You Need a Doctor.
You Don't Want Surprise Bills.
A primary care membership gives you direct access to a family doctor for one simple monthly fee whether you have insurance or not. No insurance billing. No copays. No surprises.
The Problem with Traditional Healthcare
✗ You call for an appointment and wait 3 weeks to see your doctor
✗ Your appointment lasts 10 minutes and feels rushed
✗ You get a bill 6 weeks later that you didn't expect
✗ Your insurance didn't cover what you or your doctor thought it would
✗ You avoid going to the doctor because it's too complicated, and expensive and fragmented.
How a Primary Care Membership Works
Pay One Monthly Fee
That flat fee covers visits, chronic care, wellness check-ins, and in-office procedures your doctor includes.
Reach Your Doctor Your Way
Office visits, telehealth, phone calls, and text messages when you need them.
See Your Doctor Quickly
Longer visits (30-60 minutes). Actual time to talk about your health.
Never Get a Surprise Bill
Your membership fee is the only cost. No copays, no deductibles, no unexpected bills from your doctor.
The result: Build a relationship with your doctor that extends beyond a single visit and feels trustworthy both for your care and your finances.
What Your Membership Includes
Visits & Access
- • In-office, video, and telephone
- • Longer appointment times (30-60 min)
- • Direct messaging with your doctor
Medical Care
- • Comprehensive primary care: Wellness visits, urgent care, chronic disease management, prenatal care, newborn care, sports physicals
- • Common procedures: Stitches, skin biopsies and excisions, IUD/Nexplanon insertion, splinting, nebulizer treatments, and more
- • Whole-person care: Nutrition visits, mental health support, chronic pain therapy, visits for grief and other ceremony
- • Care coordination: Specialist coordination, medication management, direct messaging with your doctor
All Ages Welcome
- • Newborns and children
- • Adolescents and young adults
- • Adults (19-65)
- • Seniors (65+)
Transparent Pricing
- • No copays or deductibles
- • No surprise bills
- • No claim denials
- • No paperwork hassles
- • Pay with HSA/FSA accounts
What About Insurance?
If You Have Insurance
You can still use a primary care membership. Many of our patients have insurance but choose to use their membership for all primary care because it's simpler, faster, and more personal. Your insurance remains active for specialists, emergencies, prescriptions, and major medical needs.
Starting January 1, 2026, your membership payments carry both insurance and potential tax benefits:
- Oregon HB 2540: If you have an Oregon-regulated plan (excluding HMOs like Kaiser), you can request that your membership payments count toward your deductible and out-of-pocket maximum. Learn more about HB 2540.
- Federal H.R. 1 (OBBB): If you have a Health Savings Account (HSA), the new federal rules let you pay or reimburse the same membership from your HSA. Read H.R. 1 and review IRS Notice 2026-05.
If You Don't Have Insurance
A primary care membership works perfectly without insurance. You get all your routine medical care for a predictable monthly cost. Labs and imaging and specialist services are negotiated at reduced cash pay rates.
We still recommend pairing your membership with a high-deductible health plan, health sharing ministry, or catastrophic coverage for emergencies, hospitalizations, and major medical events outside of our clinic's scope.
Either Way, You're Covered for Primary Care
Your membership gives you complete primary care access whether you have insurance or not. No complicated billing. No denials. Just simple, accessible healthcare.
Paying with HSA, FSA, or HRA Dollars
Before January 1, 2026
Current IRS Rules
- Health savings accounts (HSAs) generally cannot reimburse the monthly direct primary care fee (DPC) if you already have a high deductible health plan.
- Members pay the fee out of pocket and keep invoices. Only separate charges like labs, medications, or procedures qualify for health savings account (HSA) reimbursement today.
- Employer-paid fees, including cafeteria plans, are treated as employer compensation and cannot be reimbursed from the employee’s HSA.
HB 2540 (Oregon)
- The law is signed but does not take effect until January 1, 2026.
- Until then, Oregon insurers are not required to credit direct payments toward out-of-network deductibles.
On or After January 1, 2026
Federal H.R. 1 (OBBBA)
- Direct primary care memberships (DPC) can be paid with health savings account (HSA) funds if the fee stays under $150 per person (or $300 per family) each month.
- Only primary care services count. No procedures needing general anesthesia, non-vaccine prescriptions, or lab work usually done outside a primary care office.
- Direct primary care fees (DPC) may be treated as incurred on the first day of coverage, prorated on the first day of each month, or on the date payment is made when reimbursing from a health savings account (HSA).
HB 2540 (Oregon)
- Oregon-regulated plans (excluding health maintenance organizations, or HMOs) must let members submit direct primary care invoices (DPC) for out-of-network deductible credit once the insurer approves them.
- Keep invoices showing the fee, diagnosis codes, and proof of payment to send with your claim.
Sources: H.R. 1, IRS Notice 2026-05, and Oregon HB 2540.
How Much Does It Cost?
Lote Tree Community Health Membership Pricing
Children (0–18)
Includes newborns, wellness exams, sick visits
$25/month
Adults (19–65)
Full primary care coverage, unlimited visits
$85/month
Seniors (65+)
Full primary care coverage, unlimited visits.
$100/month
Example Family of 4: 2 adults + 2 children = $220/month for complete primary care access with no additional fees.
This Model Is Called "Direct Primary Care"
If you've heard the term "direct primary care" or "DPC," that's what this membership model is. The core idea is simple: you pay your doctor directly instead of billing through insurance companies.
Direct primary care practices exist across the country, serving millions of patients who want simpler, more accessible healthcare without insurance billing complexity.
Want to learn more about how direct primary care works, what it includes, and how it relates to insurance? Read our complete guide to direct primary care.
Common Questions
Can I really use this without insurance?
Yes. Your membership covers all your primary care needs regardless of insurance status. Many of our patients don't have traditional insurance or have high-deductible plans that they rarely use. The membership works either way.
What if I need to see a specialist?
Your doctor will coordinate referrals to specialists and help you navigate that process. You'll use your insurance (or pay out-of-pocket) for specialist visits. Your primary care doctor remains your care coordinator throughout.
What if I have an emergency?
Call 911 or go to the emergency room. Your membership covers primary care, not emergency services. This is why we recommend keeping catastrophic insurance coverage even if you don't use it for routine care.
Can I cancel anytime?
Yes. There are no long-term contracts. You can cancel your membership at any time.
Do you accept Medicare or Medicaid?
No. As a direct primary care practice, we don't bill any insurance including Medicare or Medicaid. However, patients with Medicare or Medicaid can still join as members and pay the monthly fee directly. Check with your plan about secondary coverage rules.
How do I get started?
Review our pricing, choose the membership that fits your family, and sign up online.
Can I really use this without insurance? +
Yes. Your membership covers all your primary care needs regardless of insurance status. Many of our patients don't have traditional insurance or have high-deductible plans that they rarely use. The membership works either way.
What if I need to see a specialist? +
Your doctor will coordinate referrals to specialists and help you navigate that process. You'll use your insurance (or pay out-of-pocket) for specialist visits. Your primary care doctor remains your care coordinator throughout.
What if I have an emergency? +
Call 911 or go to the emergency room. Your membership covers primary care, not emergency services. This is why we recommend keeping catastrophic insurance coverage even if you don't use it for routine care.
Can I cancel anytime? +
Yes. There are no long-term contracts. You can cancel your membership at any time with 30 days notice. We want patients who choose to be here, not patients locked into contracts.
Do you accept Medicare or Medicaid? +
No. As a direct primary care practice, we don't bill any insurance including Medicare or Medicaid. However, patients with Medicare or Medicaid can still join as members and pay the monthly fee directly. Check with your plan about secondary coverage rules.
How do I get started? +
Review our pricing, choose the membership that fits your family, and sign up online. No pressure, no sales calls, no hassle.
Ready to Join?
Get direct access to a family doctor who knows you, listens to you, and has time for you.
Serving NE Portland neighborhoods. See if we're near you.
Learn More
Serving NE Portland neighborhoods
See if we're near you.
What is Direct Primary Care?
Complete guide including insurance questions and Oregon law.
NE Portland Neighborhoods
See which neighborhoods we serve and how to get here.
Services We Offer
Detailed list of care for children, adults, and seniors.