On July 4, 2025, President Trump signed the One Big Beautiful Bill Act (OBBBA). The name may be over-the-top, but the impact is real — especially for direct primary care (DPC) practices and the patients who use them.
Starting January 1, 2026, patients with Health Savings Accounts (HSAs) will be able to use their HSA funds to pay for DPC services. That’s a major change. Under the old rules, paying a DPC membership fee could disqualify someone from contributing to an HSA because the IRS treated DPC as a separate health plan. Now, DPC is officially not considered a health plan for tax purposes, and the fees are recognized as qualified medical expenses.
This means patients can stay in a high-deductible health plan (HDHP), keep contributing to their HSA, and still use a DPC provider. For both patients and doctors, this untangles a long-standing tax issue that never made much sense in the first place.
Here’s what qualifies: the DPC arrangement has to offer only primary care services, delivered by a licensed primary care provider, billed as a fixed monthly fee. That fee can’t be more than $150 per month for individuals or $300 per month for families.
Not everything is covered. The law excludes services involving general anesthesia, most prescription drugs (vaccines are okay), and lab work that isn’t typically done in a basic outpatient setting. So while the monthly fee can now be paid with HSA funds, it doesn’t mean all care qualifies.
The law doesn’t force all HSA plans to cover DPC — it just allows them to. Some employers and insurers may take time to catch up, so patients and providers should double-check what’s covered.
Still, this is a big deal for concierge medicine. DPC has grown steadily in recent years as patients and doctors alike get frustrated with insurance-based care. These practices offer more time, more access, and less paperwork — but the HSA rules were a constant headache.
Now, there’s finally a path forward. Patients can use tax-advantaged dollars for care that actually works for them, and doctors can reach more people without jumping through legal hoops.
It’s not a total game-changer — but it’s a real win. And for once, a law with a ridiculous name might actually make healthcare simpler.
