Before transitioning to concierge medicine, I was first board-certified in family medicine, but my passion for aging and gerontology led me to specialize in geriatrics. With a master's in gerontology, I deeply understood the complexities of aging and the importance of comprehensive, patient-centered care. My work with patients with dementia further reinforced the need for unrushed visits and direct communication with family members and caregivers, something often constrained by traditional insurance models.
As my career evolved, I became board-certified in lifestyle medicine because I saw firsthand how proactive care—through nutrition, exercise, stress management, and overall wellness—could improve quality of life and longevity. I wanted the freedom to spend more time with patients, create individualized care plans, and focus on prevention rather than just managing disease. Concierge medicine provides the opportunity to practice medicine that aligns with these values.
As healthcare evolves, many patients are exploring alternatives to traditional Medicare-based care. One such model is concierge medicine, which offers a more personalized and accessible approach to healthcare. Below, I outline the key differences between concierge medicine and traditional Medicare-based care to help you make an informed decision.
What is Concierge Medicine?
Concierge medicine is a membership-based healthcare model where patients pay an annual or semi-annual fee directly to the practice. This fee covers:
An executive-level diagnostic patient assessment, regardless of medical necessity.
Year-round consultative exams tailored to support health goals set during the annual exam.
Enhanced access to providers, including improved communication and proactive care planning.
An electronic health data storage and communication facilitation platform to help manage health records and prevent unnecessary ER visits.
It is important to clarify that concierge medicine practices do bill Medicare and private insurance for covered medical services. The membership fee is separate from these billable services and is not reimbursable by insurance.
How is Concierge Medicine Different from Traditional Medicare-Based Care?
Feature | Concierge Medicine | Traditional Medicare-Based Care |
Annual Executive Exam | Included, regardless of necessity | Covered only if deemed medically necessary |
Consultative Exams | Unlimited, based on health goals | Limited to medical necessity |
Provider Access | Direct, timely access | Longer wait times due to higher patient volume |
Health Data & Communication | Secure electronic platform for health management | Limited digital access through patient portals |
Preventive & Proactive Care | Emphasized, with tailored wellness planning | Based on Medicare-covered preventive services |
Billing & Reimbursement | Membership fee: not reimbursable by insurance; medical services are billed separately to Medicare or private insurance | Billed through Medicare or private insurance |
Can Patients Submit a Receipt to Insurance for Reimbursement?
No, the membership fee for concierge medicine is not reimbursable by Medicare or private insurance. Since the fee primarily covers availability, an executive exam, and additional services that exceed what insurance typically reimburses, patients cannot submit receipts for reimbursement. However, if further medical services are provided outside of the membership, they may be billed separately to Medicare or insurance.
Additionally, if a doctor receives reimbursement from Medicare or private insurance for medical services, they cannot reimburse the patient to cover the membership fee. Doing so would be considered insurance fraud and is strictly prohibited.
Is Concierge Medicine Right for You?
If you value personalized, accessible healthcare emphasizing prevention and wellness, concierge medicine may be a great fit. It provides peace of mind, continuity of care, and a strong doctor-patient relationship that isn’t limited by insurance restrictions.
I recognize that concierge care can sometimes be cost-prohibitive. However, I have seen firsthand that this model allows us to get ahead of illness, keeping patients healthier and out of emergency rooms. It also enables me to serve as a patient advocate and partner in their healthcare journey. In traditional medicine, I often felt burned out because I was constantly managing chronic diseases with medications while patients struggled to make real lifestyle changes. Concierge care gives me the time and space to truly work with patients on long-term health improvements, leading to greater job satisfaction and, most importantly, better patient outcomes.
It’s important to recognize that concierge medicine is not just for when you are sick. In fact, establishing this type of doctor-patient relationship when you are healthier allows for a proactive approach to your healthcare. Too often, people wait until they are unwell to seek care, living in a reactive mindset. Concierge medicine shifts that paradigm, focusing on prevention, longevity, and overall well-being, helping patients live healthier, more vibrant lives.
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