Newton: 316.283.6655
Andover: 316.202.9990
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Newton: 316.283.6655
Andover: 316.202.9990
Picture this: you've paid your premium every single month. You finally go to the doctor. Then the bills start arriving. A $50 copay. A $300 lab charge. A letter saying your prescription needs "prior authorization." Three weeks later, you're still waiting.
Sound familiar? You're not alone. For most Kansas families, the true cost of primary care through traditional insurance is much higher than the number on their insurance card. It's scattered across copays, deductibles, delayed care, and charges that show up weeks after the visit.
Direct Primary Care works differently. We converted Integrity Medicine to a Direct Primary Care model in 2017 because we watched those insurance-driven costs squeeze our patients year after year. Here's what the numbers actually look like when you put both models side by side.
Your premium is just the starting point. Not the whole cost.
According to KFF employer health benefits data, the average cost of a family health insurance plan is approaching or exceeding $25,000 per year when combining both employer and worker contributions. Recent data shows premiums rising around 6% annually, far outpacing general inflation.
Then comes the deductible. That's the amount you pay completely out of pocket before your insurance helps with anything. For employer-sponsored plans that include a deductible, the average for single coverage is roughly $1,886 in recent years, and in many small businesses, deductibles of $2,000 to $3,000 or more are now common.
Add it together and the picture gets uncomfortable fast. A working family might contribute $6,000 or $7,000 toward their premium, then still face a $50 copay for a sick visit and a $3,000 deductible before insurance pays a dime toward a procedure.
And then there's the lab bill. A basic metabolic panel that is often available for $40 to $80 at wholesale rates can be billed at $300 to $500 through insurance channels, depending on your region and insurer. Until you meet your deductible, you may owe that full amount.
In many cases, negotiated insurance rates are still significantly higher than what you'd pay with direct-pay pricing.
Beyond the obvious line items, insurance-based care has a hidden category of costs: the cost of the system itself.
Think about delayed appointments. Prior authorization requests. The 10-minute visit with a doctor who has 30 more patients to see before noon.
These aren't just frustrating. They cost money.
When getting care is difficult, people delay it. A rash that should have been seen two weeks ago becomes an urgent care visit at $200 out of pocket. A medication question that your doctor could have answered in two minutes sends you to a walk-in clinic instead. Some studies suggest Direct Primary Care members may use urgent care 50 to 65% less than traditionally insured patients, which can translate to $300 to $750 in annual savings for those who typically make two or three visits a year.
Access matters. When reaching your doctor is easy, you use primary care the way it was designed, and you avoid the downstream costs that come from letting things go too long.
At Integrity Medicine, every member has direct access to their physician. For non-emergencies like refills, health questions, or scheduling, patients reach their doctor by email or phone. For urgent situations like chest pain, acute injuries, or stroke symptoms, you text or call your doctor directly. Your message goes straight to your physician. Nobody's desk in between.
Direct Primary Care is simple by design. You pay a flat monthly fee. That covers your primary care. No copays. No per-visit billing. No mystery charges arriving weeks later.
At Integrity Medicine, our membership pricing is based on age:
Children (0-17): $30/month
Adults (18-44): $60/month
Adults (45-64): $80/month
Adults (65+): $100/month
That covers unlimited office visits and all in-office procedures. Because we don't run routine care through insurance billing, we pass wholesale pricing directly to members on prescriptions, labs, and radiology. For many generic medications, our pricing is often around 15 to 30% of typical retail cost, which can represent significant savings for patients on maintenance medications.
For common lab panels, wholesale pricing can bring the cost of a standard metabolic workup down to often under $20, compared to what can be $400 to $800 or more through insurance billing. For someone managing a chronic condition who needs labs every few months, that difference can cover most of a year's membership.
Prescriptions follow the same pattern. A patient on two or three maintenance medications can often save $50 to $150 per month on medications alone, which adds up to $600 to $1,800 per year.
Wondering exactly what procedures and services are included? Our post on what a Direct Primary Care membership covers in Kansas walks through the full list.
Sometimes a table doesn't tell the full story. The following are example scenarios to illustrate how costs can play out differently across the two models. Individual results will vary based on your specific plan, health needs, and location.
Sarah, 45 — Traditional Insurance (Example Scenario)
Maria, 45 — Integrity Medicine Direct Primary Care (Example Scenario)
Same health needs. Very different experience, and a very different bill.
If you're managing diabetes, hypertension, or thyroid disease, you're not seeing your doctor once a year. You need regular check-ins, lab monitoring, and medication adjustments. Under traditional insurance, that kind of ongoing care generates a lot of billing friction.
Dr. Roeser, who founded Integrity Medicine in 2004 and has been practicing internal medicine in Kansas ever since, puts it plainly: "I've learned that you don't treat heart disease, diabetes, or cancer. We diagnose and treat patients who have those conditions." That distinction matters. Managing a condition well means knowing the whole person, not just the diagnosis code.
Under a Direct Primary Care model, that ongoing relationship is built into the membership. Longer appointments. Direct communication between visits. No prior authorization delays on medications your doctor already prescribed. For families in Newton, Andover, and the wider Wichita area managing complex or chronic health needs, that kind of access is a real part of the value.
Direct Primary Care is not health insurance. It doesn't cover hospitalizations, surgeries, specialist care, or emergencies. For those situations, you still need coverage.
A high-deductible health plan (HDHP) is a lower-premium insurance option with a higher deductible, designed to protect you from catastrophic costs while keeping monthly premiums more manageable. A medical sharing plan is a separate option where members pool resources to help cover each other's major medical costs, often at a lower monthly price than traditional insurance. Both pair well with a Direct Primary Care membership.
Major medical events like hospitalizations, surgery, cancer treatment, and intensive care can cost $50,000 to $500,000 or more. Insurance is what protects you from financial catastrophe in those cases.
In our practice, the majority of members carry some form of major medical coverage alongside their Integrity Medicine membership. The Direct Primary Care membership handles everything you'd typically use before hitting a deductible: doctor visits, chronic care, labs, and preventive care. A high-deductible plan then sits behind it, covering catastrophic costs at a much lower premium than a traditional low-deductible plan.
The result is full coverage for most situations, and for many families, a lower total annual spend than traditional insurance alone. And if you are hospitalized, our physicians continue to coordinate your care during the stay when hospital privileges allow, and follow up after discharge at no additional charge from us. That continuity is rare in modern primary care, and we believe it makes a real difference.
If you're weighing whether to keep your current insurance or switch to a leaner plan alongside a Direct Primary Care membership, our post on whether you need health insurance with Direct Primary Care in Kansas walks through exactly that decision.
Integrity Medicine serves patients at our Newton location and our Andover location, with board-certified physicians providing care for patients of all ages.
Children are $30/month with a paid adult and receive care from board-certified physicians, not a physician assistant or nurse practitioner. Families often find the combination of a Direct Primary Care membership and a lower-cost catastrophic plan comes out ahead of a traditional family insurance plan, both in cost and in day-to-day experience.
If you're self-employed, between jobs, or simply done watching your premium increase while your access gets worse, primary care without insurance through a Direct Primary Care membership is worth a serious look. Employers interested in better, more predictable care for their teams are welcome to reach out as well.
Pull out your insurance statements from last year. Count the premiums, the copays, the lab bills, the urgent care visits. Add the prescription costs. Don't forget the appointment you delayed because getting in took three weeks.
What's the total?
For most people, it's a number that surprises them. And for a lot of those people, a Direct Primary Care membership paired with a lean catastrophic plan would have cost less, provided better access, and cut out most of the hassle. If you're still weighing it, our post on whether Direct Primary Care is worth it for Kansas families works through the scenarios in detail.
Come in for a free meet-and-greet at Integrity Medicine. No commitment, no pressure. Just an honest conversation about whether this makes sense for your family. Our practice has served patients since 2004 and adopted the Direct Primary Care model in 2017, and we'd love the chance to show you what healthcare can feel like when insurance isn't running the show.
Schedule Your Free Meet-and-Greet
How much does Direct Primary Care cost per month? At Integrity Medicine, membership ranges from $30/month for children to $100/month for adults over 65. Most working-age adults pay $60 to $80/month. That covers unlimited office visits and all in-office procedures with no per-visit copays.
Can you use insurance with Direct Primary Care? Direct Primary Care doesn't bill insurance for primary care. Most members pair their membership with a high-deductible health plan or medical sharing plan to cover hospitalizations, specialist care, and emergencies.
Does Direct Primary Care replace health insurance? No. A Direct Primary Care membership covers your primary care needs, including visits, in-office procedures, labs, and prescriptions at wholesale pricing. You still need separate coverage for hospitals, specialists, surgeries, and major emergencies.
Can I use my HSA to pay for a Direct Primary Care membership? Some memberships may be eligible for HSA reimbursement depending on your plan structure and how the membership is categorized under IRS guidelines. This is a nuanced area of tax law. Check with your tax advisor before using HSA funds for Direct Primary Care membership fees.
Is Direct Primary Care a good fit for Kansas families? For many Kansas families, especially those on high-deductible plans or paying full individual-market premiums, pairing a Direct Primary Care membership with a catastrophic plan is more affordable and provides better day-to-day access than traditional insurance alone. We have locations in Newton and Andover serving families of all ages.
How is Direct Primary Care different from concierge medicine? Concierge medicine typically charges much higher fees and often still bills insurance. Direct Primary Care removes insurance from routine care entirely, keeping costs predictable and accessible. For a deeper look at how the two models compare, see our post on Direct Primary Care vs. concierge medicine.
Integrity Medicine serves patients at our Newton, KS and Andover, KS locations. To learn more or schedule a free meet-and-greet, contact us here.
