You have money sitting in a health savings account. You are paying, or thinking about paying, a monthly membership to a primary care practice. It seems obvious that the two should be allowed to meet. For years, they mostly were not, and the answer was tangled enough that most people stopped asking and just paid out of pocket.
That changed at the start of 2026. Here is the current picture in plain terms, along with the questions worth taking to your own plan administrator before you move any money.
The short answer
For months beginning after December 31, 2025, a qualifying direct primary care arrangement is treated as a medical expense you can pay for with HSA funds. Just as importantly, being in one of these arrangements no longer blocks you from contributing to an HSA in the first place.
That second part was the real sticking point before. Under the older reading of the rules, a monthly membership for primary care looked like a second health plan, and having a second health plan alongside a high deductible plan could disqualify you from making HSA contributions at all. Patients were put in a position of choosing. That choice is largely gone now.
Two caveats before we go further. Tax rules change, they are applied to your specific situation, and this article is general education rather than tax advice. For anything that affects your return, talk to your tax professional, and confirm how your particular account works with your HSA custodian or plan administrator.
What makes an arrangement qualify
Not every monthly healthcare subscription counts. Current guidance describes a qualifying arrangement along these lines:
- It is a fixed periodic fee paid for primary care services, rather than a fee charged per visit.
- The care comes from a primary care practitioner. That generally includes physicians practicing family medicine, internal medicine, geriatrics or pediatrics, along with nurse practitioners, clinical nurse specialists and physician assistants.
- The fee stays within a monthly dollar cap. For 2026 that is $150 per month for an individual and $300 per month at the family level, with the figures adjusted for inflation in later years.
- The arrangement is limited to primary care. Procedures needing general anesthesia, prescription drugs other than vaccines, and lab work not typically done in an ambulatory primary care setting fall outside it.
If you have read our explainer on what a DPC membership includes and what it does not, that last point will sound familiar. The membership buys you access to a doctor for primary care. It was never meant to be a substitute for hospital care, surgery or specialty treatment.
What happens if the fee is above the cap
This is the part people most often get backwards, so it is worth stating carefully. The cap does two different jobs.
- Below the cap: the arrangement does not interfere with your eligibility to make new HSA contributions, and the fees can generally be paid from the account.
- Above the cap: current guidance indicates you may still be able to reimburse the fees from an existing HSA balance, but the arrangement can affect your ability to make new contributions.
Household math matters here. A couple membership plus several children on the same agreement can add up past the family figure even when each individual piece looks small. If your household total is anywhere near the line, that is a specific question for your tax professional rather than something to estimate.
Where Ridgeview’s membership sits
Our individual membership is $99 per month at the founding rate and $129 per month at the standard rate. Two adults in the same household are $179 at the founding rate and $199 standard, with children up to age 26 at $39 per month each. You can see the full breakdown on the primary care page.
An individual membership at either rate sits under the 2026 individual figure. A two adult household sits under the family figure. Add children and the arithmetic changes, which is exactly the situation to run past your own advisor rather than assume.
What about an FSA?
Flexible spending accounts are a different animal, and the honest answer is less tidy.
The 2026 change was written around health savings accounts specifically. An FSA is an employer sponsored plan, and what it will reimburse is governed by your employer’s plan documents and the administrator who processes the claims. Some plans treat a periodic primary care fee as reimbursable. Others do not, or will reimburse only itemized charges for specific services rendered.
So the practical step is the same for both account types: ask your plan administrator in writing before you submit anything. Ask two questions. Does the plan reimburse a fixed periodic primary care fee? And if not, will it reimburse itemized services provided during the period? The answers determine what kind of receipt you need from us.
The same goes for a health reimbursement arrangement through an employer. Those are defined by the plan, not by you, and the administrator is the only reliable source.
Keep your paperwork boring
Whatever account you use, the records are your responsibility, not your doctor’s and not your bank’s. A few habits make audits and year end questions much less stressful:
- Save every receipt showing the date, the amount, what it was for and who provided it.
- Keep your membership agreement somewhere you can find it, since it describes what the fee does and does not cover.
- Do not mix categories. Keep the membership fee receipts separate from pharmacy, imaging and specialty bills.
- Write down what you were told. If an administrator confirms something by phone, follow up by email so you have it in writing.
If you need a receipt or a statement in a particular format for your account, just ask the office. That is a normal request and an easy one.
One thing that has not changed
A direct primary care membership is not health insurance. It covers your primary care relationship. It does not pay for hospital stays, surgery, emergency care, specialty treatment, imaging done elsewhere or prescriptions at the pharmacy counter. Most members keep a health plan alongside the membership, and a high deductible plan paired with an HSA is a common combination for exactly that reason.
We wrote about that pairing in more detail in how direct primary care and insurance work together. If you are weighing whether the whole model suits your situation, our honest look at who it suits and who it does not is the better starting point.
Questions worth bringing to a meet and greet
You do not need to have your tax situation solved before you come in. Many people find it easier to understand the membership first and then take the specifics to their advisor. Things members commonly want to know:
- What exactly does the monthly fee cover, in writing?
- What will I still be billed for by someone else, such as labs, imaging or prescriptions?
- What kind of receipt or statement can the office provide?
- How does the registration fee work, and is it separate from the monthly fee?
Bring the list. Nobody minds.
Talk it through with Dr. Kroner
If you want to understand how a membership would actually work for your household, the easiest next step is a conversation. Book a free 30-minute meet and greet with Dr. Kroner or call 720-807-9961. Ridgeview Direct Care is at 4045 Wadsworth Blvd #300, Wheat Ridge, CO 80033, open Monday through Friday, and serves patients in Arvada, Lakewood, Golden, Edgewater and west Denver.
This article is for educational purposes only and is not medical, tax or legal advice. Please consult your tax professional and your plan administrator about your own situation. See our medical disclaimer.