What is “concierge medicine?”

What is "concierge medicine?"

Are you tired of long waits to get an appointment? Rushed visits? Not being able to talk to your doctor by phone or communicate via email?

You aren’t alone. Doctors dislike it too. But because most physicians today are employees of a large medical group, they are required to complete 30­–40 patient visits per day. Appointments are set to last no more than 15 minutes. This is necessary to manage a typical patient load of 4,000.

Some primary care doctors are moving away from this business-focused model of medicine.

“Retainer-based,” “concierge,” or “boutique” medicine prioritizes the doctor–patient relationship. For an annual membership fee (average $1,500 – $2,400) you can join a primary care practice that is dedicated to staying small and intimate (≈150–600 patients). Your annual fee allows the doctor to guarantee

  • same-day or next-day appointments
  • longer appointments (30 minutes on average)
  • phone and email communication, with personal follow-up for lab results

You pay the membership fee out of pocket. It is not covered by Medicare. You must also maintain an original Medicare policy and likely a supplemental policy since the concierge doctor will bill Medicare for office visits. As with traditional medicine, you also still have to pay your insurance premiums, deductibles, and copayments (unless your supplemental plan covers them).

What to look for in a concierge physician

  • Is the doctor certified by the American Board of Internal Medicine? (Extra “plus” if also certified as a geriatrician.) Affiliated with a major hospital?
  • Do they “accept assignment” from Medicare? If they do, then they cannot charge you more than Medicare allows for a specific service without giving you an “Advance Beneficiary Notice of Noncoverage.” If they don’t accept assignment, that means they are willing to bill Medicare, but you may owe a balance of up to 15% above what Medicare is willing to pay. (Your supplemental plan will not pay the extra, either.)

So far, there are only 12,000 concierge physicians nationwide, but the number is growing quickly!

Interested in finding a concierge doctor?
Give us a call at (804) 993-4304.