Yes. If you have commercial health insurance, you can generally keep that coverage while using Direct Primary Care.

The two serve different roles. Direct Primary Care, or DPC, gives patients access to defined primary care services through a membership model. Health insurance may still help cover medical care outside that membership, depending on your plan.

At Saguaro Direct Care, the practice does not bill insurance for services covered by its DPC membership. Patients may still use insurance for eligible outside services, such as labs, imaging, specialist care, and hospital care.

Medicare follows different rules. Saguaro currently limits Medicare patients to certain non-covered services, so Medicare beneficiaries should review the practice’s current policy before enrolling.

Understanding these differences can help you decide whether DPC fits alongside your existing health coverage.

How Do Direct Primary Care and Health Insurance Work Together?

Direct Primary Care is a different way to pay for primary care.

Instead of billing an insurance company for each covered primary care service, a DPC practice generally charges a recurring membership fee. That fee covers a defined set of primary care services.

The American Academy of Family Physicians describes DPC as a model built around direct periodic payments between patients and primary care practices. (AAFP)

Health insurance works differently. Your plan may help cover eligible medical expenses based on its own rules. These rules may include deductibles, copays, coinsurance, provider networks, and coverage limits.

With Saguaro Direct Care, the membership focuses on primary care access and ongoing management. Health insurance may still matter when you need services outside the membership.

If you want a broader explanation first, read more about how Direct Primary Care works.

DPC Membership vs. Health Insurance at a Glance

Healthcare Need	Saguaro DPC Membership	Health Insurance May Still Apply
Primary care access	Included under membership terms	Saguaro does not bill insurance for included DPC care
Virtual follow-ups	Included under membership terms	Saguaro does not bill insurance for covered DPC follow-ups
Medication management	Included	Medication cost may be separate
Lab testing	Can be ordered or coordinated	Separate cost; coverage depends on your plan
Diagnostic imaging	Can be ordered or coordinated	Separate cost; coverage depends on your plan
Specialist care	Referral may be provided	Specialist visits are outside the membership
Hospital care	Not included	Coverage depends on your plan
Emergency care	Not included	Coverage depends on your plan
Surgery	Not included	Coverage depends on your plan

Saguaro states that labs, imaging, medications, specialist visits, hospital care, and other outside services can involve separate costs. Insurance may help with some of those expenses when the patient’s plan provides coverage. (Saguaro Direct Care FAQ)

Does Direct Primary Care Replace Health Insurance in Arizona?

No. A Direct Primary Care agreement is not a health insurance policy.

Arizona law requires a DPC agreement to clearly state that it is not health insurance. The agreement must also describe the primary care services included in the periodic fee.

Patients remain responsible for medical expenses outside that agreement. Arizona law also states that a DPC provider may not bill a patient’s health insurance for primary care services covered by the DPC agreement. (Arizona Revised Statutes §44-1799.92)

That distinction matters because DPC does not provide comprehensive coverage for every healthcare need.

For example, Saguaro’s membership does not cover emergency care, hospitalization, surgery, or specialist visits.

Separate health coverage may still be useful for those needs. Your actual benefits and costs depend on your insurance plan.

What Does Saguaro Direct Care’s Membership Cover?

Saguaro Direct Care uses a virtual-first model for adult primary care in Arizona.

Its current membership includes direct physician messaging through Spruce, phone and video access, medication management, prescription refills, preventive guidance, chronic disease management, and virtual care for common medical concerns. Saguaro also provides telemedicine access across Arizona. (Saguaro Direct Care Pricing)

The current pricing page lists the DPC membership at $109 per month. Pricing and enrollment terms can change, so patients should review current Direct Primary Care membership pricing before joining.

The membership also provides access to discounted labs and imaging and can help coordinate specialist or home-health referrals.

You can review the full Saguaro Direct Primary Care membership for current service details.

What Medical Costs Can Still Fall Outside Your DPC Membership?

Knowing what is outside the membership is just as important as understanding what is included.

Labs and Diagnostic Imaging

Saguaro can order and help coordinate laboratory testing and diagnostic imaging.

The separate cost of those services is not included in the monthly DPC membership. Patients may use insurance for labs or imaging when their health plan covers the service. Saguaro also lists discounted self-pay options where available. (Saguaro Direct Care FAQ)

For laboratory testing, Saguaro currently lists relationships with services such as LabCorp and Sonora Quest. The practice also lists local imaging options for patients in the Lake Havasu City area.

A doctor’s order does not guarantee insurance coverage.

Before completing lab work or imaging, consider asking your insurer:

• Is the facility in network?
• Do I need prior authorization?
• What deductible applies?
• Will I owe a copay or coinsurance?
• Are other covered facilities available?

These questions can help you understand your cost before receiving the service.

Specialists, Hospital Care, Surgery, and Emergencies

Some healthcare needs go beyond the scope of primary care.

Saguaro states that its monthly membership does not cover specialist visits, hospitalizations, emergency care, or minor and major surgeries.

Your Saguaro physician may help determine when outside evaluation or referral is appropriate. However, the cost of that outside care remains separate from the DPC membership.

Your health insurance may help cover those services according to your plan’s benefits, network, deductible, and other terms.

Prescription Medication Costs

Saguaro’s membership includes medication reviews, medication management, refills, and prescribing when medically appropriate. (Saguaro Direct Care FAQ)

The cost of the medication itself is separate.

Depending on the medication and your health plan, you may use pharmacy insurance benefits or available cash-pay options.

In simple terms, medication management is part of your care, but the medication itself may have a separate cost.

Do You Pay Both a DPC Membership and a Health Insurance Premium?

You may.

If you keep health insurance while joining a DPC practice, the membership fee is generally separate from your insurance premium.

Those payments serve different purposes.

The Saguaro membership pays for the primary care services included in its agreement. Your insurance plan remains separate and may help cover other eligible healthcare services.

You may still have costs for:

• Lab work
• Diagnostic imaging
• Prescription medications
• Specialist appointments
• Emergency care
• Hospital care
• Procedures and surgery

DPC is not automatically less expensive for every person. Your total healthcare costs depend on your medical needs, insurance coverage, and use of outside services.

For qualifying DPC arrangements under the current federal HSA rules, the DPC membership fee itself does not count toward an HDHP deductible or out-of-pocket maximum. Separate services, such as labs or imaging, follow the terms of the individual’s health plan. (IRS Notice 2026-5)

For current Saguaro costs, review the Direct Primary Care pricing page.

When Can Saguaro Provide a Superbill?

Saguaro states that it can provide a superbill upon request.

A superbill is an itemized medical receipt. It may contain information about services provided, diagnosis codes, and amounts charged.

However, Saguaro’s public FAQ does not clearly state which specific charges or services qualify for a superbill.

Before relying on one for reimbursement, ask Saguaro which charges the superbill applies to. Then contact your insurance carrier to learn whether those charges may qualify under your plan.

Insurance reimbursement is not guaranteed.

Your insurer determines:

• Whether the service is eligible
• Whether out-of-network benefits apply
• How much may be reimbursed
• What documentation is required
• Whether any eligible payment affects your deductible

This is especially important because Arizona law separates primary care services covered by a DPC agreement from insurance billing.

What Should You Ask Your Insurance Company Before Joining DPC?

You do not need to understand every line of your insurance policy before considering Direct Primary Care.

A few focused questions can help you understand how your coverage may work alongside the membership.

Ask your insurance company:

• Which labs are in network?
• Which imaging centers are covered?
• Do I need prior authorization for MRI, CT, or other imaging?
• Do specialist visits require a referral?
• Do I have out-of-network benefits?
• Can I submit a superbill for eligible services?
• How would eligible reimbursement affect my deductible?
• How are prescription medications covered?
• What are my emergency-room and hospital benefits?
• Are there restrictions on using outside physicians or facilities?

These questions matter because Saguaro cannot determine the terms of every patient’s insurance plan.

You can also review Saguaro’s Direct Primary Care FAQs for details about labs, imaging, referrals, membership limits, and superbills.

Can You Use an HSA for Direct Primary Care in 2026?

Federal HSA rules changed beginning January 1, 2026.

The IRS says an otherwise eligible person enrolled in certain qualifying Direct Primary Care service arrangements may remain eligible to contribute to a Health Savings Account. HSA funds may also be used for qualifying periodic DPC fees under the current rules. (IRS)

Specific requirements apply.

Not every healthcare membership automatically qualifies as a DPC service arrangement under federal tax rules. The terms of the arrangement matter, not only the monthly price.

For that reason, Saguaro’s current $109 membership fee alone does not confirm HSA eligibility.

Saguaro can explain the services and terms included in its membership. For HSA eligibility and tax treatment, review current IRS guidance and consult your HSA administrator, benefits professional, or qualified tax adviser.

Why Choose DPC If You Already Have Health Insurance?

Having health insurance does not always answer how you want to receive everyday primary care.

Saguaro’s current membership offers direct physician messaging, secure phone and video visits, same- or next-day telehealth when available, medication management, preventive guidance, and chronic disease management. (Saguaro Direct Care Pricing)

That model may appeal to people who value:

• Direct communication with a physician
• Virtual primary care across Arizona
• Ongoing follow-up
• Chronic condition management
• Medication reviews and refills
• Clear membership pricing
• Help coordinating outside care

DPC is not the right choice for everyone.

Some people may prefer an insurance-based primary care practice. Others may value using DPC for routine primary care while keeping separate insurance for broader medical needs.

The useful question is not whether DPC is better than insurance.

It is whether the two can serve different needs in a way that fits your healthcare situation and budget.

Is Saguaro Direct Care a Good Fit If You Already Have Insurance?

Saguaro may be worth exploring if you want membership-based primary care while keeping separate coverage for healthcare outside the practice.

The practice provides telemedicine throughout Arizona. Saguaro also offers member house calls in Lake Havasu City for an additional charge. (Saguaro Direct Care Pricing)

Before joining, make sure you understand:

• What the membership includes
• Which costs remain separate
• How your plan handles labs and imaging
• Your specialist and hospital benefits
• How prescription coverage works
• Whether virtual-first primary care fits your needs

Saguaro currently offers prospective patients a free consultation to discuss whether the practice may be a good fit.

Frequently Asked Questions About Health Insurance and DPC

Can I keep my health insurance if I join Direct Primary Care?

If you have commercial health insurance, you can generally keep your coverage while joining DPC. Saguaro states that patients may still use insurance for eligible outside services such as labs, imaging, specialists, and hospital care. Your actual coverage depends on your health plan.

Medicare follows separate rules, so Medicare beneficiaries should review Saguaro’s current policy before enrolling.

Is Direct Primary Care considered health insurance in Arizona?

No. Arizona law requires DPC agreements to state that they are not health insurance policies. Patients remain responsible for medical expenses outside the DPC agreement. (Arizona Revised Statutes §44-1799.92)

Does Saguaro Direct Care bill health insurance?

Saguaro states that it does not accept or bill insurance for primary care services covered by its DPC membership.

Can I use insurance for labs and imaging while using DPC?

Possibly. Saguaro allows patients to use insurance for outside lab and imaging services when applicable. Coverage, network requirements, deductibles, and patient costs depend on the individual health plan.

What happens if I need a specialist, hospital care, or surgery?

Those services are outside Saguaro’s monthly DPC membership. The practice may provide a referral when appropriate. Payment and insurance coverage for outside care depend on the provider and your health plan.

Can I submit a Saguaro superbill to my insurance company?

Saguaro says it can provide a superbill upon request. Ask the practice which specific charges it applies to, then check with your insurer about possible reimbursement. Reimbursement is not guaranteed.

Can I use HSA funds for Direct Primary Care in 2026?

Federal rules now allow HSA treatment for certain qualifying DPC arrangements. Specific requirements apply. Saguaro’s monthly price alone does not establish whether its membership qualifies, so review current IRS guidance before using HSA funds.

Understand What Each Part of Your Healthcare Pays For

Direct Primary Care and health insurance can serve different parts of your healthcare needs.

A DPC membership provides defined primary care services and physician access. Separate health insurance may still help with eligible care outside the membership.

Before making a decision, review what Saguaro currently includes and what costs remain separate. Then check how your insurance handles labs, imaging, prescriptions, specialists, emergency care, and hospital services.

If the model seems right for you, explore the Saguaro Direct Primary Care membership and current pricing.

Ready to ask questions about membership? Schedule a free consultation with Saguaro Direct Care.