Concierge. The very word conjures up images of VIP treatment at an opulent hotel by someone in a starched uniform who is there to cater to your every whim.
The concept of “concierge-level service” is now being leveraged by other industries that provide service to HNWIs (high-net-worth individuals), like luxury automotive dealerships, and even employers that are offering concierge service to their employees to help with recruiting and employee retention.
Concierge medicine has been around for a while and continues to gain popularity. In a 2005 article in the Journal of General Internal Medicine, only 152 “retainer physicians” could be identified in the United States, but in 2019, Concierge Medicine Today estimated the number to be 5,000 to 20,000.
Let's dig in.
- Concierge medicine defintion
- How does concierge medicine work?
- Pros & cons of concierge medicine
- How much does concierge medicine cost?
- How to find a concierge doctor
- Is concierge medicine worth it?
- Concierge medicine & insurance
Concierge medicine — also known as concierge care, boutique medicine, retainer-based medicine, platinum practice, and direct primary care — is membership-based healthcare designed to provide personalized care paired with accessibility and convenience.
For a flat monthly fee, you receive unlimited office and telehealth visits and direct care from a physician — without copays, deductibles, and other charges. In addition, you’re granted access to your doctor’s direct phone line to have your medical questions answered and to hear diagnostic and blood test results directly from them.
If you develop a significant health problem, your doctor will coordinate referrals to specialists and hospitals. And, with concierge medicine, there are no roadblocks thrown up by insurance companies — it’s patients and doctors working together.
Accessibility is the key to the rising popularity of concierge medicine. For example, new patients in large metropolitan areas can wait weeks to get an appointment with a traditional primary care physician, who has thousands of patients and can allocate no more than 15 minutes per visit.
Conversely, doctors who participate in concierge medicine typically have fewer than 600 patients, will see only six to ten patients per day, and spend at least thirty minutes with each of them.
There are benefits and drawbacks to the concierge medicine model, including:
- Guaranteed access to care 24 hours a day, seven days a week
- Same-day or next-day appointments
- Standard care, including blood work, physicals, preventive screening, wound care, etc. — all done in the doctor’s office
- No copays or deductibles for office visits
- Some common medications are dispensed from the office at a discount
- You still need traditional health insurance to cover costs for hospitalization, surgeons, and other specialists
- Membership and monthly fees vary by practice
- Fees increase with age
- Monthly fees paired with regular insurance premiums can be expensive
The flat monthly fee for concierge medicine is an out-of-pocket expense. Depending on your health and care needs, you might incur additional costs for services such as executive health assessments or outside lab work. Health insurance may reimburse you for some of these expenses if your doctor is considered an in-network provider.
Depending upon the practice you join and where you live, membership fees and monthly costs range from $1,200 to $10,000 per year, with the average falling between $1,500 and $2,500 per year. Some practices require a one-time initiation fee, and monthly costs will vary by age.
There are several alternatives you can investigate that may help you pay part or all of your membership costs:
Some practices offer members a family discount for bringing a spouse, kids, or parents to the plan.
Your health savings account (HSA) or flexible spending account (FSA) might help with concierge care. Check with your plan provider, but concierge medical services may apply the same as a copay or prescription at a traditional practice. Some HSAs and FSAs also reimburse for other services, such as wellness visits, if you provide receipts.
Your company may be willing to pay some or all of your membership costs. Post-pandemic, an increasing number of workplaces are promoting employee wellness, including services like executive physicals for all employees.
[ Related: 20 best employee benefits in 2022 ]
Prioritize your spending
Making concierge medicine a regular monthly expense item on your budget can help you make it an affordable priority. Adjusting other expenses like travel and entertainment may help you find the funds to pay for a membership.
If there’s a contract associated with your concierge medicine membership, be sure to read the fine print. Some practices will let you cancel the membership with a 30-day written notice, while others lock you in with a non-cancellable twelve-month contract, or charge a termination fee and don’t offer refunds.
The best place to find a concierge doctor is by referral. Ask your inner circle and find out if any family members, friends, or co-workers belong to, or know of, a concierge medical service. Ask about their experiences and how strongly they feel about referring you to the practice.
If that fails, pull up your search engine of choice and enter “concierge doctors near me” to find plenty of options. Visit practice websites and schedule a consultation, preferably free, before committing to join.
Last, check out DPC Mapper for a map that displays over 1,500 direct primary care practices across the U.S.
Not all concierge medical practices are created equal, and concierge medicine isn’t suitable for everyone. If you’re considering it, identify the services that are most important to you, and ask yourself:
- Can I afford a monthly fee on top of the health insurance premium I’m already paying?
- How important is it that I have 24/7 access to a physician?
- Do I have a chronic condition that requires specialists? If so, will I get my money’s worth out of my membership?
Concierge medicine is not a replacement for insurance — you still need coverage for hospitalizations, specialists, treatments and therapies, and other services not covered by your concierge doctor.
Since your membership covers routine care, consider switching to a high deductible health plan (HDHP) for protection against catastrophic medical expenses. A critical illness insurance policy will also help you pay deductibles, copays, and other costs related to cancer, heart attack, stroke, and many other severe illnesses.
The information and content provided herein is for educational purposes only, and should not be considered legal, tax, investment, or financial advice, recommendation, or endorsement. Breeze does not guarantee the accuracy, completeness, reliability or usefulness of any testimonials, opinions, advice, product or service offers, or other information provided here by third parties. Individuals are encouraged to seek advice from their own tax or legal counsel.