If you have a DPC membership, you cannot contribute to a health savings account (HSA), even if you also have coverage under an HSA-qualified high-deductible health plan (HDHP). (The only exception would be a DPC membership that only provides preventive care, but that is not a common design for a DPC plan, and would generally not be useful, since non-grandfathered HDHPs already provide zero-cost preventive care.) This is unfortunate, as DPCs are often marketed as a perfect complement to high-deductible health plans, since they give the person access to various primary care services without having out-of-pocket costs for each visit. But the IRS does not allow a person with a DPC membership (in addition to an HDHP) to contribute to an HSA, and DPC membership fees cannot be paid with HSA funds. This is because the IRS considers a DPC to be a "health plan" so having one runs counter to the rules that only allow HSA contributions if the person's only coverage is an HDHP. And the only health plan fees/membership costs that can be paid with HSA funds are Medicare premiums, COBRA premiums, and premiums paid while a person is receiving unemployment benefits (see Publication 969 for details). In 2020, the IRS proposed regulatory changes that would have allowed DPC membership fees to be classified as tax-deductible medical expenses under Section 213 and allowed employers to reimburse DPC fees under a health reimbursement arrangement (HRA), but the rules were never finalized (note that this proposed rule would not have changed the fact that a person with DPC coverage cannot contribute to an HSA or use HSA funds to pay the DPC membership fees). And in 2021, bipartisan legislation was introduced that would have explicitly allowed DPC memberships to be paid with HSA funds, and allowed a person with a DPC membership (in addition to an HDHP) to make contributions to an HSA. But that legislation has not advanced.