Questions to Ask a Concierge Doctor Before You Join
Six groups of questions, why each one matters, and what a clear answer sounds like.
4 min readBy Concierge Med Near Me
Photo: Jakub Żerdzicki / Unsplash
How to use this list
You do not need to ask all of these. Pick the ones that match your situation, and ask the same ones of every practice you are considering. Our interactive checklist lets you select questions and print them.
Two habits make the answers more useful:
- Ask where it is written. For anything important, ask which section of the membership agreement covers it.
- Ask for specifics. "We are very accessible" is not an answer. "Most urgent requests are seen the same day, and I answer my own cell after hours" is.
Services
What the membership actually includes.
- Which services are included in the membership fee, and is there a written list?
- Which services are not included and are billed separately?
- Are routine labs, vaccines, or in-office procedures included or extra?
- How long is a typical appointment?
- Do you coordinate referrals to specialists and follow up on results?
- If I am hospitalized, what is your role in my care?
What to listen for. A clear list, and an equally clear list of exclusions. Be cautious of any suggestion that the membership "covers everything."
Fees
What you will pay and when.
- What is the membership fee, and is it billed monthly, quarterly, or annually?
- Is there an enrollment or registration fee?
- Has the fee changed in recent years, and how much notice is given before an increase?
- Are there different fees by age, or discounts for couples or families?
- Can you give me a written price list for common services outside the membership?
What to listen for. Numbers, in writing. See membership costs for how fees are usually structured.
Insurance and Medicare
How the practice works with your coverage.
- Do you bill my insurance for office visits, or is the practice outside insurance entirely?
- Are you in network with my specific plan?
- Do you participate in Medicare, or have you opted out?
- If you have opted out of Medicare, what would I be responsible for paying?
- Will you provide documentation I can submit to my plan, HSA, or FSA administrator?
- Where do you send lab and imaging orders, and will those be billed to my insurance?
What to listen for. A direct answer to question 12 shapes everything else. If you have Medicare, question 14 is essential: Medicare does not pay for services from a physician who has opted out, except in emergencies. If you have a health savings account, ask whether the membership is structured to qualify under the 2026 IRS rules. Background: insurance and Medicare.
Availability and communication
How access works in practice.
- How many patients does each physician care for?
- How soon can I usually be seen for an urgent concern? For a routine visit?
- How do I reach you after hours, and who responds?
- Can I communicate by phone, text, email, or video, and what are typical response times?
- Who covers when you are on vacation, ill, or otherwise unavailable?
- Are virtual visits available if I am traveling, and are there state licensure limits?
What to listen for. Panel size is the best single indicator of access, because it determines how much of the physician's time there is to go around. Ask for the number.
Cancellation and agreement terms
What happens if things change.
- May I review the full membership agreement before I pay anything?
- How do I cancel, and how much notice is required?
- If I cancel partway through a billing period, is any portion refunded?
- What happens to my membership and fees if the physician retires, moves, or leaves the practice?
- How do I get a copy of my medical records if I leave?
What to listen for. A yes to question 24. The American Medical Association's guidance on retainer practices says terms should be clear and that practices should help patients who leave to transfer their care.
Credentials
Confirming who will be caring for you.
- In which states are you licensed, and are you board certified? In what specialty?
- Will I see you at every visit, or other clinicians in the practice as well?
- Is the practice independent or part of a larger network or company?
What to listen for. Then verify independently. DocInfo shows licensure and board actions, and Certification Matters shows board certification. See how to find a concierge doctor for the steps.
Questions to ask yourself afterward
| Ask yourself | Why |
|---|---|
| Did I get straight answers about cost and limits? | Transparency now predicts transparency later. |
| Do I understand what I would pay in a full year? | Use the cost worksheet to check. |
| Did the physician listen as well as talk? | You are choosing a long-term working relationship. |
| Would I be comfortable cancelling if it did not work out? | Clear exit terms lower your risk. |
Varies by practice. There are no standard answers to these questions, which is exactly why they are worth asking.
If you are still deciding whether a membership makes sense at all, start with is concierge medicine worth it?
Frequently asked questions
What is the most important question to ask a concierge doctor?
Ask what the membership fee includes and what it does not, and ask to see that in the written agreement. Most later surprises come from assumptions about what was included.
Is it rude to ask a doctor about fees and refunds?
No. You are entering a contract. Ethics guidance for retainer practices calls for clear terms and transparent billing, and a well-run practice expects these questions.
Should I get the answers in writing?
Yes, where you can. If an answer matters to your decision, ask where it appears in the membership agreement. Verbal assurances are hard to rely on later.
Can I print these questions?
Yes. Our free questions checklist lets you select the questions you want, add your own, and print a one-page list with space for notes.
Sources
- American Medical Association. Code of Medical Ethics Opinion 11.2.5: Retainer Practices.
- Medicare.gov. Concierge care.
- Medicare.gov. Does your provider accept Medicare as full payment?.
- Internal Revenue Service. Notice 2026-5 (health savings accounts and direct primary care service arrangements) (2025).
- Federation of State Medical Boards. DocInfo physician search.
- American Board of Medical Specialties. Certification Matters: Is my doctor board certified?.
We link to primary and authoritative sources where we can. Rules and figures change, so check the linked source for the current version. See our editorial standards.
This article is general education, not medical, legal, tax, or insurance advice. Concierge and direct primary care arrangements vary by practice and by state. Confirm the specifics with the practice, your health plan, or a qualified professional before you decide. Read our medical disclaimer.
