With smartphones at hand, what were once considered chores have become everyday conveniences. From streaming the next HBO hit show to ordering bespoke food for your dog, nearly every facet of modern life can be customized and automated.
Why should going to the doctor be any different?
Health care subscriptions seek to answer this question – and disrupt the marketplace in the process.
By eliminating insurance hurdles and encouraging preventive care, health care subscriptions can make care more accessible for some. Yet, they often require upfront payments, digital access, or employer sponsorship, potentially excluding low-income, uninsured, or rural patients.
What Are Health Care Subscriptions?
A health care subscription can be a lot like signing up for YouTube Premium or Spotify. You pay a monthly or yearly fee for access to services like checkups, virtual visits, and discounted prescriptions. Unlike traditional insurance, health care subscriptions are offered more directly by providers, giving patients greater flexibility, fewer hidden costs, and more control over their health care decisions. These models often provide direct access to doctors without copays, deductibles, or claims paperwork.
For providers, subscriptions ensure steady revenue and reduce administrative burdens. Clinically, they allow providers more time with patients, focusing on care rather than claims billing associated with fee-for-service payment models. Patients benefit from predictable costs and streamlined access to their provider, which encourage better quality care, preventative care, and chronic disease management, while removing financial barriers for some.
More specifically, Direct Primary Care (DPC) enhances accessibility, with some providers sharing personal phone numbers for quicker responses, faster appointment scheduling, and shorter wait times. It’s especially helpful for elderly patients or those who struggle to visit the doctor regularly.
Subscription models generally operate independently of traditional insurance. While most health care subscribers in the U.S. keep their insurance to cover specialist care, hospitalizations, or emergency services, uninsured individuals may rely on subscriptions as their primary form of health care, despite the coverage gaps.
These models have gained traction in urban and suburban areas, particularly among affluent and insured individuals frustrated with long wait times in the traditional system. Marketing often targets middle- and upper-income patients, emphasizing quick access, longer appointments, and 24/7 communication.
In low- and middle-income countries, health care subscription could expand access to essential medicines by spreading pharmaceutical costs over time, pooling resources to lower drug prices, and improving distribution. While not a universal solution, they offer a scalable way to improve affordability and consistency in resource-limited settings.
What Aren’t Health Care Subscriptions?
Health care subscriptions themselves are not a replacement for traditional health plans, but rather a supplement designed to address specific needs or populations. For example, the DPC model may be most beneficial for middle-income individuals, while the Amazon One Medical subscription caters for urban professionals who prioritize convenience.
However, these models often exclude uninsured, rural, or lower-income patients due to financial and digital access barriers. These include unreliable or non-existent internet access, limited tech fluency, language barriers, and the cost of internet services. Inadequate infrastructure and a lack of affordable, culturally sensitive content further restricts access for underserved communities.
As corporations like Amazon expand into subscription-based health care, market consolidation raises concerns about pricing power, reduced competition, and long-term affordability. Because these models operate outside of insurance regulations, they may lack accountability in quality measures. Without transparency, they risk recreating the same access gaps as traditional health care, shifting control from insurers to corporations without ensuring equitable care.
Recommendations for a More Equitable Model
To ensure health care subscriptions expand access rather than reinforce disparities, companies must prioritize affordability and inclusivity. Sliding-scale pricing, income-based subsidies, or pay-as-you-go models could make memberships more accessible to low-income patients. Expanding services beyond urban centers (e.g., through mobile clinics, telehealth infrastructure in rural areas, and partnerships with community health organizations) would help ensure underserved groups aren’t left behind.
Transparency is also critical. Companies should disclose pricing structures, patient outcomes, and enrollment demographics to assess whether their models equitably improve access. Public-private collaborations, such as integrating subscription models with Medicaid or public clinics, could incorporate them into existing systems rather than creating parallel, exclusionary options.
The clear upfront pricing of health care subscriptions can empower consumers to make more informed decisions. However, without these efforts to improve accountability, transparency, and integration with public health systems, subscriptions risk reinforcing disparities rather than advancing health equity.
Health care subscriptions arose as a response to many of the challenges faced by the health care sector. They make big promises, and their surging popularity suggests that some may be able to deliver. As these models grow, we should all take care that this innovation benefits everyone and doesn’t become another pay-to-play scheme.
