Question 1

Is Direct Primary Care legal in Colorado?

Accepted Answer

Yes. Colorado has had a DPC law since 2017. HB 17-1115 was enacted April 24, 2017, making Colorado the 20th state to pass DPC legislation. It's codified at Colo. Rev. Stat. §§ 6-23-101 to 6-23-105 and clearly puts DPC agreements outside the state insurance code. Read the statute.

Question 2

How much does Direct Primary Care cost in Colorado?

Accepted Answer

Adult DPC memberships in Colorado typically run $59–$139 a month. Family plans usually cost less per person, and kids' memberships come in cheaper too. Exact pricing depends on the practice, so browse Colorado practices to compare real rates.

Question 3

Is a DPC agreement considered insurance under Colorado law?

Accepted Answer

No. Colorado law states a direct primary care agreement isn't insurance and isn't regulated as one. No. Section 6-23-102 says a direct primary care agreement isn't insurance and isn't subject to Colorado insurance regulations. Practices don't need an insurance license to operate.

Question 4

Can a Colorado DPC doctor also bill my insurance for the same services?

Accepted Answer

No. Colorado law bars DPC practices from billing your insurer for anything already covered under your membership. No. The law prohibits a DPC practice from billing a third-party insurer for anything already covered under your membership. The fee you pay is meant to be full payment for those covered services.

Question 5

Can Colorado Medicaid patients join a DPC practice?

Accepted Answer

It's complicated. Colorado bars physicians from privately contracting with Medicaid patients for Medicaid-covered services. It's complicated. Colo. Rev. Stat. § 25.5-4-301 bars any physician from privately contracting with Medicaid patients for services Medicaid covers. In practice, that means a DPC practice generally can't enroll active Colorado Medicaid beneficiaries unless the services fall clearly outside what Medicaid covers.

Question 6

What must a Colorado DPC agreement include?

Accepted Answer

It must be written, describe the covered services and fee, disclose that it's not insurance, and allow either side to terminate. It has to be written, describe the covered services and periodic fee, disclose that it's not insurance, allow either party to terminate, and spell out the duration and renewal terms. You also have to be told that DPC doesn't replace comprehensive health insurance.

Question 7

Do I still need health insurance if I join a Colorado DPC practice?

Accepted Answer

Yes. DPC covers most day-to-day primary care, not hospital stays, ER visits, or surgery. Yes. DPC covers most day-to-day primary care but not hospital stays, ER visits, specialists, or surgery. Most Colorado members pair their membership with a high-deductible health plan for that. Learn how DPC fits into your coverage.

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Colorado DPC laws & FAQ

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