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State Insurance Commissioner Issues Direct Primary Care Memo

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Health Insurance

State Insurance Commissioner Matt Rosendale issued a memorandum stating that direct primary care provider agreements are non-insurance healthcare options.

“Montanans should have as many options on the table as possible to meet their health care needs as they see fit,” Rosendale said. “Direct primary care is yet another way for consumers to access routine, preventative, or preliminary health care. These agreements between patients and their doctors are not insurance products, and will not be regulated by my office as insurance. While direct primary care provides a good alternative for many people seeking routine or basic health care treatment, it’s important for Montanans to have insurance coverage for major and unexpected health care costs,”

Rosendale emphasized that President Trump recently issued an Executive Order to extend the short term policies from 90 days to 365 days.

“Those short term policies offer what were formerly called catastrophic coverage, and are not ACA eligible,” he said. “Under the Senate’s Tax Reduction plan that was just passed on Friday, the repeal of the individual mandate is part of that tax reduction bill. If that is able to survive the conference committee between the House and the Senate, and the individual mandate is repealed, then we know going forward that there’s going to be additional short term policies which will be extended out to a year will be available to consumers yet saving them even more money on their healthcare costs.”

The American Academy of Family Physicians supports the direct primary care model, writing that “Direct primary care rewards family physicians for caring for the whole person while reducing the overhead and negative incentives associated with fee-for-service, third-party-payer billing.”


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