Beginning January 1, 2026, a long-anticipated shift in U.S. healthcare policy will take effect – one that meaningfully changes how individuals, families, and employers can pay for primary care.

For the first time, certain Direct Primary Care (DPC) membership fees will be compatible with Health Savings Accounts (HSAs). This update removes a long-standing barrier that has limited adoption of one of the fastest-growing primary care models in the country.

The result is a clearer, more flexible path toward preventive, relationship-based care and a system that better reflects how patients actually want to experience healthcare.

What’s Changing in 2026?

Starting in 2026, federal law clarifies how Direct Primary Care is treated under HSA regulations. When statutory conditions are met, several important changes apply:

  • DPC membership fees will qualify as HSA-eligible medical expenses, up to federally defined limits
  • HSA funds may be used to pay for DPC memberships
  • DPC enrollment will generally no longer be treated as disqualifying coverage for HSA contributions
  • Employers may pair DPC with HSA-compatible insurance arrangements with greater regulatory clarity

Together, these changes resolve years of confusion and align HSAs with modern primary care delivery. As Dr. Rutvic Amin, Founder of Rainari Health, explains, “Prevention finally makes financial sense.” The policy change does more than modernize compliance – it signals a shift toward rewarding early, relationship-based care instead of reactive, high-cost treatment models.

Using HSA Funds for Direct Primary Care

Beginning January 1, 2026, individuals may use HSA funds to pay for qualifying DPC memberships. Because HSAs are funded with pre-tax dollars, this can meaningfully reduce the effective cost of primary care, depending on an individual’s tax bracket.

Federal law sets monthly limits on how much of a DPC fee may qualify:

  • Up to $150 per month for individual coverage
  • Up to $300 per month for family coverage

These limits will be indexed to inflation after 2026, allowing the policy to evolve alongside healthcare costs.

DPC No Longer Breaks HSA Eligibility

Historically, enrolling in a Direct Primary Care practice often jeopardized HSA eligibility. The IRS classified DPC as “other coverage,” even when individuals maintained a qualifying high-deductible health plan.

Under the new framework, that classification is removed when statutory requirements are met. As a result:

  • Individuals can maintain both a DPC membership and an HSA
  • Employers can offer DPC benefits without triggering HSA compliance issues
  • Patients no longer have to choose between personalized primary care and tax-advantaged savings

“This change lets patients invest in prevention without being penalized for choosing better care,” says Dr. Rutvic Amin. By restoring HSA compatibility, the new framework removes a major psychological and financial barrier that previously discouraged proactive healthcare decisions.

Industry data shows that the number of DPC practices in the U.S. has grown dramatically over the past decade, a trend expected to accelerate as HSA compatibility takes effect.

What Qualifies as Direct Primary Care?

Not every subscription-based healthcare model qualifies under the new rules. To remain HSA-eligible, a DPC arrangement must meet specific criteria.

A qualifying DPC membership must:

  • Cover primary care services only
  • Be paid as a flat monthly fee
  • Include services such as preventive care, chronic disease management, and care coordination

It must not include:

  • Specialty or hospital care
  • Surgical coverage
  • Fee-for-service or per-visit billing

These guardrails preserve the core intent of Direct Primary Care: simple, relationship-driven primary care not insurance replacement.

Expanded Insurance Flexibility

Another important development in 2026 involves insurance pairing. Certain lower-cost insurance options, including some Bronze and Catastrophic plans, may be structured to work alongside HSAs, depending on final federal guidance and plan design.

This creates greater flexibility for individuals to:

  • Use insurance primarily for emergencies and hospitalization
  • Rely on DPC for day-to-day care
  • Fund both through tax-advantaged HSA dollars

Studies consistently show that patients using DPC-style care experience fewer emergency room visits, improved chronic disease management, and higher continuity of care – outcomes that align closely with the goals of HSAs.

Why This Matters for Employers

Employers have shown increasing interest in Direct Primary Care but often hesitated due to regulatory uncertainty around HSAs. That uncertainty is now largely resolved.

Starting in 2026, employers can:

  • Offer DPC as a compliant employee benefit
  • Pair it with HSA-compatible insurance strategies
  • Improve access to care while controlling total healthcare spend

Employer case studies repeatedly demonstrate that DPC-based benefit models lead to faster access, lower utilization of high-cost services, and higher employee satisfaction – particularly as healthcare costs continue to rise.

A Broader Shift Toward Preventive Care

At a system level, this policy change reflects something larger than Direct Primary Care or HSAs alone. It signals growing recognition that:

  • Primary care is essential yet underfunded
  • Preventive, relationship-based care improves outcomes
  • Simplified payment models reduce administrative waste

Today, primary care accounts for less than 6% of total U.S. healthcare spending, despite playing the largest role in preventing costly downstream care. Aligning HSAs with DPC is one step toward correcting that imbalance.

Looking Ahead

For years, Direct Primary Care and Health Savings Accounts operated in parallel – both popular, both effective, but not fully compatible. Starting January 1, 2026, that changes.

By allowing qualifying DPC memberships to be funded with HSA dollars without breaking eligibility, federal policy begins to align with how many people want to experience healthcare: transparent, accessible, preventive, and personal.

Final implementation details are subject to IRS and Treasury guidance. Individuals should confirm eligibility with their tax advisor.