HSA & Cash-Pay

Using Your HSA for Direct Primary Care: What to Know in 2026

For years, Direct Primary Care and Health Savings Accounts didn’t mix well. Federal rules treated a DPC membership as a form of "other coverage," which could disqualify you from contributing to an HSA at all — an odd result for an arrangement that’s supposed to make healthcare simpler.

That changed on January 1, 2026. Under the One Big Beautiful Bill Act, passed in 2025, the IRS issued Notice 2026-5, which does two specific things: a Direct Primary Care membership no longer disqualifies you from contributing to an HSA, and HSA funds can now be used directly to pay DPC membership fees as a qualified medical expense.

The part worth knowing before you enroll

To keep contributing to your HSA while enrolled in a DPC membership, the fee has to stay under a federal cap — $150 per month for one person and $300 per month for more than one person, for 2026. That cap governs your ability to put new money into your HSA; using HSA dollars you already have to pay a DPC fee is a related but separate question. Our $125/month adult rate and our Founding Family Membership Rate (capped at $300/month) are within those limits. Check with your tax adviser.