Dr. Mudita Malhotra answers the five questions Rockville patients ask most before joining Aurora Primary Care — from cost and insurance to how DPC compares with concierge medicine.
Almost every new patient I meet in Rockville has a handful of practical questions before they join — about cost, about insurance, about how Direct Primary Care actually compares to other membership-based care models they may have heard of. These aren't skeptical questions; they're exactly the right ones to ask before choosing a primary care model. Here are the five I hear most often, and a straightforward answer to each.
1. How Is Direct Primary Care Actually Better for My Health?
Short answer: more time with your doctor, a smaller patient panel, and outcomes you can measure.
This is the question that matters most, so it deserves substance rather than a slogan. Most primary care doctors manage thousands of patients and see 20 or more a day, which typically means a 10 to 15 minute appointment — barely enough time to address the reason for the visit, let alone catch something quieter developing underneath it. Aurora Primary Care intentionally limits its patient panel, as most DPC practices do (often 300 to 800 patients, compared to 2,000 to 3,000+ at a standard practice), so visits can run 30 to 60 minutes when needed.
That extra time changes what's clinically possible, not just how pleasant the visit feels. Longer appointments mean we can actually discuss your sleep, stress, diet, and movement patterns — the lifestyle inputs that drive most chronic disease. And because I'm not seeing you once a year for 12 minutes, I'm tracking your numbers over months and years, not just comparing you to a generic reference range. A lab value that's still "normal" but has drifted meaningfully from your own baseline is something I catch early, because I actually know your baseline.
The published data backs this up. A study by Milliman, conducted in partnership with the Society of Actuaries, found that employees enrolled in DPC arrangements saw roughly 40% fewer emergency room visits and about 20% fewer hospitalizations compared to those in traditional health plans, along with meaningfully better chronic disease outcomes — including up to 12% better blood sugar control among patients with diabetes. That's the direct result of unhurried, continuous care: problems get caught earlier, and chronic conditions get managed more consistently.
2. Can You See Me If I Don't Have Insurance?
Short answer: yes — for many uninsured patients, DPC is one of the most affordable and reliable ways to get primary care.
For patients without insurance, DPC can be a real lifeline. Your monthly membership covers most of your everyday healthcare needs, from same-day sick visits to ongoing management of chronic conditions, at a cost that's transparent and predictable from the start. There are no surprise bills, no coding confusion, and no collection calls months later. Many uninsured patients tell me that, for the first time, they don't hesitate to reach out when something feels off, because they're not weighing the cost of a visit against rent or groceries — and that alone leads to earlier care and better outcomes.
For larger expenses like hospital stays or imaging, your membership pairs well with a low-cost catastrophic or high-deductible health plan, giving you both everyday access and protection against major medical events. Whether you're insured, uninsured, self-employed, or between plans, DPC gives you a consistent physician relationship to build on.
3. How Does This Make Sense If I Already Have Insurance?
Short answer: for most patients, the combination costs less than insurance alone — and it's now tax-advantaged.
This is the fair, practical version of the insurance question, and it deserves real numbers rather than reassurance. Based on 2026 insurance rates specific to the Maryland, DC, and Virginia market, pairing an Aurora membership with the right insurance plan — typically a High-Deductible Health Plan — saves patients between $360 and $1,210 per year compared to traditional insurance alone, depending on age and family situation.
Think of it as two layers, not one expense stacked on another. A High-Deductible Health Plan carries a lower premium specifically because it assumes you'll rarely hit the deductible. When your everyday primary care is already covered by your DPC membership, that assumption holds — you're less likely to need the expensive layer, so the cheaper insurance premium is the right fit.
There's also a 2026 tax change worth knowing about: under IRS Notice 2026-05, implementing provisions of the One Big Beautiful Bill Act, DPC membership fees became HSA-eligible starting January 1, 2026, up to $150 a month for individuals and $300 a month for families. For many patients, that means the membership fee can now be paid with pre-tax dollars.
4. What Happens If I Need Urgent Care or a Specialist?
Short answer: same-day and next-day access covers most urgent needs directly; specialist referrals are coordinated, not outsourced.
A same-day or next-day appointment with a doctor who already knows your history covers the large majority of what sends people to urgent care in the first place. That matters financially, too: a single urgent care visit for something routine, like a sore throat with a rapid strep test, commonly runs $300 to $450 without insurance, and a non-emergency ER visit can run well over $1,000. An Aurora membership includes unlimited visits with no per-visit charge, same-day or next-day appointments, and in-office testing — rapid strep, flu, COVID, urine pregnancy, EKG — at no additional cost.
According to the Agency for Healthcare Research and Quality, having a consistent primary care physician is associated with better health outcomes, lower overall costs, and fewer emergency room visits. And when a specialist is genuinely needed, I coordinate the referral and provide the clinical context directly; the specialist visit itself is then handled through your insurance, the way it's designed to be.
5. What's the Difference Between Direct Primary Care and Concierge Medicine?
Short answer: both prioritize time and access — the difference is in how each one is paid for and structured.
Direct Primary Care and concierge medicine both start from a similar idea: smaller patient panels and more direct access to your physician. Where they differ is the business model. Concierge medicine typically charges an annual retainer, often $1,500 to $5,000 or more, in addition to continuing to bill your insurance for office visits, labs, and procedures — which means insurance rules still shape visit length, documentation, and billing complexity.
Direct Primary Care, the model Aurora Primary Care uses, charges one flat monthly membership fee with no insurance billing for primary care at all — no copays, no deductibles, no downstream claims. Membership fees typically run $70 to $150 a month nationally, which is part of why DPC has become accessible to a broader range of patients. Both are legitimate ways to get more time with a doctor; the right one for you comes down to how you'd rather structure the cost and the insurance relationship.
Ready to Get Your Questions Answered?
Aurora Primary Care is a Direct Primary Care practice in Rockville, MD, serving patients across Montgomery County, DC, and Northern Virginia. If you still have questions about how DPC would work for your specific situation, we offer complimentary Meet & Greet visits to walk through what's included and whether it's the right fit. Call (240) 744-7400 or visit our membership page to get started.
Frequently Asked Questions
Q1. What is Aurora's membership pricing?
Ans: Teen (ages 12–19): $55 per month, or $35 per month at the caregiver rate when a parent is also enrolled in Aurora's TogetherCare family membership. Young Adult (20–29): $75 per month. Adult (30–64): $95 per month. There are no enrollment fees and no per-visit charges at any tier.
Q2. Can I use my HSA to pay for a DPC membership?
Ans: Yes. Starting January 1, 2026, under IRS Notice 2026-05, DPC membership fees qualify as HSA-eligible expenses, up to $150 per month for individual coverage and $300 per month for family coverage. Fees above that monthly limit can still be reimbursed from an HSA but may affect your eligibility to contribute during that coverage period.
Q3. Can I use DPC if I have Medicare or Medicaid?
Ans: Yes, patients with Medicare or Medicaid can enroll in a DPC membership — Medicare continues to cover specialist visits, hospitalizations, imaging, and emergency care, and the two do not conflict. That said, Dr. Malhotra is not currently accepting Medicare patients directly; a waitlist is open, with enrollment expected to begin in the coming months.
Q4. Is a DPC membership considered health insurance?
Ans: No. DPC is not insurance — it's a direct agreement for primary care services between you and your physician. You'll still need separate insurance coverage (or a health share plan) for specialist care, hospitalizations, imaging, and emergencies.
Q5. How quickly will Dr. Malhotra respond to my messages?
Ans: As quickly as possible through the Aurora patient app — most patients hear back the same day. Response times may be a bit longer outside regular working hours, but you're always reaching Dr. Malhotra directly, not a call center or triage line.
Q6. Can I join mid-year, or do I need to wait for an insurance open enrollment period?
Ans: You can join Aurora Primary Care at any time, regardless of your insurance company's open enrollment period — a DPC membership is a separate agreement with your doctor, not an insurance product, so there's no enrollment window to wait for. Membership starts immediately upon signing up.
