NO INSURANCE REQUIRED · NO COPAYS ON INCLUDED CARE · HSA/FSA ELIGIBLE

Membership Primary Care · Pricing Model

Can you just pay a provider monthly? Yes — here is exactly how it works

People often arrive asking whether healthcare can work like a gym membership: one monthly price, a place you belong, no negotiation at the door. For primary care, it can. This page explains the model, the four Presence memberships, the term you are agreeing to, and where the model stops.

$19.99 · $29.99 · $79/$89/$109 by age · $219 per month · 12-month commitment, billed monthly

The short answer

How the monthly model works
You pay a flat monthly fee to a practice, and that fee buys access and a relationship rather than a single transaction. Presence has four memberships: two virtual and two that include local in-person primary care.
The four prices
Virtual Family Care $19.99/month · Virtual + Local In-Office Care $29.99/month · Individual Unlimited $79/$89/$109 by age · Family Unlimited $219/month for up to five, plus $29 per additional child after five.
The gym comparison, fairly
It is accurate about billing and belonging, and inaccurate about clinical judgement. Nobody rations a treadmill, but a provider will sometimes tell you that what you need cannot be handled in a virtual visit.
The commitment
A 12-month commitment, billed monthly, continuing month to month afterwards. In-person care requires a one-time $49 clinical onboarding and medical history review.
Next step
Compare the four memberships side by side and pick the household size that matches yours.

This page sits under direct primary care — start there if you want the full picture first.

Which membership matches your use?

  • You mainly want virtual access for yourself

    Virtual Family Care at $19.99/month for the household, with scheduled local visits at $129 each.

    See individual membership
  • It is a couple or a family

    The DFW virtual-plus-local household plan at $29.99/month.

    See family membership
  • You want unlimited care including in-person visits

    Age-based Individual Unlimited membership at $79, $89 or $109/month; $219 for a family of up to five, plus $29 per additional child after five.

    Compare all plans
  • You want everyone at home covered 24/7 nationwide

    Whole Family Virtual Care: $19.99/month for the whole household, $39.99 one-time registration, 12-month commitment billed monthly, auto-renewing.

    See Whole Family Virtual Care

Memberships are not insurance. A one-time $49 onboarding fee applies to Presence memberships.

What the monthly fee is actually buying

In an insurance-billed practice, revenue arrives per encounter, which is why the schedule is built around volume. When a practice is funded by membership instead, the incentive inverts: a question answered by message on a Tuesday is no longer unpaid work to be avoided. That single change is what produces longer visits, direct access and unhurried follow-up.

So the fee is not buying a discount on visits. It is buying availability, continuity and time — and, on the Unlimited memberships, the in-person visits themselves.

Virtual Family Care

$19.99/month

Unlimited 24/7 virtual care for your entire household — care when you need it, from the comfort of home.

  • Unlimited 24/7/365 virtual visits by phone or video for your household
  • Pediatric virtual care included for children under 13
  • Skip the traffic, the waiting room and the missed workday
  • Local in-office visits $129 per visit for members ages 13+
  • Member pricing on labs, imaging and medications
  • No insurance required · No copays for virtual visits

$19.99/month · Billed monthly · 12-month commitment · Covers your household · $129 per local in-office visit · One-time $49 onboarding before a first in-person visit

See Membership Details
  • Unlimited virtual visits, 24/7/365, by phone or video with a licensed provider — no copay for virtual care and no per-visit fee.
  • Skip the traffic. Skip the waiting room. Skip missing work. And skip paying urgent care or ER prices for something that may be handled virtually.
  • Pediatric virtual care is included for children under 13. Local in-office Presence care is for ages 13+; when a younger child needs hands-on care, families can access participating pediatric partners.
  • When virtual care isn't enough, members can be seen in person at the Presence practice in North Richland Hills. Local in-office visits on this plan are $129 per visit and are not included in the monthly membership.
  • Member pricing on labs, imaging and medications through participating partners. Savings vary by service and facility.
  • Membership requires a 12-month commitment, billed monthly, and continues month to month afterward.
  • Membership is not health insurance. See Membership & Care Information in the footer for full disclosures.

12-month membership commitment · Billed monthly. Local in-office visits are billed at $129 per visit and are not included in the monthly fee. Local Presence primary care is for ages 13+. A one-time $49 clinical onboarding & medical history review is completed before your first in-person visit.

Become a Member

MOST POPULAR · BEST VALUE

Virtual + Local In-Office Care

$29.99/month

Unlimited 24/7 virtual care for your household, with two local in-office visits included every year.

  • Unlimited 24/7/365 virtual visits for everyone at home
  • 2 local in-office visits included annually; additional visits $99 each
  • Pediatric virtual care included for children under 13
  • No copays for virtual visits · No insurance required
  • Member pricing on labs, imaging and medications

$29.99/month · Billed monthly · 12-month commitment · Covers your household · 2 local in-office visits included annually, then $99 each · One-time $49 onboarding per person before a first in-person visit

See Membership Details
  • Unlimited 24/7/365 virtual visits for everyone in the household, including pediatric virtual care for children under 13.
  • Because kids get sick at night. Work runs late. Traffic is brutal. Whether it's 2:00 in the afternoon or 2:00 in the morning, your family still has access to care.
  • Two local in-office visits are included each membership year for household members ages 13+. Additional in-office visits are $99 each.
  • Children under 13 receive virtual care and referral to participating pediatric partners when hands-on care is needed.
  • Member pricing on labs, imaging and medications through participating partners. Savings vary by service and facility.
  • 12-month commitment, billed monthly. Membership is not health insurance.

12-month membership commitment · Billed monthly. Includes 2 local in-office visits per membership year for household members ages 13+; additional in-office visits are $99 each. Local Presence primary care is for ages 13+.

Become a Member

Individual Unlimited

Ages 19–44$79/month

Ages 45–64$89/month

Ages 65+$109/month

Make Presence your primary care home, with age-based pricing and local visits that aren't counted.

  • Unlimited 24/7/365 virtual visits by phone or video
  • Unlimited medically appropriate local primary care visits
  • No per-visit charge for covered local primary care
  • Same local provider for continuity of care
  • Member pricing on labs, imaging and medications

$79/month ages 19–44 · $89/month ages 45–64 · $109/month ages 65+ · Billed monthly · 12-month commitment · One-time $49 onboarding before your first in-person visit

See Membership Details
  • Unlimited virtual visits, 24/7/365, plus unlimited medically appropriate local primary care visits with no per-visit charge.
  • Wellness and annual visits, sick visits, follow-ups, referrals and authorizations are included when medically appropriate.
  • You see the same local provider each time, so your history, medications and goals carry forward between visits.
  • A one-time $49 clinical onboarding and medical history review is completed before your first in-person visit.
  • Local primary care is for ages 13+, scheduled at the Presence practice in North Richland Hills. Appointment availability varies.
  • Age-based monthly pricing: $79 ages 19–44, $89 ages 45–64 and $109 ages 65+. 12-month commitment, billed monthly. Membership is not health insurance.

12-month membership commitment · Billed monthly. Ages 13+ for local primary care. One-time $49 clinical onboarding & medical history review before your first in-person visit.

Become a Member

COMPLETE FAMILY CARE

Family Unlimited

$219/month

Complete household care with unlimited local primary care visits.

  • Unlimited 24/7/365 virtual visits for the household
  • Unlimited medically appropriate local primary care visits (ages 13+)
  • No per-visit charge for covered local primary care
  • Family of up to 5 · each additional child after 5 is $29/month
  • Member pricing on labs, imaging and medications

$219/month · Billed monthly · 12-month commitment · Family of up to 5 · Each additional child after 5 is $29/month

See Membership Details
  • Unlimited 24/7/365 virtual visits for the household, plus unlimited medically appropriate local primary care visits for members 13+ with no per-visit charge.
  • Covers a family of up to five. Each additional child after five can be added for $29/month.
  • Children under 13 receive pediatric virtual care and access to participating pediatric partners when hands-on care is needed.
  • A one-time $49 clinical onboarding and medical history review is completed before each member's first in-person visit.
  • The same local provider follows your household's history, medications and preventive care over time.
  • 12-month commitment, billed monthly. Membership is not health insurance.

12-month membership commitment · Billed monthly. Children under 13 receive pediatric virtual care and access to participating pediatric partners when hands-on care is needed.

Become a Member

Full terms, applicable in-office visit prices and the one-time $49 onboarding fee are on the pricing page. Presence is a healthcare membership, not insurance.

Membership is not health insurance. Prices shown are membership prices, billed monthly on a 12-month commitment.

Which membership fits which situation

Mostly need someone reachable

Virtual Family Care at $19.99/month covers unlimited 24/7 virtual visits for the household, with local in-office care available at $129 per visit when you want it.

A couple or a household

Virtual + Local In-Office Care at $29.99/month covers the household's virtual care, which is usually where the value is for parents.

Want Presence as your primary care home

Individual Unlimited is $79/month for ages 19–44, $89 for ages 45–64 and $109 for ages 65+, with medically appropriate local primary care visits carrying no per-visit charge and the same provider each time.

A whole family, in person

Family Unlimited at $219/month covers a family of up to five for medically appropriate local primary care plus unlimited virtual care; each additional child after five is $29/month.

Honest limits of the membership model

The model works well when

  • You want everyday care to be predictable and reachable
  • You value time with one provider more than a large network directory
  • You would rather know a price before agreeing to it

The model is the wrong tool when

  • You need coverage for hospital, emergency or surgical costs
  • You need a specialist as your main clinician rather than primary care
  • You want someone else to pay the bill after the fact — membership is paid by you, up front

Local in-person primary care is for ages 13 and up in the Fort Worth area. Appointment availability varies.

Questions people ask

Is a membership practice the same as insurance?

No. Membership is not health insurance, does not pay hospital or specialty bills, and involves no claims. It funds your primary care relationship directly.

Do visits cost extra?

Included virtual visits carry no copay and no per-visit fee. In-office visits are $129 each on the $19.99 plan, or two included a year and then $99 each on the $29.99 plan. On the Unlimited memberships, medically appropriate local visits are included.

What is the $49 onboarding?

A one-time clinical onboarding and medical history review completed before your first in-person visit, so that appointment is spent on you rather than on data entry.

Can I cancel any time?

Membership is a 12-month commitment billed monthly. After the term it continues month to month. The terms are shown next to every price rather than buried.

Is family pricing per person?

No. Virtual + Local In-Office Care is one household price, and Family Unlimited covers a family of up to five; each additional child after five is $29/month.

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.

Last updated · Membership is not insurance.

One monthly price, one provider, no billing maze

Choose the membership that matches your household, or call with questions this page left open.