Health Insurance Made Simple (And Why Direct Primary Care Makes It Easier)

Health insurance can be really confusing. There are so many big words and rules. Let’s break it down in a way that’s super easy to understand.

What Is Health Insurance?

Health insurance helps you pay for your doctor visits, hospital stays, medicine, and more. You pay money (called a premium) every month, and the insurance company helps cover your health costs.

But there’s more to it than just that.

Common Health Insurance Words You Should Know

Premium: The money you pay every month, even if you don’t go to the doctor.
Deductible: The amount of money you have to pay yourself each year before insurance helps.
Copay: A small fee (like $20 or $40) you pay each time you go to the doctor.
Coinsurance: After you meet your deductible, this is the percentage you still pay. Example: You pay 20%, insurance pays 80%.
Out-of-pocket max: The most you will ever pay in one year. After this, insurance pays 100%.

Where Do People Get Health Insurance?

Through a Job (Employer Insurance)
- Your boss picks a plan and helps pay for it.
- You pay the rest from your paycheck.
From the Government (Marketplace Insurance)
- You go online and buy your own plan.
- If you don’t make much money, the government helps you pay for it.
Medicare
- For people 65 and older or with disabilities.
- The government pays most of it.
Medicaid
- For people with very low income.
- Free or very low-cost, paid for by the government.

So Where Does the Money Come From?

You pay part (your premiums).
Your job may pay part (if you have employer insurance).
The government helps if you qualify.
Insurance companies use this money to pay doctors, hospitals, and medicine companies.

But Here’s the Problem...

It's expensive.
It's hard to understand.
You may not even get to talk to the same doctor.
Long wait times.
Surprise bills.

A Better Way: Direct Primary Care (DPC)

With Direct Primary Care, you pay your doctor directly — no insurance needed for regular care.

What You Get with DPC:

One low monthly fee (like a gym membership).
Unlimited visits, texts, and calls with your doctor.
No copays. No hidden bills.
Same-day or next-day appointments.
A doctor who actually knows you.

What About Big Stuff Like Surgery or Hospital?

DPC is not insurance — so for big things like surgery or hospital stays, people often pair DPC with:

1. High-Deductible Health Plan (HDHP)

Costs less each month.
Only helps with big emergencies.
Use your DPC doctor for everything else.

2. Health Sharing Plans

Not insurance, but people share costs with each other.
Great for healthy people or families.
Usually cheaper than insurance.

3. Catastrophic Plans

For very young or healthy people.
Only covers major stuff.
Use DPC for everyday care.

Why This Combo Works

Needs	Traditional Insurance	DPC + HDHP or Healthshare
Everyday care	Hard to get, expensive	Easy, affordable, personal
Emergency care	Covered	Covered (through HDHP or share plan)
Cost	$$$	$$
Wait time	Long	Short
Doctor relationship	Random	One doctor who knows you

Final Thoughts

Health insurance is important, but it doesn't always work well for regular care. Direct Primary Care makes everyday health simple, affordable, and personal. You can still have something for emergencies — but for the 90% of health stuff you actually use, DPC just works better.

Want to learn more? Text or call us at Vertical Health Direct Primary Care. 214-506-3058

Simple. Smart. Human.