Quick answer: A DPC membership agreement is the contract that defines your primary care relationship: what visits, services, and communication are included, what it costs, and how either side can end it. The five clauses below tell you most of what you actually bought. To compare practices, browse our DPC doctor directory and see typical pricing in our guide to direct primary care cost.
Why the Agreement Matters More Than the Brochure
Direct primary care practices usually describe themselves in warm, general terms: longer visits, easy access to your doctor, no insurance billing. That description is often accurate, but the membership agreement is where the specifics live. Two practices with similar websites can differ substantially in what they include, how they charge, and what happens if your circumstances change.
Reading the agreement before you sign is the simplest way to avoid surprises. You do not need a legal background to understand most of it — DPC agreements tend to be shorter and plainer than insurance contracts. You mainly need to know which sections carry the most weight.
Clause 1: What Is Included — and What Is Not
This is the heart of the agreement. Look for a specific list of covered services: office visits, annual physicals, chronic disease management, minor procedures, lab work, and communication methods such as phone, email, or messaging. Some practices include basic labs and in-office supplies; others pass those costs through at a discounted but separate price.
Pay equal attention to exclusions. A DPC membership is primary care only. It does not cover hospital stays, emergency room care, specialists, imaging at outside facilities, or most prescription costs. If an agreement seems vague about what happens when you need care the practice cannot provide, ask before signing.
Clause 2: Fees, Billing, and Price Changes
The agreement should state the monthly fee clearly and explain how billing works — automatic bank draft and credit card are common. Look for three specifics:
- The exact monthly amount and any enrollment or reactivation fees
- How and when the practice can raise the fee, and how much notice you receive
- Whether any services are billed separately, and whether those prices are disclosed upfront
Most DPC memberships in the U.S. commonly run in the $50–$150 per month range, though practices vary. For a fuller picture of what drives that number, see our breakdown of direct primary care cost.
Clause 3: Term, Cancellation, and Refunds
Find out how the membership renews — month to month is typical, but some practices use longer terms. Then look at cancellation: how much notice is required (often 30 days), whether you can cancel mid-month, and whether any prepaid months are refundable.
Also check what happens if you cancel and later want to return. Some practices charge a re-enrollment fee or place returning members at the back of a waitlist. None of these terms are unreasonable on their face; the point is knowing them in advance.
Clause 4: Access, Availability, and Doctor Changes
The access promise is a big part of why people choose DPC, so the agreement should describe it concretely. Look for how the practice handles after-hours questions, same-day or next-day appointments, telehealth, and what happens when your physician is on vacation or leaves the practice.
That last point deserves attention. Ask what the practice does if a physician departs — whether you are reassigned, offered a refund, or free to exit without penalty. A short paragraph on this in the agreement is a good sign the practice has thought it through.
Clause 5: Relationship to Insurance, Medicare, and Records
A DPC agreement is not health insurance, and a well-written one says so plainly. It should state that the membership does not replace coverage for hospital care, emergencies, or most specialty services. If you have insurance, the agreement may describe whether the practice bills your plan for outside services (most DPC practices do not bill insurance at all).
If you are on Medicare, note that DPC practices typically do not bill Medicare for their membership, and this is a relationship worth confirming before you join. And check the records clause: you are generally entitled to a copy of your medical records, but the agreement may describe the format, timing, and any copying fees. If you are new to the model entirely, our overview of what direct primary care is covers these boundaries in more detail.
A Few Clauses Worth a Second Look
- Dispute resolution: some agreements require arbitration or specify a venue for disputes
- Scope of care: what the practice will and will not manage, and when you are referred out
- Household and family terms: whether family members must each hold separate memberships
- Telehealth across state lines: relevant if you travel or split time between states
Nothing here means DPC agreements are risky — most are straightforward and written to be understood. It simply means that the differences between practices show up in the fine print. If a clause is unclear, the practice should be willing to explain it in plain language; reluctance to do so is itself useful information. More common questions are answered in our DPC FAQ.
Frequently Asked Questions
Can I negotiate a DPC membership agreement?
Sometimes. Practices may be flexible on family pricing, pause options, or billing dates, though core fees and scope of services are usually fixed. It costs nothing to ask, and the response tells you how the practice handles communication generally.
Is a DPC membership agreement the same as insurance?
No. It is a service contract for primary care only. It does not cover hospitals, emergency rooms, or most specialty care, which is why most members pair DPC with some form of insurance or cost-sharing for major medical events.
What happens to my membership if my doctor leaves the practice?
That depends on the agreement, which is why the physician-change clause matters. Common approaches include reassignment to another doctor in the practice, a refund window, or the option to cancel without penalty.
Can I get a refund if I cancel mid-month?
Practices differ. Many require 30 days’ notice and do not pro-rate a partial month, while a few refund unused time. The cancellation and refund section of your specific agreement is the definitive answer.
Ready to compare practices? Start with our directory of DPC doctors, and bring this list of clauses to any conversation — our DPC clinic checklist pairs well with the agreement itself and helps you ask the right questions before you sign.