Big news for Oregonians who use Direct Primary Care or pay out of pocket for medical care: a new law will soon make it easier to get credit for those payments.
An annual deductible is the amount of money you have to pay out of your own pocket for covered medical services each year before your health insurance starts helping with the cost. With this new bill, your DPC membership fees will count towards your deductible.
Beginning January 1, 2026, most health insurance companies in Oregon will be required to count some out-of-pocket health care payments toward your annual deductible—even if the provider is outside your insurance network.
This means if you’re paying directly for services—like those at a Direct Primary Care clinic—you could get closer to meeting your deductible, which can save you money if you need additional care later in the year.
To qualify:
- The care must be medically necessary
- The service must be covered by your insurance plan
- The amount you paid must be less than what the same care would’ve cost through your insurance
Note: Kaiser Permanente is not included in this new rule, but most other insurers in Oregon are.
This is a big step toward making more flexible, affordable care options like DPC even more accessible.
According to Hugh Ady, a lobbyist based in Salem, Oregon, who was involved in managing the passage of this bill, it makes Oregon the 6th state in the country to have deductible crediting. Dr. Nick Jones of Clear Health Direct Primary Care (Eugene) was instrumental in the bill’s development, and he and Dr. Lorna Shanks of Shanks Primary Care (Portland) provided compelling testimony before the House and Senate committees that spurred Representatives and Senators from both parties to sign on as bill sponsors.
Source: https://olis.oregonlegislature.gov/liz/2025R1/Measures/Overview/HB2540