Direct Primary Care (DPC)

Direct Primary Care (DPC) is a new model of healthcare delivery. Unlike traditional practices, DPC providers do not bill your insurance. Instead, patients pay a monthly fee for their care.  In this case, providers are not beholden to insurance rules and requirements,  and patients are not subject to surprise bills from copays, coinsurance, and deductibles.  In removing this interference from insurance companies, providers are freed to provide timely, affordable, excellent care. 

What’s Included with the DPC monthly subscription fee?

Primary Care

• Office visits with no copays or fees

• Virtual care (through Patient Portal or telephone)

• Preventive Care visits

• Chronic care management (HIV, diabetes, high blood pressure, asthma, depression, etc)

• Urgent same or next day appointments

• Gender-affirming hormone therapy and monitoring

• PrEP prescription and monitoring

• HIV care

• STI screens

• Pre-operative clearance

• And more...

Procedures included in membership (pathology/lab costs will be supplemental):

• Skin tag removals

• Cryotherapy with liquid nitrogen for warts and other skin lesions

• Ear lavage

• Incision and drainage of abscesses

• EKGs

• Contraception management

• Pap smears

FAQ

What is Direct Primary Care (DPC)?

DPC is healthcare delivery model that focuses on prioritizing the patient-doctor relationship. In DPC, the provider bills the patient directly. By removing interference from insurance companies, we’re able to put your needs first. For a flat monthly fee, you get unlimited office visits with no copays, direct access to your doctor by phone, portal messaging, same day or next day visits, and unrushed office visits. In the fee-for-service model of healthcare, insurance plans only pay providers when a visit has been completed. Portal messaging or emails do not meet billing requirements for visits. This creates an unnecessary requirement that a visit is booked before any of your healthcare needs are met. In addition, The price for your care at CHM is transparent with no surprise costs from deductibles or coinsurance that you learn about after the fact. Another benefit is that your therapeutic relationship with your provider is protected. As long as your DPC account is active, your provider will remain your PCP, regardless of whether your employment status or insurance plan changes - that includes switching to a public plan such as Apple Care or Medicare.

Are your services covered by my insurance?

No. Your insurance will not cover this monthly DPC subscription. The purpose of the DPC model is to remove the “middleman” of the insurance company, which is ultimately beholden to the demands of shareholders rather than the needs of their customers. DPC removes all of the uncertainty around cost of primary care services - that guessing game of how much you’ll have to pay after a doctor’s visit.

Should I still have insurance?

Absolutely. Direct primary care is primary care only - the services we can deliver to you through our clinic. You’ll still need coverage for those services we don’t provide, such as emergency care, hospitalization, long-term care, diagnostic imaging, labs, pharmacy costs, and specialist referrals.

It is important to think carefully about your healthcare needs, and whether you should carry a more affordable high deductible catastrophic plan or a more expensive higher coverage plan. The advantage of DPC is that you’ll already have paid your DPC provider for all your primary care needs.

Can I use my FSA to pay for services?

You can use a Flexible Spending Account (FSA) to pay for direct primary care services. However, not all FSA third party administrators allow use of FSAs for monthly fees, but may allow a lump sum annual payment. You will need to confirm with them. At this time, we are not able to accept annual payments for our services, but we may introduce that in the future.

What does the DPC Subscription Cost?
Dr. Vy Chu’s DPC monthly fee is $95/month. Joshua Lumsden, PA-C, charges $99/month. They both have lower rates if they are seeing all adults in the household (couple/throuple/poly/family rate).

How might I save money by paying a monthly fee for direct primary care?

Participating in direct primary care may or may not save you money. Here are some ways that people have saved money with DPC:

1. Decreased monthly health costs. If paired with a low premium, high deductible insurance plan, the premium money you save might be much greater than the monthly membership fee for primary care. Still, you will need to envision different scenarios of out-of-pocket costs for medical care you receive from parties other than your DPC provider.

2. Less time away from work and family. Under the DPC model, you can optimize the amount of care we provide you via electronic means. Fewer trips to the clinic means less time away from work and family.

3. Fewer surprise bills from insurance companies. With DPC, you know up front how much you are paying for primary care. No more guessing whether the office visit will be billed at a level 3, 4, or 5, if an appointment for a given topic will or won’t be covered under your insurance plan, or what your out-of-pocket cost will be for an office procedure.

Once I join a direct primary practice, may I terminate my membership?

Yes, at any time and for any reason, but you must provide written notice to your DPC provider (email or through the Patient Portal will suffice). Monthly fees will be prorated to the date they receive your written termination. Importantly, you will not be allowed to rejoin your provider’s DPC practice for one full year from the date you discontinued your membership. *
*An important exception here is for Dr. Chu’s patients in the first year after his transition to DPC (July 1, 2025). Should they transition to DPC for a short period then decide to leave, but then find that their care is substandard elsewhere, Dr. Chu has agreed to take his patients back and will waive the one-year waiting period.

Can my DPC provider terminate my membership?

Yes, but not solely on the basis of your health status or protected status. Per RCW 48.150.050, “…the direct practice may discontinue care for direct patients if: (a) The patient fails to pay the direct fee...; (b) the patient has performed an act that constitutes fraud; (c) the patient repeatedly fails to comply with the recommended treatment plan; (d) the patient is abusive and presents an emotional or physical danger to the staff or other patients of the direct practice; or (e) the direct practice discontinues operation as a direct practice.”

Can a DPC provider decline to accept me in into their DPC practice?

Yes, per RCW 48.150, a direct practice may decline to accept a patient “if the practice has reached its maximum capacity, or if the patient’s medical condition is such that the provider is unable to provide the appropriate level and type of health care services in the direct practice”.

Where can I learn more about direct primary practices in Washington State?
Direct Primary Care is monitored in Washington state. Each year, the Office of the Insurance Commissioner collects data on DPC practices, including average monthly price charged at each practice. We encourage you to review the most recent annual report here.

How do I sign up?

As of July 2025, Joshua Lumsden, PA-C is accepting new patients who are interested in direct primary care. Joshua will begin DPC on April 1, 2025. If you’re interested in direct primary care with either , please sign up here.