What Is Concierge Medicine?

Concierge medicine is a simple idea wrapped in a confusing name: the practice accepts fewer patients, and members pay a membership fee for the access that makes possible.

In a conventional primary care practice a physician may be responsible for two to three thousand patients. That arithmetic decides everything else — how long each visit runs, how far out the next opening is, and whether you reach your own doctor or whoever is covering. A concierge practice deliberately limits its panel to a fraction of that number. The membership fee is what makes the smaller panel financially possible.

What you are buying is not different medicine. It is time, availability, and continuity with one physician who knows your history.

What the membership typically includes

• Longer appointments that start close to the scheduled time.
• Same-day or next-day scheduling for urgent problems.
• Direct contact with your physician rather than a call queue.
• Virtual visits when a trip to the office is unnecessary.
• Continuity — the same physician each time.

What it does not include

This is where most misunderstandings start. A concierge membership is not insurance and does not replace it.

• Hospital stays, surgery and emergency care
• Imaging, laboratory work and diagnostic testing
• Prescription medications
• Treatment by specialists outside the practice

Members keep their health insurance and continue to use it for all of the above. If a practice suggests its membership replaces insurance, treat that as a warning sign.

What it costs

Fees vary widely by region and by how much the practice includes — commonly from around $1,500 to well over $10,000 per year. Higher fees usually reflect a smaller patient panel rather than better medicine.

At Bazzi Concierge the membership is $4,000 per year for an individual and $7,500 per year for a couple. Full detail is on the pricing section.

How it works with insurance and Medicare

Concierge medicine vs. direct primary care

The two get confused constantly. Both charge a membership fee, but they are built differently:

• Direct primary care usually does not bill insurance at all, charges a lower monthly fee, and covers routine primary care within that fee.
• Concierge practices usually continue billing insurance for covered visits and charge a higher annual fee for access and availability.

Who it suits — and who it does not

It tends to be worth it for people who have a chronic condition needing regular management, who are managing cardiovascular risk, who travel often and need a reachable physician, who have been frustrated by waiting weeks for an appointment, or who simply want one doctor who knows their history.

It is probably not worth it for someone who is healthy, sees a doctor once a year, is happy with their current practice, or would find the fee a financial strain. Paying for access you will not use is not a good trade, and any honest practice will tell you so.

Questions worth asking any concierge practice

• How many patients does the practice accept, and how many does it have now?
• What exactly does the fee cover, in writing?
• How do I reach the physician after hours, and who answers?
• What happens if I need to be admitted to hospital?
• Who covers when my physician is away?
• Is the fee refundable if I move or change my mind?

Common questions

What is concierge medicine?

Concierge medicine is a membership model in which patients pay an annual or monthly fee to a practice that limits how many patients it accepts. The smaller panel is what makes longer appointments, same-day or next-day scheduling and direct access to the physician possible.

How much does concierge medicine cost?

Fees vary widely by practice and region, commonly from about $1,500 to well over $10,000 per year. At Bazzi Concierge the membership is $4,000 per year for an individual and $7,500 per year for a couple.

Does the membership fee replace health insurance?

No. A concierge membership is not insurance and does not cover hospital care, surgery, imaging, laboratory work, prescriptions or specialist treatment. Members keep their health insurance and continue to use it for covered services.

How does concierge medicine work with Medicare?

A physician who participates in Medicare may not charge a membership fee for services Medicare already covers. The fee can only cover things Medicare does not pay for, such as enhanced availability and non-covered amenities. Medicare-covered services are still billed to Medicare in the usual way. Ask any practice you are considering to explain in writing exactly what the fee does and does not include.

What is the difference between concierge medicine and direct primary care?

Both charge a periodic membership fee. Direct primary care practices typically do not bill insurance at all and charge a lower monthly fee. Concierge practices usually continue to bill insurance for covered visits and charge a higher annual membership for access and availability.