Can I Use Insurance with Direct Primary Care?
At Pink Pearl Primary Care, we operate under a Direct Primary Care (DPC) model—meaning we do not bill insurance for our services. Instead, we keep costs affordable, transparent, and simple through a low monthly membership or pay-per-visit fee.
But that doesn’t mean your insurance is useless! In fact, there are several ways it can still work alongside your DPC membership.
Ways You Can Use Insurance with DPC:
1. Lab Work & Imaging
If you have insurance, we can send your lab orders or imaging referrals to in-network facilities that accept your coverage.
2. Specialist Visits
If we refer you to a specialist (e.g., cardiologist, dermatologist), you can absolutely use your insurance for those visits.
3. Emergency & Hospital Care
Insurance is still recommended for emergencies, hospitalizations, surgeries, or serious unexpected illnesses that require more advanced care.
4. Prescription Coverage
We can send prescriptions to your preferred pharmacy, and you may still use your insurance card for medication costs (depending on your pharmacy benefits).
5. Have an HSA?
Good news! Beginning January 1, 2026, federal law expanded HSA compatibility with qualifying Direct Primary Care arrangements.
Eligible patients may be able to use HSA funds tax-free toward qualifying DPC membership fees while maintaining HSA eligibility.
For 2026, qualifying DPC arrangements are subject to federal monthly fee limits of $150 for individual coverage or $300 when the arrangement covers more than one individual.
Because individual health plans and tax circumstances vary, we recommend confirming eligibility with your HSA administrator or tax professional.
We Don’t Bill Insurance—But You Might Still Get Reimbursed.
But we understand that many of our patients have insurance and want to make the most of it. That’s why we offer support for out-of-network reimbursement through trusted third-party services:
1. Reimbursify
Quick and easy claim filing from your smartphone. Upload your superbill and submit to your insurance in minutes. Visit reimbursify.com to get started.
2. SuperBill
Want help submitting claims automatically? SuperBill takes care of everything—from generating your superbill to checking your eligibility. Visit thesuperbill.com to get started.
What We Don’t Do:
- We don’t bill or process insurance claims
- We don’t accept Medicare or Medicaid
- We don’t require referrals or prior authorizations
📩 Still Have Questions?
We’re happy to explain how our care model can complement your existing insurance.
Contact us anytime or bring your questions to your first visit.