How to Switch to a Direct Primary Care or Concierge Doctor: A Step-by-Step Guide

A direct primary care (DPC) practice charges a flat monthly or annual membership fee in exchange for broad primary care access. A concierge practice works similarly but often layers a retainer on top of traditional insurance billing, or operates on a pure cash-pay model. Either way, the membership is not health insurance. It does not count as minimum essential coverage under federal law, and it does not replace a plan that covers hospitalizations, specialist care, or emergencies. The American Academy of Family Physicians (AAFP) describes DPC as a practice model where the physician-patient relationship is funded directly, removing third-party billing from primary care.

Before you start the switching process, get clear on what your new practice includes. Most DPC memberships cover unlimited or near-unlimited primary care visits, basic in-office procedures, and direct communication with your doctor by phone or message. Concierge practices vary widely. Read the membership agreement carefully before you sign anything, and ask the practice staff to walk you through exactly what is and is not covered by the monthly fee.

Your medical records belong to you. Under the HIPAA Privacy Rule, your current provider must give you access to your records, typically within 30 days of a written request. You can ask for a summary or a full copy. Common items to request include your problem list, medication list, immunization history, recent lab results, imaging reports, and any specialist notes. Your new doctor will use these to understand your health history from day one.

Providers are allowed to charge a reasonable, cost-based fee for copying records, though many practices waive this fee for electronic copies. If your records are in an electronic health record system, ask for them in a standard electronic format such as a PDF or a CCD file. The HHS Office for Civil Rights oversees HIPAA compliance and publishes guidance on your right to access records at hhs.gov. If a practice refuses or delays unreasonably, you can file a complaint with HHS.

Timing matters, especially if you have ongoing health needs. Try to avoid a gap where you have left your old practice but have not yet had your first appointment with the new one. A good rule of thumb is to enroll in your new practice and schedule an intake visit before you formally end your relationship with your current doctor. Many DPC and concierge practices offer a meet-and-greet or onboarding call before your first full visit.

If you are managing a chronic condition, coordinate the handoff so you do not run out of medications or miss a follow-up. Ask your new doctor's office whether they can begin managing your care before your first in-person visit, and whether they accept electronic record transfers from your old practice. Some practices will reach out to your previous provider directly once you sign a release of information form.

DPC and concierge membership agreements are legal contracts. Read them before you sign. Key things to look for include the monthly or annual fee, what services are included, how the practice handles after-hours calls, the notice period required to cancel, and whether there are any enrollment or termination fees. Some practices require 30 days' written notice to cancel; others require 60 or 90 days. A few charge a prorated fee if you leave mid-cycle.

Also check whether the practice has a patient-to-physician ratio cap, which is common in DPC and concierge models and is part of what makes them different from traditional practices. If the practice accepts insurance for any services, ask which services are billed to insurance and which are covered by the membership fee. This distinction matters if you have a health plan and want to avoid surprise out-of-pocket costs.

Active prescriptions are one of the most important things to manage during a transition. Ask your current doctor for a sufficient supply or a bridge prescription to cover you until your new doctor can take over prescribing. Your new DPC or concierge doctor will typically want to review your medications at your first visit before continuing or changing anything. Do not stop or change any medication on your own during the transition.

For specialist referrals, let your specialists know you are changing your primary care provider. Give them the contact information for your new doctor so they can send notes and coordinate care. Many DPC practices have established relationships with local specialists and can often facilitate referrals more quickly than a traditional practice because of the direct communication model. Ask your new practice how they handle specialist coordination before you enroll.

You do not need your current doctor's permission to leave their practice. A simple written or verbal notice is courteous and professional. Some practices will ask you to sign a form acknowledging the end of the care relationship. If your current doctor is part of an insurance network, notify your health insurer of the change so your records reflect your new primary care provider. This matters for insurance plans that require you to designate a primary care physician for referrals.

If you are on Medicare, be aware that DPC practices can participate in Medicare in a limited way, but the rules are specific. Medicare beneficiaries enrolled in a DPC practice may still use Medicare for services outside the DPC membership, including hospitalizations and specialist visits. CMS has published guidance on how DPC practices interact with Medicare. Check Medicare.gov or ask your new practice directly about how they handle Medicare patients.

Many people pair a DPC membership with a high-deductible health plan (HDHP) for catastrophic coverage. If you use a Health Savings Account (HSA) with your HDHP, be aware that the IRS has specific rules about HSA eligibility when you also have a DPC membership. As of current IRS guidance, a DPC membership fee is generally not a qualified HSA expense, and having a DPC membership may affect your ability to contribute to an HSA depending on how the plan is structured. Review IRS Publication 969 at irs.gov or speak with a tax professional before making assumptions about HSA compatibility.

If you have a marketplace plan through HealthCare.gov, your DPC membership does not replace that coverage. You will still pay your plan premium and use your insurance for services outside the DPC scope, such as emergency care, hospitalizations, and most specialist visits. Keep your insurance card updated with your new primary care provider's information if your plan requires a designated PCP.

DirectMedicine is a directory of direct-pay, cash-pay, and DPC practices across the United States. When you are ready to find a new direct primary care doctor or concierge practice, the directory lets you filter by location, practice type, and services offered so you can compare options side by side. Each listing is designed to show you what a practice offers and how to contact them directly, so you can ask the questions that matter most to you before you commit.

The goal of DirectMedicine is price transparency and informed choice. Rather than guessing what a practice charges or what is included in a membership, you can use the directory to identify practices that publish their fees and scope of care upfront. From there, the steps in this guide give you a clear path to making the switch with confidence and without gaps in your care.