Short answer: No. Medicare says it does not cover the membership fee for concierge care, so you pay that fee yourself. Medicare can still pay its share for services it covers, if your doctor accepts Medicare. Ask what the fee buys and get the details in writing before you sign.
Medicare.gov says Medicare does not cover membership fees for concierge care, and you pay all costs for services Medicare does not cover, including the fee. In concierge medicine, a doctor charges a fee before they will see you or accept you into the practice. Medicare.gov says the fee depends on the contract or agreement you sign with the doctor or doctor group.
If your concierge doctor accepts Medicare, you still have your Medicare coverage for services Medicare covers. Medicare.gov says doctors who accept assignment cannot charge you extra for Medicare-covered services. Accepting assignment means the doctor agrees to take the Medicare-approved amount as full payment. Doctors who do not accept assignment may charge more than the Medicare-approved amount, up to a limit called the limiting charge. In many cases that limit is 15% above the Medicare-approved amount. All doctors who work with Medicare may charge you for services Medicare does not cover.
A doctor who has opted out of Medicare is different. Medicare.gov says Medicare will not pay for services from an opt-out provider, except in emergencies.
Medicare.gov also says that with a doctor who does not accept assignment, you might have to pay the full amount at the time of service.
Medicare.gov says that when Medicare may not pay for an item or service, the doctor must give you a written notice called an Advance Beneficiary Notice of Noncoverage. It tells you before you receive the service that you may have to pay. Read it carefully, and ask questions if anything is unclear. Keep a copy of anything you sign.
Because the fee is yours to pay, compare it with what you would get. Add up how often you see your doctor and what the practice offers for that money. A fee is an agreement between you and the practice, so you can say no or ask for time to think.
Medicare.gov adds that state laws and consumer protections may apply, and it suggests contacting your state's insurance department or consumer protection bureau. You can also find a direct-pay doctor near you and compare practices.
Medicare.gov says doctors who accept assignment cannot charge extra for Medicare-covered services. They may still charge for services Medicare does not cover, including the membership fee.
Medicare.gov says Medicare will not pay for items or services from a provider who opts out, except in emergencies. You may need to sign a private contract.
