What is concierge medicine?

How concierge medicine works

You sign a contract with a doctor or doctor group and pay a membership fee before they accept you as a patient. Medicare.gov notes it's also called retainer-based medicine, boutique medicine or direct care. A 2024 literature review describes the core of the model as a smaller patient roster and continuity of individualized care.

• What the fee usually buys: more access to your doctor and services or amenities insurance may not cover. The contract spells out exactly what's included.
• What's billed separately: many practices still bill your insurance or Medicare for covered visits, so copays, coinsurance and your deductible can still apply.
• What's outside the practice: hospital care, specialists, imaging and many tests.

What concierge medicine costs

There is no standard price. Medicare.gov says your fee depends on the contract or agreement you sign with the doctor or group. The AAFP says concierge practices charge a higher annual fee than direct primary care, paid yearly or monthly.

Published figures are older. A 2024 review in the Journal of Family Medicine and Primary Care reported that, based on 2014 data, concierge practices typically charged an annual retainer of $1,500 to $1,700 (about $135 a month). Current fees vary by practice and city, so ask each one for its fee in writing.

Your total yearly cost is the membership fee plus whatever your insurance doesn't pay for covered care, plus your health plan premium.

Do you still need insurance?

Yes, for most people. The 2024 review notes that concierge patients still need insurance for hospitalizations, specialist visits and tests outside the practice. A membership fee doesn't protect you from a large hospital bill.

If you have Medicare, Medicare.gov sets out the rules:

• Medicare doesn't cover the membership fee; you pay it yourself.
• A doctor who accepts assignment can't charge you extra for Medicare-covered services.
• A doctor who doesn't accept assignment can charge up to 15% over the Medicare-approved amount for covered services.
• If Medicare may not pay for a service, the doctor should give you an Advance Beneficiary Notice of Noncoverage first, listing the services and why.

Medicare.gov also says state laws may apply, and suggests contacting your state insurance department or consumer protection office with questions.

Concierge medicine vs direct primary care, and HSAs

Direct primary care (DPC) is the closest relative. The AAFP says DPC practices rely on patient fees instead of billing insurance, and monthly DPC fees generally range from $50 to $100. Concierge practices charge more and often keep billing insurance. Full comparison: concierge medicine vs direct primary care.

HSA owners: IRS Notice 2026-5 lets a qualifying DPC arrangement (fixed fee up to $150 a month for one person or $300 for more than one, in 2026) sit alongside an HSA. The fixed fee must be the only pay for that care. The notice says an arrangement that bills members separately for the care it covers, through insurance or otherwise, doesn't qualify. A concierge practice that bills your insurance for that care likely won't meet the rules. Check with a tax advisor before you pay a concierge fee from an HSA or sign up while contributing to one. See HSA and direct primary care.

Questions to ask before you join

• What does the fee include, and what is billed separately?
• Do you bill my insurance? Do you accept Medicare assignment?
• How fast can I get a same-day visit, a call back or a message answered?
• Who covers when my doctor is away?
• How do I cancel, and is any of the fee refunded?
• What do tests, items or services cost before I agree to them?

Gabriel Core and Plus are another option for more access: $49 or $89 per adult a month, kids under 18 included, cancel anytime, with unlimited virtual primary care and virtual urgent care. Plus adds two in-person urgent care visits a year (up to $150 each) and the first root-cause visit each year (up to $200). Like concierge care, it's a membership, not health insurance.