Americans Are Skipping Doctor Visits — And It's Not Because They're Healthy
Here's a number that should alarm you: 36% of American adults skipped or delayed medical care last year because of cost. Not because they didn't need it. Because they couldn't afford it.
And it's getting worse. 44% of adults say healthcare costs are difficult to afford — even those with insurance. ACA marketplace premiums jumped 21–26% for 2026. Employer-sponsored family plans now average around $27,000 per year. And over half of American workers are stuck in high-deductible health plans that require thousands in out-of-pocket spending before coverage kicks in.
So what does affordable primary care actually look like in 2026? What does a doctor visit really cost — with insurance, without insurance, and through alternatives like Direct Primary Care (DPC)?
We pulled real pricing data from 1,348+ DPC practices across all 51 states and territories listed on Connectedly Health to give you an honest breakdown. No spin. Just math.
The True Cost of a Doctor Visit in 2026
Let's start with the sticker price. Here's what you can expect to pay for a single primary care visit in 2026, depending on how you access care:
| Care Type | Cost Per Visit | What's Not Included |
|---|---|---|
| Without insurance | $150–$300 | Labs, imaging, prescriptions — all extra |
| With insurance (copay) | $10–$50 copay | Monthly premiums ($687–$752/mo), deductible ($1,500–$8,000+), limited provider choice |
| Urgent care | $150–$280 | No continuity of care, often long waits |
| Emergency room | $1,500–$3,000 | Surprise bills, facility fees, specialist charges |
| DPC membership | $0 (included in membership) | Monthly membership $29–$330/mo (median $80/mo). Doesn't cover hospitalization or specialists |
Notice something? The "cheap" option — a $25 insurance copay — doesn't look so cheap when you factor in the $687–$752 monthly premium you're paying just to get that copay rate. That's the hidden math most people miss.
The Hidden Math: What "Affordable" Insurance Actually Costs Per Year
Insurance premiums are just the starting point. Here's what healthcare actually costs annually when you add up everything — the math your insurance company doesn't put on a billboard.
| Expense | ACA Silver Plan (Individual) | Employer Plan (Family) |
|---|---|---|
| Monthly premium | $687–$752/mo | ~$2,250/mo (employer + employee share) |
| Annual premiums | $8,244–$9,024 | ~$27,000 |
| Deductible | $1,500–$5,000 | $3,000–$8,000 |
| Copays (est. 6 visits) | $150–$300 | $150–$300 |
| Total annual spend | $9,894–$14,324 | $30,150–$35,300 |
Even with subsidies that lower ACA premiums, most Americans are spending $6,000 to $14,000+ per year on healthcare — often before insurance pays a single dollar toward their care.
And here's the kicker: over 50% of US workers are now in high-deductible health plans. That means you could be paying $400/month in premiums and still owe $5,000 out of pocket before your insurance covers anything beyond preventive care.
For a deeper comparison, see our full DPC vs. insurance cost breakdown.
Why Primary Care Costs Keep Rising
Primary care costs didn't get this high by accident. Three forces are driving prices up every year:
1. Insurance Overhead
Traditional primary care practices spend 25–30% of revenue on billing and insurance paperwork. That cost gets passed to you.
2. Hospital and Health System Consolidation
When hospitals buy up independent practices, prices go up. Studies consistently show that hospital-owned practices charge 20–40% more for the same services.
3. Administrative Burden
The average primary care doctor spends nearly two hours on paperwork for every one hour with patients. That inefficiency drives up costs across the entire system.
DPC practices eliminate most of this overhead by cutting out insurance billing entirely. That's how they can offer comprehensive primary care for a flat monthly fee.
The Cost Breakdown: DPC Memberships by Price Tier
So what does a DPC membership actually cost? We analyzed pricing data from 1,348 practices on Connectedly Health to give you a real picture. Here's what we found:
| Price Tier | Monthly Cost | Number of Practices | % of All Practices |
|---|---|---|---|
| Budget-friendly | Under $75/mo | 515 practices | 38% |
| Mid-range | $75–$120/mo | 653 practices | 48% |
| Premium | Over $120/mo | 180 practices | 13% |
Key numbers:
- National average: $91/month
- National median: $80/month
- Lowest membership: $29/month
- Highest membership: $330/month
That means 86% of DPC practices charge $120/month or less — and more than a third are under $75/month. The median of $80/month is less than what many people pay for their cell phone plan.
Pricing by State
DPC costs vary by region. Here's what the average membership looks like in some of the most-searched states:
| State | Average Monthly Cost |
|---|---|
| Ohio | $80/mo |
| North Carolina | $85/mo |
| Florida | $92/mo |
| Texas | $96/mo |
| Colorado | $104/mo |
| California | $109/mo |
Want to see pricing in your state? Check our DPC Pricing Index or browse practices by state.
What You Actually Get for $80/Month
A DPC membership isn't just "cheap doctor visits." At the median price of $80/month, most practices include:
- Unlimited office visits — no copays, no per-visit fees
- Same-day or next-day appointments — most DPC doctors have smaller patient panels (600–800 vs. 2,500+ in traditional practices)
- Longer visits — 30–60 minutes instead of the typical 7–15 minutes
- Direct communication — call, text, or email your doctor directly
- Telehealth — 62% of DPC practices on our platform offer virtual visits
- Basic lab work — often at wholesale cost (70–95% cheaper than hospital pricing)
- Chronic disease management — diabetes, hypertension, thyroid conditions, and more
- Preventive care — annual physicals, screenings, and wellness planning
- Medication discounts — many practices offer wholesale or discounted prescriptions
For a full breakdown of what's typically included, read our guide on what's included in a DPC membership.
Annual Cost Comparison: DPC vs. Traditional Healthcare
Here's where the math gets interesting. Let's compare total annual healthcare costs for three common scenarios:
| Scenario | Traditional Insurance | DPC + Catastrophic Plan | Annual Savings with DPC |
|---|---|---|---|
| Healthy adult (3–4 visits/year) | $8,344–$9,224 | $2,760–$3,960 | $4,384–$6,264 |
| Family of 4 (12–15 visits/year) | $27,300–$27,750 | $9,600–$13,200 | $14,100–$18,150 |
| Chronic condition (monthly visits) | $11,624–$14,624 | $3,060–$5,040 | $6,584–$11,564 |
Important note: DPC does not replace insurance for hospitalizations, surgeries, or specialist care. Many DPC members pair their membership with a high-deductible or catastrophic health plan. If you have an HSA, you may be able to use HSA funds to pay for your DPC membership.
Not sure if DPC makes sense for your situation? Read 5 signs DPC is right for your family or our guide on whether you still need insurance with DPC.
How to Find Affordable Primary Care Near You
Step 1: Know Your Current Costs
Add up what you actually spend on healthcare each year: premiums, deductibles, copays, and prescriptions. Most people are surprised by the total.
Step 2: Search for DPC Practices
Use our provider search tool to find DPC practices near you. There are 1,348+ practices across every state — chances are good there's one near you.
Step 3: Compare Pricing
Check our DPC Pricing Index to see how practices in your area compare to national averages. Remember, 515 practices offer memberships under $75/month.
Step 4: Ask the Right Questions
Before joining, ask the practice: What's included? Are labs included or discounted? Do they offer telehealth? What's the patient panel size? Can they help coordinate specialist referrals?
Step 5: Consider Pairing DPC with a Catastrophic Plan
DPC covers your day-to-day primary care. A low-premium catastrophic or high-deductible plan covers you if something major happens. Together, they often cost far less than a traditional insurance plan — with better access to your doctor.
The Bottom Line on Affordable Primary Care in 2026
The healthcare system wants you to think a $25 copay is "affordable." But that copay comes attached to $8,000–$27,000 in annual premiums, a deductible you may never meet, and 15-minute appointments with a doctor who has 2,500 other patients.
Here's the real math:
- A doctor visit without insurance costs $150–$300
- With insurance, you're paying $8,000–$27,000/year for the privilege of a $25 copay
- With DPC, you pay $80/month (median) for unlimited visits, same-day access, and a doctor who actually knows your name
Across 1,348 practices on Connectedly Health, the average DPC membership is $91/month — with options starting as low as $29/month. That's real, affordable primary care — no insurance middleman, no surprise bills, no 3-week wait for an appointment.