October 16, 2026
Direct Primary Care vs Concierge Medicine: What Is the Difference and Which Is Right for You?
Direct primary care and concierge medicine both charge a membership fee, but only one stops billing your insurance for visits. Compare fees, access and cost, and see which model fits you, from Advanced Optimal Healthcare in Lutz, FL.
Medically reviewed by Dr. Anilda Ortiz, DNP, APRN, FNP-C. Last updated: October 2026.
Direct primary care vs concierge medicine is a comparison between two membership models, and they are not the same thing. A direct primary care practice charges a flat monthly fee, gives you direct access to your provider and does not bill your insurance for office visits. A concierge practice usually charges a larger annual retainer and, in most cases, still bills your insurance for each visit. Advanced Optimal Healthcare in Lutz, FL is a direct primary care practice, which is why an office visit here never produces a copay, a deductible charge or a surprise bill.
Why Does This Practice Not Take My Insurance for Visits?
It is the first question almost every prospective member asks at a meet-and-greet. Advanced Optimal Healthcare does not bill insurance for office visits at any membership level because billing insurance is what shortens appointments. A practice paid per visit has to see many patients a day to cover its costs, which is how rushed visits, long waits and phone trees become normal. A practice paid a flat monthly fee can schedule one patient at a time, see you on time and let the appointment run as long as the problem needs.
Whether that is better for you depends on how you use care. For many people in Lutz, Land O' Lakes and Wesley Chapel it is a better trade; for some it is not.
What Direct Primary Care Is
Direct primary care, often shortened to DPC, is a membership model in which you pay the practice directly, usually by the month, for your primary care. The fee covers your visits and your access to the provider. No claim is sent to an insurer for the visit, there is no copay at the front desk and no deductible to meet first. The Direct Primary Care Coalition describes the model as a flat periodic fee paid to the practice for primary care services in place of fee-for-service insurance billing, and a national survey of DPC practices (Eskew et al., J Am Board Fam Med, 2015) used the same definition: a periodic fee and no third-party billing for the services that fee covers.
A direct primary care membership in Lutz works like this: you pay a set amount each month, and in return you get unlimited routine and sick visits, longer appointments, and direct access to your provider by phone, secure text, video chat and email, in the office or by telehealth. Blood draws happen in the office, certain lab tests are run on site, and members receive discounted pricing on labs, imaging and medications. Your insurance stays in place for everything outside the practice.
What Concierge Medicine Is
Concierge medicine also charges a membership fee for enhanced access, which is why the two models get confused. The differences sit in the billing and the price. A concierge practice usually still bills your insurance for each visit, so you pay the retainer and then your insurer, and often you, pay again when you are seen. The retainer is usually charged annually rather than monthly, and it is usually considerably higher than a direct primary care fee, because it is a premium layer on top of insurance-based care rather than a replacement for the billing itself. Direct primary care removes the insurance system from the visit entirely, which is what keeps the fee lower and the pricing transparent.
Direct Primary Care vs Concierge Medicine: Side by Side
| Feature | Direct primary care at Advanced Optimal Healthcare | Concierge medicine |
|---|---|---|
| Fee structure | Flat monthly membership, billed monthly, cancel with 30-day notice | Usually an annual retainer paid up front |
| Insurance billing | Insurance is never billed for office visits, at any level | Usually still billed for each visit, with copays and deductibles |
| Typical cost | $99 to $299 per month for an individual primary care membership | Usually considerably more, on top of what insurance charges |
| Visit length | Longer, unhurried appointments with one patient scheduled at a time | Often longer than a conventional practice; varies by practice |
| Access | Direct access by phone, secure text, video chat and email, plus telehealth visits | Enhanced access is the main selling point; the details vary by practice |
What Advanced Optimal Healthcare Is, Plainly
Advanced Optimal Healthcare is a direct primary care practice in Lutz, FL, founded in 2020 by Dr. Ortiz, a board-certified family nurse practitioner with more than 14 years in primary care, internal medicine and family practice. There are two separate membership tracks.
Primary care memberships
Individual primary care memberships come in three levels: Foundational at $99 per month, Advanced at $199 per month and Optimal at $299 per month. Family plans are available at the Foundational level: $159 per month for two people, $320 per month for four, and $80 per month for each additional person. An individual inside a family plan can hold the Optimal level at the Optimal price.
Every primary care membership includes unlimited routine and sick visits, direct access by phone, secure text, video chat and email, longer unrushed appointments, transparent pricing with no copays or deductibles, discounted labs, imaging and medications, telehealth, preventive exams, and priority scheduling and discounted pricing on wellness services. Your annual physical exam, sick visits when a cold, flu or infection hits, and ongoing medication management for conditions such as high blood pressure and diabetes all sit inside the membership. The differences between the levels are reviewed at the complimentary consultation.
Wellness memberships
Wellness memberships are a separate track for the practice's wellness services, priced at $399, $499 and $699 per month for the Foundational, Advanced and Optimal levels. A wellness membership is not part of a primary care membership, and the two are billed separately.
Who Each Model Suits, Honestly
Direct primary care suits people who want a provider they can actually reach: families with children who get sick on a schedule of their own, adults managing a chronic condition, people with high-deductible plans who avoid care because every visit costs money, and self-employed people who want predictable costs. Employers with five or more staff can cover their team through employee health benefits built on the same model, which provides primary care visits for employees and is not health insurance.
Concierge medicine tends to suit people who already carry comprehensive insurance and are comfortable paying a large annual retainer for a premium layer of access, copays and deductibles included.
Some people are better off staying with a traditional practice. If your plan has very low copays, you see your provider once a year, you are satisfied with that access and you never avoid care because of cost, a membership may not pay for itself. The same is true if you want all of your care inside one large hospital system. We would rather say so at a meet-and-greet than sign a member who will not use what they pay for.
What Members Use Their Insurance For
This is the question that worries people most. Direct primary care does not replace health insurance, and we do not recommend dropping coverage. Members keep their insurance for pharmacy prescriptions, lab work and imaging ordered outside the practice's discounted options, specialist visits, urgent care, emergency care and hospital stays. When you need a specialist, Dr. Ortiz makes the referral, sends the records and coordinates the plan, and the specialist bills your insurance as usual. Many members pair the membership with a high-deductible plan: the membership covers the everyday care that would otherwise fall under the deductible, while insurance stands behind the expensive and unlikely events.
Frequently Asked Questions About Direct Primary Care vs Concierge Medicine
Does direct primary care replace my health insurance?
No. A direct primary care membership covers your primary care visits and your access to the provider; it is not an insurance product and does not cover specialists, hospital care, emergencies or pharmacy prescriptions. Members keep their insurance for those things, and many pair the membership with a high-deductible plan.
What happens if I need a specialist or a hospital?
Your provider refers you, sends your records and coordinates the plan, and the specialist or hospital bills your insurance as it normally would. Direct primary care changes how your primary care is paid for, not how the rest of the system works. In an emergency you go to the emergency room, and afterward Dr. Ortiz manages the follow-up.
How much does direct primary care cost?
At Advanced Optimal Healthcare, individual primary care memberships are $99, $199 or $299 per month for the Foundational, Advanced and Optimal levels. Family plans at the Foundational level are $159 per month for two, $320 for four and $80 for each additional person. Billing is monthly, and you can cancel with 30-day notice. What each level includes is walked through at the complimentary consultation.
Can I use my HSA or FSA for the membership?
Membership may be HSA eligible. Federal rules on how direct primary care fees are treated for health savings accounts changed recently and include limits, so confirm with your plan administrator or a tax advisor before paying from an HSA. FSA rules depend on your employer's plan. We provide itemized receipts for whatever documentation your plan requires.
Is direct primary care worth it if I rarely get sick?
It can be, but not always. If you want a preventive relationship, an unhurried annual physical, lab literacy and a provider you can text when something feels off, the membership delivers value even in a year with no illness. If you only want a yearly visit and your current plan makes that cheap and easy, a traditional practice may serve you fine.
What is the difference between this and a concierge practice?
Advanced Optimal Healthcare is a direct primary care practice, not a concierge practice. The membership is a flat monthly fee, and insurance is never billed for office visits at any level. A concierge practice usually charges an annual retainer, usually costs considerably more, and in most cases still bills your insurance for each visit.
See the Membership Levels and Book a Meet-and-Greet in Lutz, FL
The simplest way to decide is to sit down with us. The meet-and-greet is a complimentary 20-minute conversation at our office in Lutz, FL, serving Land O' Lakes, Odessa and the greater Tampa area, where we walk through the primary care membership levels, answer your insurance questions and tell you plainly whether the model fits. Schedule a complimentary consultation or call (813) 330-6224. We are currently accepting new patients.
