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Does Medicare cover concierge medicine?

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Many of us have experienced the frustration of trying to find a doctor who is accepting new patients, long waits to see the doctor, and rushing appointments. Enter concierge medicine.

“Concierge medicine is when people pay an annual membership fee to get a more personalized approach to their health care,” says Brett Jorgensen, CEO of Concierge. MDFPthe largest network of concierge providers, with more than 1,100 affiliated primary care physicians.

Due to the rise in chronic diseases and the rapid growth in the elderly population, there is an increasing need for health care services. As a result, the global concierge pharmaceutical market is booming, with North America leading the way.

While there is no national registry of doctors who use the concierge model, One industry publication It is estimated that there are between 12,000 and 13,000 doctors in the United States offering a subscription-based medical program.

This is a drop in the bucket compared to More than 500,000 primary care physicians in the United StatesHowever, the number of concierge doctors is increasing at a rate 3% to 5% annually.

Concierge medicine: An increasing choice for older patients

“Most of our members are between the ages of 50 and 80, and are more focused on their health path,” Jorgensen says. “They want to have a more personal relationship with their doctor and delay, avoid, or better manage chronic disease.”

All MDVIP concierge physicians accept Medicare, and more than half of its 400,000 members are enrolled in Medicare.

How much does a concierge membership cost?

the Average cost of an annual concierge membership It ranges from $2,000 to $5,000 per year. This allows concierge doctors to do this Serving fewer patientsgenerally ranging from 400 to 600, compared to 2,000 to 3,000 in a traditional primary care practice.

What Services are included Concierge membership?

According to Jorgensen, membership fees typically cover:

  • Same-day or next-day appointments (in-person or virtual)
  • Answers to questions on the same day
  • Longer visits Sometimes 30 minutes or more
  • Annual personal wellness plans

Some concierge doctors also include these benefits as part of the membership fee:

  • Direct access to your concierge doctor, by email and phone
  • Enhance blood work
  • Ability to visit other in-network concierge doctors while traveling
  • Covering young people in the family

What Medicare covers

Just like any medical provider, concierge doctors may or may not choose to accept insurance, including Medicare.

“If a concierge physician accepts Medicare, the physician must accept Medicare-approved charges for all covered services for Medicare patients,” says Diane Omdahl, MD, author of “The Concierge Physician Accepts Medicare, the Doctor Must Accept Medicare-Approved Charges for All Covered Services for Medicare Patients.” Medical care for you and co-founder of Medicare Consulting 65 Incorporated. Medicare deductibles and co-payments will also apply.

Typical services covered by Medicare include blood tests associated with the diagnosis, MRIs and X-rays, and same-day surgery, Amdahl says.

“The membership fees charged by concierge doctors are not covered by Medicare or Medicare Advantage,” Amdahl says.

If doctors have contracts with Medicare Advantage plans, services and payments depend on the plans' coverage criteria, deductibles and copayments, Amdahl says.

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