$0 Primary Care Visits Are Now an Insurer's Pitch to Employers

On October 7, Centene announced that some Ambetter members in Indiana and Missouri will get $0 primary care visits, $0 lab services, and virtual primary care starting in the 2027 plan year. The care comes through Marathon Health. The plans are sold through what Centene now calls CHOICE Arrangements, the new name for ICHRA, where an employer hands each worker a set amount of money and the worker picks an individual plan.

Read that slowly. One of the biggest insurance companies in the country looked at everything it could put in the window for employers, and it picked primary care with no copay and no lab bill.

Direct care doctors have been saying this for well over a decade. Take the toll booth off the front door and people walk through it. They come in for the cough before it is pneumonia. They ask about the blood pressure before it is a stroke. The cheapest visit in medicine is the one that happens early.

So I am glad. Honestly. When an insurer starts selling your idea, you have won the argument.

But $0 is not a price. It is a location. The cost did not disappear. It moved into the premium, where nobody sees it on the day of the visit. And read the fine print in the announcement: select counties, eligible members, starting in 2027. The relationship belongs to the contract between the plan and the vendor. Change plans next fall and your doctor may not come with you.

Direct care keeps the same front door and changes who holds the key. The price is posted on the door. One monthly membership. Your doctor's own phone number. Wholesale labs and medications at what they actually cost. If you switch insurance, your doctor stays. Since January 1, HSA money can even pay a qualifying membership, up to $150 a month for one person or $300 for a family.

And here is the part employers should hear before open enrollment closes: you do not have to wait for an insurer to pick your county. An ICHRA, or whatever we are calling it this year, pairs just fine with a direct care membership. Give your people the individual plan for the big stuff and a doctor they can text for everything else.

Free at the counter is nice. Owning the relationship is better.

READ MORE: investors.centene.com/2026-10-07-Ambetter-Health-Solutions-and-Marathon-Health-Expand-Access-to-Primary-Care-for-Members-in-Indiana-and-Missouri