Direct primary care laws by state

Federal tax law: from January 2026, a direct primary care arrangement does not by itself stop a person from contributing to an HSA if its fees total no more than $150 a month, or $300 when it covers more than one person. HSA funds may also pay those fees. The IRS kept the same limits for 2027.

IRC §223(c)(1)(E); IRS Notice 2026-5; Rev. Proc. 2026-24 · source · verified 31 Oct 2026

Alaska law allows direct health care agreements for primary care services, set out within the state insurance title. The agreement must state that the patient does not get the insurance patient protections of AS 21.07. It may not be offered to people who can receive Medicaid. A patient may cancel within 30 days for a refund, and either side may end it on 30 days' notice.

AS 21.03.025 · source · verified 1 Nov 2026

Arizona law says a direct primary care agreement is not the business of insurance under Title 20. The agreement must be in writing with a set disclaimer, allow either side to end it on 30 days' notice, and bar the provider from billing the patient's insurer for covered primary care. No more than 12 months may be prepaid.

A.R.S. §§44-1799.91 to 44-1799.96; §20-103(E) · source · verified 31 Oct 2026

Arkansas law says the state Insurance Code does not apply to a direct healthcare agreement. The agreement must be in writing, state that it is not health insurance, and let either side end it without penalty; any notice period may not exceed 60 days. The provider may not charge extra for services the periodic fee already covers.

Ark. Code §23-60-104 · source · verified 31 Oct 2026

Colorado law says direct primary care is not insurance and is not regulated by the insurance commissioner. The agreement must bar fee-for-service claims to a health insurer for the covered primary care, and must disclose that it is not health insurance. Employers and others may pay the fee.

C.R.S. §§6-23-101 to 6-23-105 · source · verified 31 Oct 2026

Florida law says a direct health care agreement is not insurance and is not subject to the Florida Insurance Code. The agreement must be in writing, carry a set notice that it is not health insurance and that no claims are filed with the patient's insurer for covered services, and allow either side to end it on 30 days' written notice.

Fla. Stat. §624.27 · source · verified 31 Oct 2026

Georgia law says a direct primary care agreement with a physician is not insurance and is not subject to state insurance laws. The agreement must be in writing, state that it is not health insurance, and limit prepayment to 12 months. The physician must give at least 30 days' notice to end it.

O.C.G.A. §33-7-2.1 · source · verified 31 Oct 2026

Idaho's Direct Primary Care Act says these agreements are not regulated as insurance under Title 41. Neither the patient nor the provider may bill an insurer for services under the agreement. The agreement must say it is not health insurance, and the patient may end it at will by written notice, with unearned fees refunded within 30 days.

Idaho Code §§39-9201 to 39-9209 · source · verified 31 Oct 2026

Indiana law says a direct primary care agreement is not insurance and is not subject to the state insurance title (IC 27). The provider does not bill a third-party payer for the covered primary care. The agreement must be in writing, state that it is not health insurance, and limit prepayment to 12 months.

Ind. Code §§25-1-10-1 to 25-1-10-5 · source · verified 31 Oct 2026

Iowa law says a direct health care agreement is not insurance and is not under the insurance commissioner. The provider may not bill an insurer for services under the agreement. It must carry a bold notice that it is not health insurance, limit prepayment to 12 months, and give 60 days' written notice of changes to fees or terms.

Iowa Code §135N.1 · source · verified 31 Oct 2026

Kansas law says a medical retainer agreement is not insurance and is not subject to the state insurance chapter. The agreement must be in writing, carry a boldface notice that it is not insurance, and bar both provider and patient from billing an insurer for its services. Routine care may include in-office drugs and certain lab work.

K.S.A. 65-4978 · source · verified 31 Oct 2026

Kentucky law says a direct primary care membership agreement is not coverage under a health benefit plan and is not regulated under the insurance code (KRS Chapter 304). The agreement must state that the provider will not bill a health plan or Medicaid fee-for-service for the covered care. A patient cannot be required to prepay more than 12 months; unearned fees are refunded.

KRS 311.6201-311.6202 · source · verified 31 Oct 2026

Louisiana law says a direct practice that follows the statute is not a health insurer and is not subject to the insurance title. The practice may not file claims with an insurer for services the agreement covers. Fees may rise at most once a year with 60 days' notice, and the agreement must carry a set disclaimer.

La. R.S. 37:1360.81-1360.91 · source · verified 31 Oct 2026

Maine law says a direct health care service agreement is not an insurance policy and is not regulated by the Bureau of Insurance. The provider agrees not to bill third parties for covered services. The agreement must disclose that it is not health insurance and that fees may not count toward a deductible. A 2025 law extended it beyond primary care.

22 M.R.S. §1771 · source · verified 31 Oct 2026

Michigan law says a medical retainer agreement is not insurance and entering one is not the business of insurance. The agreement must be in writing, state that it is not health insurance, and bar both provider and patient from billing an insurer for its services. Either side may end it on written notice.

MCL 500.129 · source · verified 31 Oct 2026

Takes effect 1 Aug 2027

Minnesota enacted a direct primary care law in 2026 that takes effect August 1, 2027. It says these agreements are not insurance. Agreements must be in writing and state that they are not health insurance; the practice may not bill a health plan for covered services, must give 30 days' notice to end care, and may raise fees at most once a year.

Minn. Stat. §62Q.20; §62A.01, subd. 5 · source · verified 31 Oct 2026

Missouri law says a medical retainer agreement is not insurance and is not subject to Chapter 376 of the Revised Statutes. It covers physicians, dentists and chiropractors. The agreement must be in writing, state that it is not health insurance, and allow either side to end it on written notice. A 2022 change lets employers pay the fees.

RSMo §376.1800 · source · verified 31 Oct 2026

Since July 1, 2025, Montana law lists direct patient care agreements among the services the state Medicaid program may cover, as set by department rule. The state may not require a Medicaid enrollee who has such an agreement to join primary care case management.

MCA 53-6-101(4)(t); MCA 53-6-116(7) · source · verified 31 Oct 2026

Montana law says the insurance code does not apply to direct patient care agreements. The provider may not submit claims to a health insurer for services under the agreement or charge extra for included services. The agreement must carry a set notice that it is not an insurance policy, and any notice period to end it may not exceed 60 days.

MCA 50-4-106 to 50-4-109; MCA 33-1-102(15) · source · verified 31 Oct 2026

Nebraska's Direct Primary Care Agreement Act says a direct agreement is not insurance and is not subject to the insurance chapter. The provider may not bill an insurer for services under the agreement. It must carry a notice that it is not insurance; the provider gives 30 days' notice to end it and 60 days' notice of fee changes.

Neb. Rev. Stat. §§71-9501 to 71-9511 · source · verified 31 Oct 2026

New Hampshire law says primary care under a direct primary care agreement is not insurance and the provider is not under the insurance commissioner. The agreement must state that it is not health insurance and that no claims are filed with the patient's insurer for covered services. Any notice period to end it may not exceed 90 days.

RSA 329:1-e · source · verified 31 Oct 2026

North Carolina law says a medical direct primary care agreement is not insurance and is not subject to the insurance chapter. It is a periodic-fee agreement with no fee-for-service billing of third parties. The agreement must be in writing, state that it is not health insurance, and allow either side to end it with written notice.

N.C. Gen. Stat. §58-3-8 · source · verified 31 Oct 2026

North Dakota law leaves direct primary care out of its definition of a discount plan, so DPC is outside the state's discount-plan registration rules. The statute does not say that direct primary care is not insurance, and sets no agreement or disclosure rules.

N.D. Cent. Code §26.1-53.1-01(5)(c) · source · verified 31 Oct 2026

Ohio law says a direct primary care agreement that meets the statute is not insurance, and the state insurance title does not apply to it. The agreement must be in writing, state that it is not health insurance, and end within 60 days of written notice with no penalty. The provider may not charge extra for services the fee covers.

Ohio Rev. Code §3901.95 · source · verified 31 Oct 2026

Oklahoma law says a direct primary care membership agreement is not insurance and is not regulated by the Insurance Department. No insurance license and no medical discount plan registration are needed to offer one. Either side may end it on written notice, and unearned fees are refunded if the patient ends it.

36 O.S. §§4604-4605 · source · verified 31 Oct 2026

Oregon certifies retainer medical practices: a practice certified by the Department of Consumer and Business Services is outside the Insurance Code except for these rules. A certified practice offers primary care only, may not bill an insurer or the state medical assistance program for agreement services, and must disclose that it is not insurance.

ORS 735.500-735.510; ORS 731.036(11) · source · verified 31 Oct 2026

South Carolina has no direct primary care statute. House Bill 3966, which would say a direct primary care agreement is not insurance, was introduced and referred to committee on February 12, 2025, with no later action recorded.

SC H. 3966 (126th Session, 2025-2026) · source · verified 31 Oct 2026

South Dakota law says a direct primary care agreement is not insurance and is not subject to the insurance title. The agreement must be in writing, state that it is not health insurance, limit prepayment to 12 months, and return unearned funds. A practice may not refuse or drop patients solely because of their health status.

SDCL 34-54-1 to 34-54-4 · source · verified 31 Oct 2026

Tennessee law says a direct medical care agreement is not insurance and is not regulated by the Department of Commerce and Insurance. The agreement must carry bold disclosures, including that it is not health insurance and that fees may not count toward a deductible. No more than 12 months may be paid in advance.

Tenn. Code §§63-1-501 to 63-1-504 · source · verified 31 Oct 2026

Texas law says a direct patient care agreement is not health insurance and is not regulated by the Texas Department of Insurance. Physicians and other licensed practitioners may offer one, including by telehealth. The practice may not bill an insurer or HMO for care paid under the agreement, and must give written notice that it is not insurance.

Tex. Occ. Code ch. 117 (§§117.001-117.006) · source · verified 31 Oct 2026

Utah law exempts a medical retainer agreement from the insurance code's rule that only licensed insurers may take advance payment for health care. The agreement must be in writing, describe the routine services it includes, state that it is not health insurance, and bar the provider from billing an insurer for those services.

Utah Code §31A-4-106.5 · source · verified 31 Oct 2026

Virginia law says a direct primary care agreement for a monthly fee is not health insurance or an HMO, as long as fees are not required before the period they cover. The agreement must carry a set disclaimer, and the practice must disclose that it will not bill a health carrier for covered services.

Va. Code §§54.1-2997 to 54.1-2998 · source · verified 31 Oct 2026

Washington law says direct practices that follow chapter 48.150 RCW are not insurers. A practice must file an annual statement with the Insurance Commissioner, may not submit claims to carriers for covered services, and may raise its fee at most once a year with 60 days' notice. The agreement must carry a set disclaimer.

RCW 48.150 · source · verified 31 Oct 2026

West Virginia law says a direct medical care membership agreement is not insurance and is not regulated by the Office of the Insurance Commission. The practice may not bill third-party payers for agreement services. The agreement must be in writing, state that it is not health insurance, allow 30 days' notice to end it, and limit prepayment to 12 months.

W. Va. Code §§30-3F-1 to 30-3F-5 · source · verified 31 Oct 2026

Wisconsin has no direct primary care statute. The legislature passed 2025 Senate Bill 4 on direct primary care, the governor vetoed it on August 8, 2025, and the veto was sustained on May 13, 2026.

WI 2025 SB 4 (companion AB 8) · source · verified 31 Oct 2026

Wyoming law says the Insurance Code does not apply to a direct primary care agreement. The agreement must be in writing, describe the services and fees, and state that it is not health insurance. Either side may end it without penalty, with any notice period no longer than 60 days, and the provider may not charge extra for included services.

Wyo. Stat. §26-1-104(a)(vi); §26-22-301(c) · source · verified 31 Oct 2026