Tool
Care Model Comparison
Choose a model to see how it generally works. Add a second model to read them side by side.
Concierge medicine
A practice that charges a recurring membership or retainer fee. Many concierge practices also continue to bill insurance or Medicare for covered visits, so the fee is paid in addition to your usual coverage.
- Membership fees
- A recurring retainer, often billed annually, quarterly, or monthly. Amounts vary widely by practice and region.
- Insurance billing
- Many practices still bill insurance or Medicare for covered visits. Some do not. Ask each practice.
- Appointment availability
- Practices typically limit how many patients each physician sees and describe shorter waits and longer visits. Terms are set by the agreement and are not guaranteed.
- Included services
- Defined by the membership agreement. Commonly access and communication features, longer visits, and care coordination.
- Additional costs
- Cost sharing on visits billed to insurance, plus labs, imaging, prescriptions, and anything outside the agreement.
- Specialist services
- Not part of the membership. The physician may help coordinate referrals. Specialists bill separately.
- Insurance considerations
- A membership is not insurance. Coverage is still needed for specialists, hospital care, and emergencies. Insurers generally do not pay the membership fee.
This model may suit you if
- You place a high value on access to one physician
- You want to keep using your insurance for covered services
- You can absorb a membership fee on top of premiums and cost sharing
Check before you commit
- Exactly which services the membership fee covers
- Whether the practice bills your plan or Medicare, and how
- Refund and cancellation terms in the written agreement
These are general descriptions. Fees, included services, and billing arrangements vary by practice. Confirm the details in writing with any practice you are considering. Read more about concierge medicine.
This tool describes common patterns, not any specific practice. Two practices that use the same label can differ on nearly every row. Use it to learn the vocabulary, then verify the details with each practice you contact.