Most people who look into concierge medicine start with the same practical question: what does it cost? The honest answer is that there is no single price. Each practice sets its own concierge fee, and what that fee pays for differs from one office to the next. This article walks through what shapes a fee, what the public record says, and how to compare practices on more than the number.

Two kinds of cost, not one

At most concierge practices you are looking at two separate kinds of cost. The first is the concierge fee, usually charged once a year or in installments. The second is the ordinary cost of medical care: office visits, lab work, imaging and tests, which many practices bill to your insurance the same way any doctor would.

That second part matters more than people expect. Medicare, for example, does not cover concierge fees, but a concierge doctor who accepts assignment still bills Medicare for covered services and cannot charge you extra for them. So your deductibles, copays and coinsurance still apply to visits and tests, on top of the membership.

What shapes a concierge fee

Practices arrive at their fees in different ways, but a few factors come up again and again:

  • Panel size. A doctor who cares for far fewer patients needs each one to support more of the practice. Smaller panels usually mean higher fees.
  • What the fee includes. Some fees cover an extended annual physical, certain in-office tests or a wellness program. Others mainly cover access to the doctor.
  • Access. Same-day or next-day appointments, after-hours phone access and video visits all take staff time to provide.
  • Insurance billing. A practice that bills insurance for visits is set up differently from one that does not, and that affects the fee.
  • Location and overhead. Rent, staffing and the local market vary.

What a federal report found, back in 2005

The most detailed public look at concierge fees is still a 2005 report from the U.S. Government Accountability Office, GAO-05-929, based on data collected in 2004. It is history, not a guide to current prices, but it shows how wide the range has always been.

In that survey, annual fees ran from $60 to $15,000, and the most common fee was $1,500. More than 80 percent of practices charged between $500 and $3,999. The GAO also found that physicians who switched to the model cut their patient panels from an average of 2,716 to 491, and saw about 10 patients a day instead of about 26. Prices have moved a great deal in twenty years, so treat these figures as a picture of how the model began.

How one national network describes its model

MDVIP, a national network of affiliated physicians, describes itself as founded in 2000, with more than 1,400 affiliated physicians and more than 400,000 patients. By its own description, insurance is billed for medical care and the concierge fee covers its wellness program. That is one common structure. Independent practices set their own terms, so the only way to compare is to ask each one directly. We cover the differences in more detail in Concierge medicine vs. MDVIP.

Questions to ask any practice about cost

Before you compare fees, it helps to know exactly what each one buys. These questions tend to bring out the useful answers:

  1. What does the concierge fee include, and what is billed separately?
  2. Which insurance plans do you bill for visits, labs and tests?
  3. How quickly can I be seen when I am sick, and how do I reach the doctor after hours?
  4. Is there a written agreement, and how do I cancel or get a refund if I move?
  5. Can family members come to visits, and how do you share updates with them?

Some people also ask whether the fee can come from a health savings account. The answer is less simple than it sounds, and we explain why in Can you pay concierge fees from an HSA or FSA?

How Legacy Medical handles the fee

Legacy Medical charges an annual concierge fee and bills insurance, including Medicare, Aetna, Cigna and BlueCross BlueShield, for visits, labs and tests. The fee itself is not billed to insurance. Members are seen the same or next business day, can reach the practice by phone around the clock, and have labs drawn in our office. Each year includes an executive physical with labs and an ECG.

We do not publish the fee online. We prefer to explain it in person, along with what it covers, so you can weigh it against your own needs rather than against a number on a web page. Our insurance and fees page explains how billing works, and our membership page outlines what members receive.

If you would like to talk it through, the first step is a complimentary meet and greet with Dr. Shtern at our Palm Beach Gardens office. Family members are welcome to come along.

This article is general information, not advice for your situation. Members can call the office with questions about their own care.