The definition, without jargon
Self-pay primary care means the practice charges you and you pay it. No claim is filed, no allowed amount is negotiated afterwards, and no explanation of benefits arrives weeks later revising what you owe. A published price is the whole transaction.
That is why self-pay practices tend to publish prices at all. When a plan is not adjudicating the bill, the price has to be something a person can read before they agree to it.
Two different shapes of self-pay
| Per visit | Membership | |
|---|---|---|
| You pay | Each time you are seen | A fixed amount monthly |
| Best for | Occasional, one-off problems | Ongoing care and households who use care regularly |
| Relationship | Transactional | Continuity with the same provider |
| Cost behaviour | Cheap if you rarely need care | Predictable, and cheaper once you use care a few times a year |
Membership versus paying per visit works through the arithmetic, and what is direct primary care explains the membership model in full.
What self-pay does well
- You know the price before the visit, so care is a decision rather than a gamble.
- Visit length is set by the practice rather than by billing requirements.
- There is no deductible to satisfy before primary care becomes affordable.
- Administration is minimal, which is part of why the price can be lower.
What self-pay does not do
It does not protect you against a hospital admission, surgery, a specialist course of treatment or an emergency department bill. Self-pay primary care — including a Presence membership — is not insurance and should not be treated as a substitute for it. Read healthcare without insurance for how people usually combine the two.
What Presence charges
Our one-time prices are Quick Care from $19.99, a $39 phone visit, a $49 video visit, a $69 extended video visit, and $149 for a one-time in-office visit at our North Richland Hills practice for ages 13 and older. Membership is $19.99 a month for household virtual care with local in-office visits at $129 each, or $29.99 a month which includes two local in-office visits per membership year for the household and $99 for each additional local visit. Full detail sits on membership pricing.