The DPC Insurance Question: How to Answer Without Losing the Lead

“Do you take my insurance?”

It’s the DPC insurance question that kills more conversions than any other. And most practices answer it wrong.

The instinct is to explain the model. To clarify that Direct Primary Care operates outside of insurance billing, that the membership covers everything, that it’s actually simpler and often cheaper. All true. All irrelevant if you’ve already lost the patient.

Here’s the problem: when you answer a question about insurance with “no,” you’ve closed a door before you understood why they opened it. They called you for a reason. Something about their current care is broken. That broken thing is your opening, not the logistics of how you bill.

This article gives you a discovery-first framework for handling the DPC insurance question, one that turns an objection into an enrollment conversation. Like every part of the operating system for your practice, this conversation should be systematic, repeatable, and focused on patient value. You’ll learn exactly what to say, what questions to ask, and how to connect a patient’s frustrations with fee-for-service care to the solutions DPC provides.

The goal isn’t to dodge the insurance question. It’s to answer it in context, after you’ve earned the right to explain why it matters.

What Is the DPC Insurance Question?

The DPC insurance question occurs when prospective patients ask “Do you take my insurance?” during initial contact with a Direct Primary Care practice. This question represents the most common objection in DPC enrollment conversations, as patients must understand why membership-based care provides better value than traditional insurance-billed primary care.

Understanding how to explain DPC to patients starts with recognizing what this question really means. They’re not asking about billing mechanics. They’re asking whether choosing your practice will cost them more money on top of what they already pay for insurance premiums.

Why “No” Is the Wrong Answer to DPC Patient Objections

When someone asks “Do you take my insurance?”, they’re not actually asking about billing mechanics. They’re asking: “Will this cost me more money on top of what I already pay?”

That’s a fair question. They’ve been paying premiums for years. They’ve seen money come out of every paycheck. They want value from that investment. When you lead with “no,” you trigger a defensive reaction, a sense that they’re about to get charged twice for the same thing.

But here’s what they don’t know yet: they’re not getting value from that investment now.

The fee-for-service system has conditioned patients to accept 10-minute appointments, 3-week waits, phone trees that never reach a human, and surprise bills that arrive months later. They think that’s normal. They’ve forgotten what good care feels like, or they’ve never experienced it.

Your job isn’t to explain insurance exemptions. Your job is to help them realize what they’ve been missing.

According to the American Academy of Family Physicians, 94% of DPC physicians report practice satisfaction, compared to 57% of physicians in traditional settings. That satisfaction comes from somewhere. It comes from actually practicing medicine instead of fighting billing codes. That difference shows up in patient experience, and it’s what you need to surface before the DPC insurance question gets answered.

The Discovery-First Framework: How to Explain DPC to Patients

Instead of answering the insurance question immediately, redirect to discovery. This isn’t deflection. It’s respect. You’re saying: “I want to understand your situation before I give you generic information.”

Here’s the five-step framework for handling DPC patient objections.

Step 1: Acknowledge Without Answering

The patient asked a direct question. Ignoring it feels evasive. So acknowledge it, then buy time to redirect.

What to say:

“That’s a great question, and I want to make sure I give you the right answer for your situation. Can I ask what brought you to us today?”

Or:

“I can definitely address that. First, help me understand, what’s prompting you to look for a new physician?”

You’ve validated their question. You’ve signaled that you’ll answer it. And you’ve opened the door to discovery.

Step 2: Discover Their Real Problem

Now you listen. Not for information to rebut, but to understand what’s actually broken in their care.

Discovery questions to use:

• “What’s been frustrating about your current healthcare experience?"
• "When’s the last time you felt truly heard by your doctor?"
• "How long does it typically take you to get an appointment when you need one?"
• "What made you start looking for something different?”

These questions surface specific pain points. And specificity is what makes the later conversation work.

Every patient acquisition conversation should start with discovery, not with your pitch. When you understand what’s broken in their current care, you can show them exactly how your practice fixes it.

What to listen for:

• Access problems: “I can never get in when I’m sick”
• Time problems: “My appointments feel rushed”
• Communication problems: “I can never reach anyone”
• Trust problems: “I feel like just a number”
• Financial problems: “I never know what anything will cost”

Each of these maps directly to a DPC solution. But you need to hear it in their words first.

Step 3: Amplify Their Frustrations

Once they’ve shared their experience, validate it. Don’t minimize. Don’t rush to solutions. Let them feel understood.

What to say:

“That sounds incredibly frustrating. You’re calling because you’re sick, you need help, and the system makes you wait three weeks and then rushes you out in ten minutes. That’s not what healthcare should be.”

Or:

“You’re not alone in this. Most of the patients who come to us have the same story. They’re paying for insurance, paying copays, and still not getting the care they need.”

This is the moment you shift from stranger to ally. You’re on their side against a system that’s failing them.

Then connect it to the bigger picture:

“This is exactly why we built our practice differently. Membership medicine works because it aligns our incentives with your health, not with billing codes. The traditional system is designed around billing, not around patients. We stepped outside of that.”

Step 4: Present DPC as the Tailored Solution

Now you’ve earned the right to explain what you offer. But don’t do it generically. Connect your solutions to the specific problems they mentioned.

Use their exact language. Mirror back what they told you and show how your practice addresses it directly.

If they said: “Last time I was sick, I couldn’t get an appointment for two weeks.”

You say: “You mentioned waiting two weeks when you were sick. Our members typically see us within 24 hours. Often the same day.”

If they said: “My doctor doesn’t even look up from the computer.”

You say: “You said your doctor doesn’t make eye contact. We don’t have the billing pressure that creates that. When we’re with you, we’re actually with you.”

This isn’t salesmanship. It’s showing them you listened and that what they experienced matters.

Step 5: Answer the DPC Insurance Question in Context

Now circle back to insurance. They asked, and you should answer. But now the answer has context.

What to say:

“So, to answer your question about insurance. We operate differently than a traditional practice. Instead of billing insurance for each visit, we operate on a subscription healthcare model where you pay a monthly membership that covers everything, your appointments, messaging, phone calls, and basic labs and procedures.”

Then address the logical follow-up:

“A lot of our members keep a high-deductible insurance plan for catastrophic coverage, things like hospitalizations or specialist care. But for primary care, your membership covers it. No copays, no surprise bills, no waiting for claims.”

Connecting Pain Points to DPC Solutions

The discovery-first framework only works when you can bridge patient frustrations to specific solutions. Here’s how common DPC patient objections map to your practice advantages.

The Pain-to-Solution Bridge

Table: How DPC Addresses Traditional Healthcare Frustrations

Making It Personal

These solutions only work if your operations can deliver on them. When you promise same-day appointments and direct messaging, your connected practice systems need to make that seamless, from scheduling to clinical documentation to patient communication.

Handling Common DPC Patient Objections: The “I Already Pay for Insurance” Response

This one comes up often in every DPC sales conversation. Here’s how to handle it:

What to say:

“I understand. And you should absolutely keep insurance for big things, emergencies, surgeries, specialist referrals. But think about how much value you’re actually getting from your insurance for primary care. The wait times, the rushed visits, the billing surprises. Our membership gives you actual access to your physician, not just a card in your wallet.”

You can also note the direction policy is heading:

“Actually, starting in 2026, DPC memberships will be eligible for HSA contributions. That means you can use pre-tax dollars for your membership while keeping catastrophic insurance coverage. The system is starting to recognize this model works.”

Why Technology Reinforces the Value

Your patient experience doesn’t end with the conversation. It extends to every touchpoint, including your patient portal.

This is where many DPC practices undermine their value proposition. They promise a different kind of care, then hand patients a clunky EMR portal that looks identical to every hospital system’s login page. Same password frustrations. Same buried lab results. Same generic experience.

If you’re telling patients “we’re different,” your digital tools should prove it.

A modern patient portal reinforces everything you just promised:

• Direct messaging: When they send a message, it goes to you, not a queue
• Easy scheduling: Book appointments without phone trees
• Clear health information: Lab results and visit notes accessible and readable
• Your brand, not your vendor’s: White-label design that reflects your practice

This isn’t a nice-to-have. It’s proof of the differentiated DPC patient experience you’re selling. When a patient opens your portal and sees a clean, modern interface that clearly belongs to your practice, it confirms they made the right choice.

Mastering the DPC Sales Conversation

Notice what happened in the example above. This wasn’t a sales pitch. It was a diagnostic conversation. The best DPC sales conversations don’t feel like sales at all, they feel like problem-solving.

When you approach enrollment as discovery, you’re not convincing anyone. You’re helping someone realize whether DPC solves their problem. That distinction matters.

The DPC insurance question is really a gateway to a deeper conversation about what’s broken in their care. Every DPC sales conversation should follow this pattern:

1. Listen before explaining - Their frustrations are your opening
2. Validate before solving - Make them feel understood
3. Connect before asking - Bridge their specific pain to your specific solution
4. Answer in context - The insurance question makes sense after they understand value

Treat every inquiry as a DPC sales conversation that starts with listening, not explaining.

The Complete Conversation: An Example

Here’s how this framework plays out in practice:

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Patient: “Hi, I found your practice online. Do you take Blue Cross?”

You: “Thanks for calling. I can definitely answer that for you. First, help me understand, what made you start looking for a new doctor?”

Patient: “I’m just frustrated. My current doctor is impossible to reach. Last month I had a sinus infection and couldn’t get in for almost two weeks.”

You: “Two weeks when you’re sick. That’s frustrating. What happened?”

Patient: “I ended up going to urgent care. Paid the copay there, then got a bill from the lab a month later. I don’t even know what I’m paying for anymore.”

You: “That’s exactly what we hear from a lot of people. You’re paying premiums, paying copays, and still not getting the care you need when you need it. It shouldn’t work that way.”

Patient: “It really shouldn’t.”

You: “That’s actually why we practice differently. We’re what’s called a Direct Primary Care practice. Instead of billing insurance per visit, our members pay a monthly membership that covers everything. Appointments, messages, phone calls, even basic labs. Most importantly, when you need us, you can reach us. Same day or next day appointments are normal here.”

Patient: “So you don’t bill insurance at all?”

You: “Not for our membership services. A lot of our members keep a high-deductible plan for big things, emergencies, surgeries, specialist referrals. But for your primary care, the relationship you have with your physician, that’s covered by your membership. No surprise bills. No waiting three weeks when you’re sick.”

Patient: “What does the membership cost?”

You: “It depends on your age and whether you’re signing up individually or as a family. I can walk you through the options. Would you like to come in for a meet-and-greet so you can see the practice and ask any questions?”

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Notice what happened. The DPC insurance question got answered. But it got answered after the patient understood why the model exists and what it solves.

When to Let a Lead Go

Not everyone is right for DPC. Some patients have excellent insurance with low copays and a physician they love. Some genuinely can’t afford a membership on top of their premiums. Some want the anonymity of a large health system.

That’s okay.

The discovery conversation helps you identify fit, not just for enrollment, but for long-term satisfaction. A patient who joins without understanding the model will churn. A patient who joins because they genuinely want a different kind of care will become an advocate.

If someone is clearly not a fit, say so honestly:

“It sounds like your current setup is working well for you. If that ever changes, we’re here.”

That honesty builds trust, even if it doesn’t build your panel today.

And sometimes that trust leads to referrals. A patient who isn’t right for your practice today might have a friend or coworker who is. Or they might come back in six months when their situation changes. Making it easy for them to find you when they’re ready means having a web presence that clearly explains who you serve and what makes you different.

Frequently Asked Questions About DPC and Insurance

Does DPC take insurance?

No, DPC practices do not bill insurance for membership services. Instead, you pay a monthly membership fee directly to your physician that covers all primary care services, including appointments, messaging, phone calls, and basic labs. This eliminates copays, billing surprises, and insurance paperwork for your primary care.

Do I still need health insurance if I join a DPC practice?

Yes, most DPC members maintain a high-deductible health insurance plan for catastrophic coverage. Your insurance covers emergencies, hospitalizations, specialist care, and major medical expenses. Your DPC membership covers your relationship with your primary care physician.

Can I use HSA funds for DPC membership?

Starting in 2026, DPC memberships will be eligible for HSA contributions. This means you can use pre-tax dollars for your membership while maintaining catastrophic insurance coverage. Check with your HSA administrator for current guidelines.

Why should I pay for DPC if I already pay for insurance?

Your insurance premiums buy catastrophic coverage, but most patients get poor value for primary care, including long waits, rushed visits, and surprise bills. DPC membership gives you actual access to your physician when you need it. You keep insurance for big medical events and use DPC for everything your primary care doctor can handle.

How do I explain DPC to my family?

The simplest explanation: “It’s like a gym membership for healthcare. I pay a monthly fee directly to my doctor, and that covers all my primary care visits, calls, and messages. I keep insurance for emergencies and specialists, but for my regular doctor visits, I just go, no copays, no surprise bills, and I can actually reach my doctor when I need them.”

Key Takeaways: Mastering the DPC Insurance Question

The DPC insurance question isn’t an obstacle. It’s an opportunity to understand what someone actually needs.

Remember:

• Don’t lead with “no.” Lead with curiosity.
• Discover why they called before explaining your model.
• Validate their frustrations with fee-for-service care.
• Connect your solutions to their specific pain points.
• Answer the DPC insurance question in context, after they understand the value.
• Let your technology prove the experience you promise.
• Treat the insurance question as a DPC patient objection that reveals unmet needs.
• Approach every inquiry as a DPC sales conversation that starts with listening.

DPC exists because the traditional system fails patients. Every conversation about insurance is really a conversation about that failure and about what’s possible when you step outside of it.

The 1,500+ DPC practices nationwide are proof that this model works. Your next enrollment starts with listening.

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Ready to give your patients a modern experience that reinforces everything you promise? See how Practice Portal works for DPC practices like yours.