Direct primary care · HSAs · 2026 rules
Direct primary care and your HSA: the 2026 rules
New IRS rules for 2026 let you pair certain primary care memberships with an HSA. Here is what qualifies, what doesn’t, and where people trip up.
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- $150 single / $300 family
- Fixed monthly fee only
- Fee doesn’t count toward deductible
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What counts as a direct primary care arrangement
- Primary care only, from primary care practitioners: physicians in family, internal, geriatric or pediatric medicine, nurse practitioners, clinical nurse specialists and physician assistants.[2]
- Paid only by a fixed periodic fee. An arrangement that also bills you or your insurance separately for its services doesn’t count.[2]
- Fee limit: total DPC fees can’t exceed $150 a month for one person or $300 a month for an arrangement covering more than one person. The limit is adjusted for inflation for tax years after 2026.[2]
- Not included as primary care: procedures that need general anesthesia, prescription drugs other than vaccines, and lab services not typically done in a primary care office.[2]
Details people miss
- Longer billing periods are allowed if the total stays within the monthly limit. For 2026, a single person’s fee could be $1,800 for a year, $900 for six months or $450 for three months.[2]
- It’s the terms that count, not what you use. If an arrangement includes services beyond primary care, skipping those services doesn’t make it qualify.[2]
- Your fee doesn’t count toward your health plan’s deductible or out-of-pocket maximum.[2]
- Your HSA plan can’t cover the membership for you before you meet the deductible.[2]
Which health plans work with an HSA now
As of January 1, 2026, Bronze and Catastrophic plans available through an exchange are treated as HSA-compatible.[1] The same plan bought off the exchange also counts if it’s available on the exchange.[2] Telehealth before the deductible no longer blocks HSA contributions, a rule now permanent for plan years starting on or after January 1, 2025.[3] For 2027 contribution limits, see HSA limits for 2027.
Where Amaze Health fits
Amaze Health’s sign-up form describes its subscriptions as unlimited access to Amaze medical providers and its app: $49.99 a month for an individual and $59.99 a month for an individual plus immediate family, each with an annual contract.[4] It is a membership, not health insurance, and doesn’t replace a health plan. Whether any membership meets the IRS definition depends on its terms,[2] so check with your tax professional before paying it from an HSA; we don’t make that call here. More: virtual primary care in Michigan.
This page is general information, not tax advice.
Sources
- IRS news release IR-2025-119, Treasury, IRS provide guidance on new tax benefits for health savings account participants (Dec. 9, 2025). https://www.irs.gov/newsroom/treasury-irs-provide-guidance-on-new-tax-benefits-for-health-savings-account-participants-under-the-one-big-beautiful-bill
- IRS Notice 2026-5, guidance on HSA changes (bronze/catastrophic plans, direct primary care), Q&A-6, A-11 to A-16 and section on DPC arrangements. https://www.irs.gov/pub/irs-drop/n-26-05.pdf
- IRS, Working Families Tax Cuts provisions page (Premium Tax Credit; Health Savings Account expansion). https://www.irs.gov/newsroom/working-families-tax-cuts
- Amaze Health sign-up form (individual and immediate-family subscriptions), viewed Oct 16, 2026. https://app.amazepbc.com/members/confirmaccess?rs=0&activationcode=RESELLERPRODUCTS2025&referencecode=V7QWDZ18
Checked October 16, 2026. 2027 Marketplace plans and final 2027 rates aren’t published yet; we’ll update this page when they are.
Frequently asked questions
Can I use my HSA to pay for direct primary care in 2026?
Yes, for arrangements that meet the IRS rules: primary care only, paid by a fixed periodic fee, and no more than $150 a month for one person or $300 for more than one.
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Does a direct primary care membership make me ineligible for an HSA?
Not starting January 1, 2026, if the arrangement meets the IRS definition and you are otherwise HSA-eligible.
Get my options or call 616-808-9426.
Does my DPC fee count toward my deductible?
No. The IRS says DPC membership fees don't count toward an HSA plan's deductible or out-of-pocket maximum.
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Will you sell my information?
No. We do not sell your information. Nexus uses it to answer your request and shares it only as our Privacy Policy explains, for example with your insurance carrier when you enroll, or with service providers that help us run our website.
Get my options or call 616-808-9426.