Everything my doctor can do in the office, is part of the monthly fee. Everything on top of it - either cash or insurance. Labs are very cheap when ordering through my doctor (I am talking about $4-$8 for typical stuff). Prescription drugs - i fill through the insurance (fixed co-pay in my case) and if something major will happen, like accident or such, my regular insurance will kick in (after paying several thousands out of pocket)

The thing is - the most expenses I had throughout the years I lived in the USA were on primary doctor and labs. Only in one year out of 10 I had an accident where without a regular insurance I would be screwed.

So high-deductible plan + direct care is the most optimal setup for me right now.