Honestly, if you've been following the healthcare space, you know it’s usually a mess of red tape and rising premiums. But the direct primary care news October 2025 cycle finally dropped a bombshell that actually matters for your wallet. It’s not just another "innovative model" headline. We are talking about a fundamental shift in how the IRS looks at your doctor’s subscription fee.
For years, the federal government acted like Direct Primary Care (DPC) was a "second insurance plan." This meant you couldn’t use your Health Savings Account (HSA) to pay for it without risking a tax penalty.
That changed this month.
The Treasury and the IRS officially issued guidance following the "One Big Beautiful Bill" (OBBB) Act. Starting January 1, 2026, DPC fees are finally considered legitimate medical expenses. But the news hitting the wires right now is the clarification on how you can contribute to an HSA while being a DPC member. Basically, the "DPC-HSA cliff" is gone.
Why October 2025 Changed Everything for Your HSA
The big news this month centers on Notice 2026-05. The IRS basically said, "Fine, DPC isn't a health plan; it’s a medical service."
This is massive.
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Previously, if you had a high-deductible health plan (HDHP) and a DPC membership, the IRS argued you had "other coverage." That disqualified you from putting money into your HSA. You were stuck. You either chose the doctor you liked (DPC) or the tax-advantaged savings (HSA). You couldn't have both.
Now, the October guidance confirms that as long as your DPC agreement doesn't cover "big" stuff like surgery or hospitalization, it doesn't count as "disqualifying coverage."
- The Specifics: You can use HSA funds tax-free for those monthly $70–$150 fees.
- The Catch: Your DPC contract needs to be "service-based." If it looks like insurance—meaning it pays for outside labs or imaging—it might still be tricky.
- The Timeline: While the law was signed earlier, the implementation details released this October are what doctors are actually using to draft their 2026 contracts.
The Corporate Takeover: A Bitter Pill?
It’s not all sunshine. A report from Health Affairs released this fall shows a weird, almost scary trend in the DPC world.
Independent ownership of DPC practices has plummeted from 84% to about 60% in just a few years. Meanwhile, corporate-affiliated practices grew by over 570%.
Think about that.
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The whole point of DPC was to get away from "The Man." It was supposed to be a small office, a doctor who knows your kids' names, and no corporate billing department. But private equity and big health tech have noticed that people actually like this model. They are buying up solo practices at a record pace.
In October 2025, we saw several smaller regional DPC networks in the Midwest get swallowed by larger management groups.
Is it bad? Not necessarily. It usually means better apps and 24/7 tech support. But for the purists who joined DPC to escape corporate medicine, the October data is a wake-up call. You might still be paying a flat fee, but the person owning the building might be a venture capital firm in Manhattan.
Big Pharma and Direct-to-Consumer Sales
One of the more surprising bits of direct primary care news October 2025 involves, of all things, AstraZeneca.
President Trump announced mid-month that the administration struck a deal with AstraZeneca to offer "Most-Favored-Nation" pricing. This isn't just for Medicare. Part of the deal involves a push for direct-to-consumer (DTC) sales for primary care medicines.
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This aligns perfectly with the DPC model.
DPC docs often dispense medications at wholesale prices directly from their office. If big pharma starts playing ball with direct sales at lower benchmarks, the "middleman" (the pharmacy benefit manager or PBM) gets cut out even further. We saw the PBM Reform Act of 2025 stalling in the Senate this month, but these direct-to-consumer deals are a way around the legislative gridlock.
What Most People Get Wrong About DPC Right Now
A lot of folks think DPC is just for wealthy people. It’s the "concierge" label that confuses everyone.
But the October 2025 data shows that the fastest-growing demographic for DPC isn't the 1%. It's small business owners and "1099" contractors. With the "subsidy cliff" for ACA plans looming at the end of 2025, people are looking for ways to lower their premiums.
The play right now? Buy the cheapest, "catastrophic" HDHP plan you can find to cover the "bus hits you" scenarios. Then, pair it with a DPC membership for everything else.
Actionable Steps for the End of 2025
If you're looking at your open enrollment options for 2026, here is what you actually need to do based on the latest news:
- Check your DPC Contract: Ask your doctor if their 2026 membership agreement is "HSA-compliant" based on the new IRS Notice 2026-05.
- Max out your HSA: Since you can now officially use these funds for DPC fees starting in January, it’s worth bumping up your contributions during this enrollment period.
- Watch the "Corporate" Label: If you value the "mom and pop" feel, ask your doctor point-blank if they’ve sold to a larger network. Many are doing it to handle the new regulatory paperwork from the OBBB Act.
- Compare Med Prices: With the new AstraZeneca and Pfizer DTC deals, ask your DPC doctor if they can get your maintenance meds (like Eliquis or Jardiance) through their direct channels rather than the local pharmacy.
The landscape is shifting from a "fringe movement" to a "tax-advantaged standard." Just make sure you aren't paying for "concierge" prices when you're actually getting a corporate-managed clinic.