Newton: 316.283.6655
Andover: 316.202.9990
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Newton: 316.283.6655
Andover: 316.202.9990
"Do you still need health insurance if you join a Direct Primary Care practice?" It's the first question most people ask us.
Yes, you still need health insurance with Direct Primary Care. Joining a Direct Primary Care practice does fundamentally change how much coverage you need, what kind of plan makes financial sense, and how much you'll pay for it. For many Kansas families, the combination of Direct Primary Care and a leaner insurance plan costs significantly less than traditional insurance alone while delivering far better primary care access.
This guide explains exactly what your Integrity Medicine membership covers, where it stops, how to pair it intelligently with insurance, and one major 2026 federal change that makes the Direct Primary Care-plus-insurance strategy more tax-efficient than ever. If you're newer to the model and want to understand the basics first, our guide on how Direct Primary Care works in Kansas is a good place to start.
Direct Primary Care is a membership model for primary care, not a health insurance plan. Direct Primary Care memberships give patients access to a variety of primary care services, but people still need health insurance in case they end up needing medical care that goes beyond what a Direct Primary Care membership provides.
That distinction matters for a practical reason. The services most likely to create serious financial hardship, including hospitalizations, major surgery, emergency care, and specialist treatment for a serious diagnosis, all fall outside the scope of primary care. No Direct Primary Care membership, regardless of how comprehensive, is designed to absorb a $200,000 hospital bill or a course of cancer treatment.
The Direct Primary Care model is a cost-saving supplement, not a replacement for an insurance plan.
Understanding this isn't a limitation. It's actually the key to using both tools correctly. Direct Primary Care handles the predictable, frequent, and ongoing side of your healthcare. Insurance handles the unpredictable, catastrophic, and rare side. When each does its job, the combination is both more affordable and more effective than relying on traditional insurance alone for everything.
Consider how car insurance works. It doesn't pay for oil changes, tire rotations, or routine maintenance. It covers accidents and events you can't predict or afford out of pocket. Health insurance was created with the same idea in mind. Over time, traditional health plans started to include coverage for routine care like doctor visits, checkups, and labs, but that doesn't mean they do it well. The system was not built to manage everyday healthcare, and trying to use it that way often leads to higher costs, limited access, and shorter appointments.
Direct Primary Care is the routine maintenance. Insurance is the accident coverage. You need both, but Direct Primary Care changes what your insurance needs to do.
At Integrity Medicine, your monthly membership fee covers the vast majority of the care most Kansas families use in a given year. Here's a full breakdown of what's included.
Unlimited office visits. There's no per-visit charge and no limit on how often you come in. Members also have direct access to their physician by email or phone for non-emergencies, and by text or call for urgent situations.
Preventive and wellness care. Annual physicals, wellness exams, preventive screenings, blood pressure monitoring, and routine lab coordination are all part of membership.
Chronic condition management. Ongoing care for conditions like high blood pressure, type 2 diabetes, thyroid disease, COPD, asthma, and high cholesterol. Direct Primary Care is particularly well-suited to chronic care because members can check in frequently without worrying about the cost of each visit.
Same-day and next-day sick visits. Illness, infections, sinus issues, UTIs, strep, minor injuries, and flu-like symptoms are handled quickly and without an urgent care bill.
In-office procedures. This is one of the most comprehensive parts of Integrity Medicine's membership. Included procedures cover EKGs, pulmonary function testing, allergy testing, joint and trigger point injections, biopsy and fluid aspiration, lipoma removal, toenail removal, laceration repair, abscess drainage, mole and wart removal, Nexplanon insertion and removal, IUD placement, well-woman exams, school and sports physicals, and more. You can see the complete list on our membership pricing page.
Dramatically discounted medications. Through Integrity Medicine's wholesale generic pharmacy, members typically pay around 15% of standard retail pricing, roughly 85% less than buying medications elsewhere.
Discounted labs and imaging. Labs and radiology are offered at negotiated wholesale prices, not retail rates.
Direct physician access. Every member receives their doctor's direct contact information. For non-urgent questions, refills, and follow-ups, you reach your doctor by email or phone. For urgent needs, you can text or call directly.
For individuals without insurance, Direct Primary Care can still provide 80 to 90 percent of the care they need. That's a meaningful number, and it also makes clear that a portion of potential healthcare needs remain outside the membership. That's exactly why insurance still matters.
Knowing where your Direct Primary Care membership ends helps you choose the right insurance coverage to fill the gap. These categories fall outside your membership.
Hospital stays. Inpatient admissions, including medical and surgical hospitalizations, are not covered.
Emergency room care. Direct Primary Care is fantastic for proactive and urgent but non-emergency care, but it's not an emergency room. If you're facing a true emergency, including chest pain or heart attack symptoms, stroke indicators, severe injuries with heavy bleeding, or serious breathing difficulties, always call 911 or go to the nearest ER immediately.
Specialist visits. Cardiologists, orthopedists, dermatologists, and other specialists bill separately. Your Direct Primary Care physician coordinates referrals and communicates with specialists, but the specialist visits themselves aren't included in membership.
Major surgery and anesthesia. All surgical procedures requiring a hospital or surgical center fall outside the membership.
Advanced imaging. CT scans, MRIs, and similar studies at outside facilities are not covered, though Integrity Medicine helps members find lower-cost options.
Specialty medications. Wholesale pricing covers most generic medications well, but expensive brand-name or specialty drugs for conditions like cancer, rheumatoid arthritis, or multiple sclerosis typically require insurance coverage to remain affordable.
The practical upshot: Direct Primary Care handles the everyday and ongoing, while insurance handles the expensive and unexpected. The goal is not to replace one with the other but to let each do what it was built to do.
Yes. The better question is not which one to choose but how the two work together most effectively.
Most Integrity Medicine members carry some form of insurance or medical coverage alongside their membership. That combination is not a workaround. It's the model working as intended.
The vast majority of members' medical needs are met by their Direct Primary Care clinic. When your primary care is secure, health insurance goes back to being exactly that: insurance, something to keep in your back pocket for a rainy day.
That shift in how you think about insurance is significant. In the traditional model, patients often choose comprehensive insurance plans with low copays for office visits because they need frequent, affordable access to primary care. With Direct Primary Care, that access is already covered by your membership. You no longer need an insurance plan optimized for routine care. Instead, you can choose a leaner plan optimized for what insurance was always designed to do: protect you from large, unpredictable medical costs.
That shift often means lower monthly premiums, especially when paired with a high-deductible health plan.
The most common and financially effective combination for Direct Primary Care members in Kansas is pairing a Direct Primary Care membership with a high-deductible health plan, commonly called an HDHP.
An HDHP carries lower monthly premiums than most traditional plans. The tradeoff is a higher deductible, meaning you pay more out of pocket before insurance covers non-preventive services. For patients without Direct Primary Care, that deductible gap can hurt. Routine visits, prescriptions, and labs all hit out of pocket until the deductible is met.
With an Integrity Medicine membership, that gap largely disappears. Your routine care is already handled through your membership. The medications, labs, and office visits that would otherwise push you toward your deductible are now covered at dramatically lower cost, or included entirely. Your HDHP sits in reserve for exactly the situations it was built for: hospitalizations, surgeries, specialist care, and emergencies.
If you're relatively healthy and don't expect to need extensive specialist care or hospital visits, pairing Direct Primary Care with a lower-cost insurance plan could save you thousands in premiums while giving you direct access to personalized, comprehensive primary care.
This matters especially for Kansas families in 2026. The average monthly premium for a benchmark silver plan in Kansas for a family of four in 2026 before applying Advance Premium Tax Credits increased from $1,848 to $2,381, a 28.9 percent increase. With insurance costs climbing sharply, pairing a Direct Primary Care membership with a lower-premium HDHP is an increasingly practical way to control total healthcare spending without sacrificing coverage. For a deeper look at how the two models stack up financially, our comparison of Direct Primary Care vs. traditional insurance-based care in Kansas walks through the differences in detail.
When shopping for an HDHP to pair with your Integrity Medicine membership, ask which hospital systems and specialist networks the practice refers to most frequently. Choosing a plan that includes those providers in-network makes care coordination smoother when you do need to use your insurance.
One of the most significant recent changes for Direct Primary Care patients took effect January 1, 2026, and it's especially relevant for Kansas families considering the Direct Primary Care-plus-HDHP strategy.
On July 4, 2025, the One Big Beautiful Bill Act was signed into law, expanding several tax-advantaged health benefits. Starting January 1, 2026, Direct Primary Care memberships are now HSA-eligible, meaning Americans can use tax-free HSA funds to pay for their monthly Direct Primary Care membership.
This removes a long-standing tax barrier. Previously, having a Direct Primary Care membership could create complications for HSA contributions. Starting in 2026, Direct Primary Care membership fees can be paid using HSA funds without disqualifying patients from contributing to their HSA, a meaningful unlock especially for patients enrolled in high-deductible health plans.
Practically, Kansas Direct Primary Care members can now pay their Integrity Medicine membership with pre-tax HSA dollars, continue contributing to their HSA normally, and stack the tax advantages of an HSA with the care advantages of Direct Primary Care.
To make this concrete, consider how the math can look for a Kansas family of four.
Traditional silver plan approach (2026):
Direct Primary Care plus HDHP approach:
The savings potential is real, and that's before accounting for what you'd spend on copays, urgent care visits, and full-price prescriptions under a traditional plan. Individual results vary based on age, health history, subsidy eligibility, and which specific plans are available in your county, so working through your specific numbers with an insurance broker is worthwhile.
For families who use primary care regularly, the Direct Primary Care-plus-HDHP combination frequently costs less in total than a traditional insurance plan while delivering better access, longer visits, and a physician who knows your family.
Some Integrity Medicine members pair their Direct Primary Care membership with a medical sharing plan rather than traditional insurance. These programs pool monthly contributions from members to help cover major medical expenses.
Medical sharing plans typically cost less than traditional insurance premiums and can work alongside Direct Primary Care for members who rely heavily on their primary care practice for routine needs. Health care sharing ministry plans are not considered health insurance, are not subject to insurance laws and regulations, and do not guarantee coverage for serious health conditions the way a major medical plan does.
If you're considering a medical sharing plan, evaluating the coverage terms carefully and working with an independent insurance broker is strongly recommended. Integrity Medicine can help you understand your primary care usage and health history so you can make a more informed comparison.
When you need a specialist: Your Integrity Medicine physician coordinates referrals and communicates directly with specialists on your behalf. You can reach your doctor by email or phone with non-urgent questions about referrals and follow-up care. The specialist visit itself is billed separately and typically covered by your insurance plan. Having a Direct Primary Care physician coordinate specialist care, with more time and better communication than a traditional high-volume practice allows, often leads to better outcomes and fewer unnecessary referrals.
When you need the ER: Go. Don't delay care for a true emergency because of uncertainty about coverage. Your HDHP covers emergency care after your deductible, and your Direct Primary Care membership provides follow-up care and ongoing management after the emergency is resolved. Integrity Medicine physicians can also provide continuity of care during and after a hospital stay at no additional cost, a level of coordination that most traditional practices don't offer.
A related benefit worth noting: Direct Primary Care patients tend to use the ER less frequently than patients without Direct Primary Care access. Families with Direct Primary Care memberships report 40% fewer emergency room visits, largely because they can reach their primary care doctor quickly when issues arise. That reduced ER utilization is one of the real financial benefits of Direct Primary Care that doesn't always show up in a simple premium comparison.
Whether Direct Primary Care is worth the monthly fee depends heavily on how your household uses healthcare. Our detailed guide on whether Direct Primary Care is worth it for Kansas families walks through the scenarios where it delivers the most value. Here's a quick overview by patient type.
If you have employer-sponsored insurance: Direct Primary Care complements it well. Your insurance handles specialist and hospital care while your Integrity Medicine membership replaces the frustrating, slow, high-copay experience of traditional primary care with something far better. Many members in this situation find that prescription and lab savings alone cover a significant portion of the monthly membership fee.
If you're self-employed or buying on the Kansas marketplace: The Direct Primary Care-plus-HDHP combination is worth serious consideration. Lower premiums, HSA tax advantages (now usable for Direct Primary Care fees starting in 2026), and comprehensive primary care through Integrity Medicine may reduce your total annual healthcare spending while improving your access to care.
If you currently have no insurance: Direct Primary Care gives you access to the large majority of the care you'll need. We strongly encourage pairing your membership with at least a catastrophic plan for serious medical events. Talk to an independent insurance broker about what's available at your income level and whether any marketplace subsidies apply.
If you're on Medicare: Direct Primary Care and Medicare can work alongside each other. Integrity Medicine charges $100 per month for patients over 65. Medicare covers specialist visits, hospital care, and services outside the Direct Primary Care scope, while your membership provides a primary care relationship that's typically far more accessible and personalized than what Medicare-based primary care delivers.
No Direct Primary Care membership was designed to absorb a catastrophic medical event. A single hospital admission, a serious surgical complication, or an unexpected cancer diagnosis can generate costs that no monthly membership fee was ever meant to cover.
Insurance exists because those events, while rare, are financially devastating without protection. Direct Primary Care makes your insurance work harder and go further by handling routine care directly. Removing insurance entirely creates a financial exposure that most Kansas families and individuals are not positioned to absorb.
The right combination gives you the best of both: the relationship, access, affordability, and physician knowledge of Direct Primary Care, plus the financial protection of major medical coverage for the events that fall outside it.
If you'd like to talk through how your current insurance situation would work alongside an Integrity Medicine membership, schedule a free Meet & Greet and we'll walk through it together. You can also review membership pricing or read more about how Direct Primary Care works in Kansas before reaching out.
Does Direct Primary Care count as health insurance in Kansas?No. Direct Primary Care is not health insurance and does not satisfy minimum essential coverage requirements under the ACA. It covers primary care services through a flat monthly membership fee but does not replace coverage for hospital stays, emergencies, specialist care, or major medical events. Most Kansas Direct Primary Care patients carry some form of insurance alongside their membership.
Is Direct Primary Care worth it if you already have health insurance?Yes, for most Kansas families. Even with existing insurance, an Integrity Medicine membership replaces slow, copay-heavy traditional primary care with same-day access, direct physician communication via email or phone for non-emergencies (and text or call for urgent needs), and dramatically lower costs on prescriptions and labs. Many members find that savings on medications and labs alone offset a significant portion of the monthly fee.
What happens if you go to the ER as a Direct Primary Care member?Your Direct Primary Care membership does not cover emergency room visits. If you face a true emergency, go immediately. Call 911 or head to the nearest ER. Your HDHP or other insurance covers ER care after your deductible. Your Integrity Medicine physician provides follow-up care after the emergency at no additional charge and can coordinate with hospital physicians during a stay.
Can you drop your health insurance if you join a Direct Primary Care practice in Kansas?We don't recommend it. Direct Primary Care covers the large majority of routine care needs very well, but it does not cover hospitalizations, surgeries, emergency care, or specialist treatment for serious conditions. Without some form of insurance or medical coverage for those events, you carry significant financial risk. Most members pair Direct Primary Care with an HDHP or medical sharing plan.
Can you use an HSA to pay for a Direct Primary Care membership?Yes, starting January 1, 2026. A new federal law made Direct Primary Care membership fees HSA-eligible. Members can now use pre-tax HSA dollars to pay for their Integrity Medicine membership, up to $150 per month for individuals and $300 per month for families.
How much does it cost to pair Direct Primary Care with insurance in Kansas?Costs vary based on age, family size, plan type, and county. As a general example, an Integrity Medicine membership for a family of four runs approximately $180 per month. Pairing that with a bronze or catastrophic HDHP could bring total monthly healthcare spending to $1,080 to $1,380, compared to $2,381 or more for a benchmark silver plan alone, before factoring in additional savings on prescriptions, labs, and urgent care visits through Direct Primary Care.
What if I need a specialist while I'm an Integrity Medicine member?Your Integrity Medicine physician coordinates referrals and manages your overall care continuity. For non-urgent coordination questions, reach your doctor by email or phone. Specialist visits are billed separately and typically covered by your insurance plan. Having a Direct Primary Care physician coordinate specialist care, with more time and better communication than a traditional high-volume practice allows, often leads to better outcomes and fewer unnecessary referrals.
