Is there a direct primary care doctor near Mequon, Wisconsin?

Yes. Lotus Direct Care is a direct primary care practice at 1516 W Mequon Rd, Suite 103, Mequon, WI 53092, led by Dr. Aaron Rosenberg, MD. It serves Mequon and the surrounding North Shore and Milwaukee metro area, including Cedarburg, Grafton, Thiensville, Glendale, Whitefish Bay, Shorewood, Bayside, Fox Point, River Hills, Brown Deer, Wauwatosa and Brookfield. The office is about 15 minutes from Milwaukee. Phone: (262) 242-0700.

What does direct primary care cost at Lotus Direct Care?

Membership is $150 per month for an individual. A couple is a flat $200 per month, not $200 per person. Children living in the same household are $20 per month each. There are no enrollment fees and no copays. Membership requires a 3-month minimum, paid up front, and is available to patients ages 2 and up. After the minimum you can cancel with 30 days' written notice; if you leave and later return there is a $99 re-initiation fee.

Can I keep my insurance if I join a direct primary care practice?

Yes, and you generally should. Direct primary care is not insurance and is not a health plan; it is a monthly membership that covers your primary care directly with the physician. Keep your insurance for specialists, hospital care, emergencies, imaging and surgery. Many members pair the membership with a high-deductible health plan.

What is included in the Lotus Direct Care membership?

Unlimited office visits with 30 to 60 minute appointments, same-day and next-day availability, direct contact with Dr. Rosenberg by phone, text and email, chronic disease management, acute illness care, minor procedures and wound care, an annual comprehensive health assessment, prescription management and care coordination with specialists. Lab work is not included in the membership price, but members get wholesale lab pricing.

Are there any add-ons to the membership?

There are exactly two. Lotus Plus, an enhanced care add-on, is $129 per month with a 6-month minimum. The second is a medication-assisted treatment add-on for buprenorphine care. Other services such as PRP therapy and ketamine therapy are billed separately and are not membership tiers.

What kind of doctor is Dr. Aaron Rosenberg?

Dr. Aaron Rosenberg, MD is a primary care physician. He holds a full, unrestricted medical license in Wisconsin and sees patients in person at the Mequon office. His practice covers direct primary care, personalized and functional medicine, longevity medicine, weight management including GLP-1 medications, hormone therapy and addiction medicine.

How is direct primary care different from a regular doctor's office?

A traditional primary care visit averages 7 to 10 minutes and often takes 2 to 4 weeks to schedule. At Lotus Direct Care appointments run 30 to 60 minutes and same-day visits are available. Because insurance is removed from primary care there are no copays, no deductibles for the membership and no billing paperwork, and you contact the physician directly rather than going through staff.

Does Lotus Direct Care accept new patients?

Yes. The practice keeps a limited patient panel so that appointment length and direct access stay available. You can call (262) 242-0700 to ask questions or arrange a free consultation before joining.

For employers, HR, and benefits administrators

Why a Lotus membership is HSA-eligible: the legal framework

Short answer: yes, it is eligible, and here is exactly why, how, and under what federal law. As of January 1, 2026, a direct primary care membership priced at or under $150 a month for one person (or $300 for more than one) is no longer disqualifying health coverage for HSA purposes, and its fee is a qualified medical expense an HSA can pay. Congress wrote this into the Internal Revenue Code in 2025; the IRS explained the mechanics in a notice released in December 2025. Our $150 Standard membership ($200 for a family) was priced to sit under that federal cap. This page walks through the statute and the guidance directly, with citations, so your benefits team can verify it independently rather than take our word for it.

Member-facing HSA FAQ See membership pricing

What changed in 2026

July 4, 2025

Signed into law

Congress passes and the President signs Public Law 119-21, 139 Stat. 72 — the One, Big, Beautiful Bill Act (OBBBA). Section 71308 of the Act amends Internal Revenue Code section 223, the section that governs Health Savings Accounts.

December 2025

IRS guidance issued

The Treasury Department and IRS release Notice 2026-5, "Expanded Availability of Health Savings Accounts under the One, Big, Beautiful Bill Act." It answers 20 questions about how the new direct primary care rule works and opens a public comment period through March 6, 2026.

January 1, 2026

Effective date

The new rule applies "to months beginning after December 31, 2025" (Notice 2026-5, Section II.B.3). From this date forward, a qualifying direct primary care membership no longer disqualifies someone from HSA eligibility, and its fee is a qualified medical expense an HSA can pay.

The legal framework

Two federal documents govern this: the statute itself, and the IRS notice interpreting it. Section 71308 of the One, Big, Beautiful Bill Act (Public Law 119-21, 139 Stat. 72, signed July 4, 2025) amended Internal Revenue Code section 223 — the section that defines HSA eligibility — by adding a new subsection for direct primary care service arrangements (DPCSAs). IRS Notice 2026-5 (December 2025) then answers common questions about how the new rule applies. The five provisions below are the ones that decide whether a membership qualifies.

IRC § 223(c)(1)(E)(i), added by OBBBA § 71308(a)

“A direct primary care service arrangement (DPCSA), as defined below, "is not treated as a health plan" for purposes of the rule that normally disqualifies someone from HSA eligibility if they have coverage besides a qualifying high-deductible health plan (HDHP).”

Plain language: enrolling in a qualifying DPC membership no longer counts as "other health coverage" that would knock you out of HSA eligibility. Before this law, it did.

IRC § 223(c)(1)(E)(ii), definition of DPCSA

“An arrangement under which an individual receives medical care consisting solely of primary care services from a primary care practitioner, where the sole compensation for that care is a fixed periodic fee.”

Plain language: one flat recurring fee, primary care only, no separate per-visit billing or insurance billing layered on top.

IRC § 223(c)(1)(E)(ii)(II), the dollar cap

“The arrangement does not qualify as a DPCSA for HSA-eligibility purposes if the aggregate monthly fee exceeds $150 for one individual, or $300 for an arrangement covering more than one individual. The cap is indexed for inflation for taxable years after 2026.”

Plain language: this is the number that matters. Stay at or under $150 (individual) or $300 (more than one person) and the carve-out applies.

IRC § 223(c)(1)(E)(iii), excluded services

“"Primary care services" for this purpose does not include (1) procedures requiring general anesthesia, (2) prescription drugs other than vaccines, or (3) laboratory services not typically administered in an ambulatory primary care setting.”

Plain language: a membership can still be primary-care-only and cover vaccines, urgent care, and routine in-office labs. It cannot bundle surgery under anesthesia, most prescriptions, or send-out lab panels and still qualify.

IRC § 223(d)(2)(C), added by OBBBA § 71308

“An expense for coverage under "any direct primary care service arrangement" is not subject to the general rule that blocks an HSA from paying for insurance.”

Plain language: the membership fee itself is a qualified medical expense an HSA can pay or reimburse directly — it is not treated like an insurance premium, which HSAs normally cannot cover.

Why Lotus qualifies — and what does not

The federal cap is $150/month for one individual and $300/month for an arrangement covering more than one individual (IRC § 223(c)(1)(E)(ii)(II)). A membership must also cover primary care services only, with no other services bundled in, to meet the statutory definition of a DPCSA at all.

Plan	Monthly fee	Under the $150 / $300 federal cap?	Primary-care-only scope?	HSA-eligible?
Standard — individual	$150/month	Yes	Yes	Yes
Standard — family	$200/month	Yes	Yes	Yes
Lotus Plus add-on	$129–$199/month	Yes	No	No

Lotus Plus fails on scope: it is priced under the cap, but it is an add-on bundling services beyond primary care, so it does not meet the DPCSA definition regardless of price. See the member FAQ for what that means for your monthly bill if you combine plans.

For employers and HR: a checklist

An employee stays HSA-eligible. An employee enrolled in an HSA-qualified HDHP does not lose HSA eligibility because they also carry a Lotus Standard membership — the fee is under the federal cap, so the membership is not disqualifying coverage (IRC § 223(c)(1)(E); Notice 2026-5, II.B.3).

The fee can be paid from the HSA. The Standard membership fee is a qualified medical expense the employee's HSA can pay directly, or the employee can pay out of pocket and reimburse themselves from the HSA later (IRC § 223(d)(2)(C); Notice 2026-5, Q&A-18–19).

Up-front annual payments are reimbursable too. An HSA may treat the expense as incurred on the first day of each covered month, the first day of the coverage period, or the date paid — so a prepaid annual membership is not a problem (Notice 2026-5, Q&A-19).

Normal employer HSA contributions still work. An employer can continue making its usual contributions to an employee's HSA, which the employee can then use, alongside their own funds, toward the Lotus fee like any other qualified expense.

An employer paying the DPC fee directly is a different question. Notice 2026-5 (Q&A-18) says that if an employer pays a DPC fee directly — including through a section 125 cafeteria plan salary reduction — that payment is not treated as an HSA-reimbursed expense of the employee; it is compensation excluded from income under IRC § 106 instead. If you want to structure employer-side payment or reimbursement of the fee, ask your benefits counsel.

Going over the cap has a real consequence, not just a label change. A membership priced above $150/$300 can still have its fee reimbursed from an HSA under § 223(d)(2), but it will disqualify the employee from making new HSA contributions while enrolled at that price (Notice 2026-5, Q&A-20). This is why the specific dollar amount matters, not just the words "direct primary care."

Anything about plan documents, cafeteria-plan mechanics, ICHRA/QSEHRA coordination, or how to reflect this in your benefits enrollment materials is outside what this page can answer — ask your benefits counsel.

A letter you can hand to HR

Plain text, ready to copy, paste, and sign. It states the law and cites its sources so your benefits team can verify it themselves.

To the HR / Benefits Department:

I am enrolled in the Lotus Direct Care Standard membership, a direct primary
care arrangement priced at $150 per month for an individual ($200 per month
for a family). Under federal law, this membership is HSA-eligible.

The One, Big, Beautiful Bill Act (Public Law 119-21, 139 Stat. 72, signed
July 4, 2025) added a new provision to Internal Revenue Code section 223 —
section 223(c)(1)(E) — providing that a "direct primary care service
arrangement" priced at or under $150/month for one person is not treated as
disqualifying health coverage for HSA-eligibility purposes. A separate
provision, section 223(d)(2)(C), makes the membership fee itself a
qualified medical expense payable directly from an HSA. IRS Notice 2026-5
(December 2025) explains how both provisions apply. These rules took effect
for months beginning after December 31, 2025.

Because my membership fee is under the federal cap, I remain eligible to
contribute to my HSA while enrolled, in addition to my HSA-qualified
high-deductible health plan, and I may pay or reimburse the membership fee
directly from my HSA.

Sources:
- IRS Notice 2026-5: https://www.irs.gov/pub/irs-drop/n-26-05.pdf
- IRS newsroom summary: https://www.irs.gov/newsroom/treasury-irs-provide-guidance-on-new-tax-benefits-for-health-savings-account-participants-under-the-one-big-beautiful-bill

Please let me know if you need anything further from Lotus Direct Care.

Questions employers and members ask

Does this apply to any direct primary care membership, or only Lotus?

It applies to any arrangement that meets the federal definition: primary-care-only services, one fixed periodic fee, no separate billing, and at or under the $150/$300 monthly cap. Lotus's $150 Standard and $200 Standard Family memberships meet that definition. A DPC membership priced or scoped differently might not.

Why does the exact price matter so much?

Because the statute's carve-out is defined by the dollar cap, not by the label "direct primary care." Internal Revenue Code section 223(c)(1)(E)(ii)(II) sets the line at $150 for one person and $300 for more than one. A membership at $151 is legally a different thing for HSA purposes than a membership at $150, even if the care is identical.

Does being HSA-eligible change what care I get as a Lotus member?

No. HSA eligibility is a tax-code label about how the membership fee is paid and whether it affects your HSA contribution eligibility. It does not change your visits, access, or the scope of care described in your membership agreement.

Can I pay for Lotus Plus with my HSA?

No. Lotus Plus is priced under the dollar cap, but it fails the separate "solely primary care services" test because it adds services beyond primary care — a body-composition dashboard, supplement discounts, quarterly labs, and procedure discounts. Your underlying Standard membership fee stays HSA-eligible even if you add Plus; only the Plus portion is not.

Does this affect my high-deductible health plan (HDHP) or its deductible?

No. The Lotus membership fee does not count toward your HDHP's deductible or out-of-pocket maximum, and your HDHP cannot pay Lotus's fee or waive its own deductible for it (Notice 2026-5, Q&A-15–16). The two are separate: the HDHP still needs to satisfy its own deductible rules independently.

Our HSA administrator or benefits vendor still says no. What do we do?

Some administrators have not updated their systems or guidance for a change that only took effect in 2026. Share this page, the statute citations, and IRS Notice 2026-5 with them directly. If they still decline, that is a plan-administration decision for your benefits counsel — we are not able to override a third-party administrator's policies.

Will the $150/$300 cap stay the same every year?

No. The statute indexes the cap for inflation for taxable years after 2026, so the exact dollar figure is expected to rise over time. Check the current-year figure before assuming any price is automatically under the cap in a future year.

This is general information, not tax or legal advice. It reflects our reading of Public Law 119-21 and IRS Notice 2026-5 as of September 2026. The $150/$300 monthly caps are indexed for inflation for taxable years after 2026 and will change; confirm the current figures before relying on them. Your own HSA eligibility also depends on your HDHP, your HSA administrator's policies, and your employer's benefits plan. This page is pending review by ComplianceLDC, our compliance program. Please consult your tax advisor, CPA, benefits counsel, or HSA plan administrator about your specific situation.

Sources. Statute: IRS Notice 2026-5 (PDF), quoting and interpreting Public Law 119-21, 139 Stat. 72 (July 4, 2025). Summary: IRS newsroom release. Lotus plan facts and member-facing HSA guidance: HSA FAQ and membership pricing.

Lotus Direct Care, SC. Membership is not health insurance and does not meet minimum essential coverage. This page is general information, not medical, tax, or legal advice, and is pending ComplianceLDC review.