms, including any commitment period, are set out in the membership terms and provided before you enrol. Whole Family Virtual Care carries a 12-month commitment, billed monthly, which renews automatically.
We put the terms in front of you rather than in a footer, because a surprise renewal is the fastest way to lose someone's trust.
Limits: The approved membership agreement governs; the summary on site is plain-language.
What is the onboarding or registration fee?
Presence memberships carry a one-time $49 onboarding fee. Whole Family Virtual Care has a separate $39.99 one-time registration fee.
They are different products with different terms, which is why both numbers are stated wherever the relevant offer appears rather than merged into one figure.
Limits: Fees are stated before enrolment and are not insurance premiums.
Other answer categories
About this information
Written by the Presence care team for patients considering care with us. Presence care is delivered by licensed providers, including a board-certified Adult-Gerontology Primary Care Nurse Practitioner — not by a physician, and not by software. Meet your provider.
This page explains how our service works. It is general information, not a diagnosis, and it is not a substitute for an evaluation of your own situation. Whether testing, treatment or a prescription is appropriate is decided during a visit.
If this is an emergency — chest pain, trouble breathing, stroke symptoms, severe bleeding, or thoughts of harming yourself — call 911 or go to the nearest emergency department. See our emergency care notice.
Still deciding?
Call and we will tell you honestly which option fits your household — including when the answer is none of ours.