Insights / For families
What Direct Primary Care Actually Costs in Montana
The real monthly range, what sits inside the fee, what it does not cover, and how it compares against a marketplace plan once subsidies are counted.
If you have started looking into direct primary care in Montana, the first thing you probably wanted was a number. Most sites make you fill in a form to get one. Here is the actual range, what sits inside it, and what it does not cover.
The short answer
Direct primary care works on a flat monthly membership paid to the practice, not to an insurance company. Nationally, the American Academy of Family Physicians puts typical fees at roughly $20 to $49 a month for children and $50 to $100 a month for most adults.
Montana sits inside that range. What moves your number is age, how many people are on the membership, and whether you are adding anything beyond primary care.
For reference, CoreMed's own primary membership starts at $175 a month for a first adult, $150 for a spouse and $50 per child, and that includes considerably more than a typical standalone direct primary care practice. You can price your own household on the quote calculator without giving us a phone number.
What the monthly fee usually buys
The core of every direct primary care arrangement is the same. You get access to your own doctor without a bill each time you use it:
- Unlimited primary care visits, with no charge at the visit
- Longer appointments, typically 30 to 60 minutes rather than the 7 to 15 most people are used to
- Same-day or next-day availability for urgent things
- Direct contact with your doctor by phone, text or email between visits
- Chronic condition management, the ongoing work of blood pressure, diabetes, thyroid and the rest
- Basic in-office procedures and testing
What varies between practices is everything beyond that. Some include labs. Some include imaging. Some include mental health, physical therapy or dental. Ask exactly what is inside the fee before you compare two numbers, because a $75 membership that excludes labs and a $175 membership that includes them are not the same product.
What it does not cover
This part matters, and any practice that is straight with you will say it first.
A direct primary care membership is not insurance. It does not pay for hospital stays, surgery, specialists or emergencies. Most people pair it with something that handles large bills, whether that is a high-deductible plan, a marketplace plan or a cost-sharing arrangement.
If someone sells you a membership as a replacement for insurance, walk away.
How the maths usually works out
The comparison people care about is against a marketplace plan.
In Montana in 2026, the full price of an individual marketplace plan averages around $750 a month before any tax credit, after a weighted average rate increase of 29.1%. But roughly eight out of ten Montana marketplace enrollees qualify for an advance tax credit, and the average subsidised enrollee actually pays about $107 a month.
So the honest version is this. If you qualify for a substantial subsidy, a marketplace plan is very hard to beat on price alone, and we will tell you that. Where a membership tends to win is when you do not qualify for much of a subsidy, when your deductible is high enough that you never actually reach it, or when what you want is to be able to see a doctor without thinking about the cost first.
Run your own numbers. Do not take anyone's word for which is cheaper for you, including ours.
A change worth knowing about for 2026
As of 1 January 2026, health savings account money can be used to pay direct primary care membership fees, and joining a practice no longer disqualifies you from contributing to an HSA. The law caps what you can pay this way at $150 a month for an individual and $300 a month for a family.
That closed the last real practical obstacle for a lot of households. We wrote about what changed in Your HSA Just Changed.
Questions worth asking any practice
- What exactly is included, and what is billed separately?
- What do labs cost, and where are they drawn?
- How many patients does each doctor carry? Smaller panels are the whole point.
- How do I reach my doctor after hours?
- Is there a joining fee, and what is the notice period to leave?
- What happens if I need a specialist or a scan?
Where CoreMed fits
We are a Montana membership healthcare company operating across Eureka, the Flathead Valley, Helena, Bozeman and Billings, with Missoula opening next. Our memberships are built on direct primary care and pair it with cost sharing for the large, rare things.
We are not the only option and we are not right for everyone. If a subsidised marketplace plan is better for your household, that is a good outcome and we would rather you heard it from us.
You can see what every clinic in your region looks like on the find care pages before you sign up for anything, or email info@coremedhealth.com with a question.
This article is general information, not medical or financial advice. Fee ranges are from the American Academy of Family Physicians. Montana marketplace figures are for 2026 and reset annually.
